title: Altered cardiorespiratory response to exercise in overweight and obese women with polycystic ovary syndrome.
abstract: In polycystic ovary syndrome (PCOS), cardiovascular risk is increased. Peak O2 uptake (V˙O2peak) predicts the cardiovascular risk. We were the first to examine the contribution of systemic O2 delivery and arteriovenous O2 difference to V˙O2peak in overweight and obese women with PCOS. Fifteen overweight or obese PCOS women and 15 age-, anthropometry-, and physical activity-matched control women performed a maximal incremental cycling exercise test. Alveolar gas exchange (volume turbine and mass spectrometry), arterial O2 saturation (pulse oximetry), and cardiac output (CO) (impedance cardiography) were monitored. Hb concentration was determined. Arterial O2 content and arteriovenous O2 difference (C(a-v)O2) (Fick equation) were calculated. Insulin resistance was evaluated by homeostasis model assessment (HOMA-IR). PCOS women had lower V˙O2peak than controls (40 ± 6 vs. 46 ± 5 mL/min/kg fat-free mass [FFM], P = 0.011). Arterial O2 content was similarly maintained in the groups throughout the exercise test (P > 0.05). Linear regression analysis revealed a pronounced response of CO to increasing V˙O2 in PCOS women during the exercise test: A ∆CO/∆V˙O2 slope was steeper in PCOS women than in controls (β = 5.84 vs. β = 5.21, P = 0.004). Eventually, the groups attained similar peak CO and peak CO scaled to FFM (P > 0.05). Instead, C(a-v)O2 at peak exercise was lower in PCOS women than in controls (13.2 ± 1.6 vs. 14.8 ± 2.4 mL O2/100 mL blood, P = 0.044). HOMA-IR was similar in the groups (P > 0.05). The altered cardiorespiratory responses to exercise in overweight and obese PCOS women indicate that PCOS per se is associated with alterations in peripheral adjustments to exercise rather than with limitations of systemic O2 delivery.
authors.affiliation: Department of Sports and Exercise Medicine, Clinicum, University of Helsinki, Helsinki, Finland antti-pekka.rissanen@helsinki.fi.
authors.forename: Antti-Pekka E
authors.initials: AP
authors.lastname: Rissanen
authors.affiliation: Department of Obstetrics and Gynecology, Helsinki University Hospital and Helsinki University, Helsinki, Finland.
authors.forename: Tiina
authors.initials: T
authors.lastname: Koskela-Koivisto
authors.affiliation: Department of Sports and Exercise Medicine, Clinicum, University of Helsinki, Helsinki, Finland.
authors.forename: Harriet
authors.initials: H
authors.lastname: Hägglund
authors.affiliation: Department of Sports and Exercise Medicine, Clinicum, University of Helsinki, Helsinki, Finland Clinic for Sports and Exercise Medicine, Foundation for Sports and Exercise Medicine, Helsinki, Finland.
authors.forename: Anne S
authors.initials: AS
authors.lastname: Koponen
authors.affiliation: Clinic for Sports and Exercise Medicine, Foundation for Sports and Exercise Medicine, Helsinki, Finland.
authors.forename: Jyrki M
authors.initials: JM
authors.lastname: Aho
authors.affiliation: Department of Obstetrics and Gynecology, Helsinki University Hospital and Helsinki University, Helsinki, Finland.
authors.forename: Maritta
authors.initials: M
authors.lastname: Pöyhönen-Alho
authors.affiliation: Department of Obstetrics and Gynecology, Helsinki University Hospital and Helsinki University, Helsinki, Finland.
authors.forename: Aila
authors.initials: A
authors.lastname: Tiitinen
authors.affiliation: Department of Sports and Exercise Medicine, Clinicum, University of Helsinki, Helsinki, Finland Clinic for Sports and Exercise Medicine, Foundation for Sports and Exercise Medicine, Helsinki, Finland Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Heikki O
authors.initials: HO
authors.lastname: Tikkanen
authors.affiliation: Department of Sports and Exercise Medicine, Clinicum, University of Helsinki, Helsinki, Finland Clinic for Sports and Exercise Medicine, Foundation for Sports and Exercise Medicine, Helsinki, Finland.
authors.forename: Juha E
authors.initials: JE
authors.lastname: Peltonen
mesh_terms: D000328:Adult; D015444:Exercise / Q000502:physiology*; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D009765:Obesity / Q000503:physiopathology*; D050177:Overweight / Q000150:complications / Q000503:physiopathology*; D010101:Oxygen Consumption / Q000502:physiology; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000503:physiopathology*; D012129:Respiratory Function Tests
keywords: Arteriovenous oxygen difference; cardiac output; impedance cardiography; peak oxygen uptake