Abstract
Purpose
To examine the effect of habitual physical activity (PA) on the metabolic and hormonal profiles of women with polycystic ovary syndrome.
Materials and methods
Anthropometric, metabolic and hormonal assessment and determination of habitual PA levels with a digital pedometer were evaluated in 84 women with PCOS and 67 age- and body mass index (BMI)-matched controls. PA status was defined according to number of steps (≥7500 steps, active, or <7500 steps, sedentary).
Results
BMI was lower in active women from both groups. Active PCOS women presented lower waist circumference (WC) and lipid accumulation product (LAP) values versus sedentary PCOS women. In the control group, active women also had lower WC, lower values for fasting and 120-min insulin, and lower LAP than sedentary controls. In the PCOS group, androgen levels were lower in active versus sedentary women (p = 0.001). In the control group, free androgen index (FAI) was also lower in active versus sedentary women (p = 0.018). Homeostasis model assessment of insulin resistance and 2000 daily step increments were independent predictors of FAI. Each 2000 daily step increment was associated with a decrease of 1.07 in FAI.
Conclusions
Habitual PA was associated with a better anthropometric and androgenic profile in PCOS.
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References
Yildiz BO, Bozdag G, Yapici Z et al (2012) Prevalence, phenotype and cardiometabolic risk of polycystic ovary syndrome under different diagnostic criteria. Hum Reprod 27:3067–3073. doi:10.1093/humrep/des232
March WA, Moore VM, Willson KJ et al (2010) The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria. Hum Reprod 25:544–551. doi:10.1093/humrep/dep399
Lim SS, Davies MJ, Norman RJ et al (2012) Overweight, obesity and central obesity in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update 18:618–637. doi:10.1093/humupd/dms030
Wiltgen D, Spritzer PM (2010) Variation in metabolic and cardiovascular risk in women with different polycystic ovary syndrome phenotypes. Fertil Steril 94:2493–2496. doi:10.1016/j.fertnstert.2010.02.015
Wild RA, Rizzo M, Clifton S et al (2011) Lipid levels in polycystic ovary syndrome: systematic review and meta-analysis. Fertil Steril 95:1073–1079. doi:10.1016/j.fertnstert.2010.12.027
Moran LJ, Misso ML, Wild RA et al (2010) Impaired glucose tolerance, type 2 diabetes and metabolic syndrome in polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update 16:347–363. doi:10.1093/humupd/dmq001
Wiltgen D, Benedetto IG, Mastella LS et al (2009) Lipid accumulation product index: a reliable marker of cardiovascular risk in polycystic ovary syndrome. Hum Reprod 24:1726–1731. doi:10.1093/humrep/dep072
Ehrmann DA, Liljenquist DR, Kasza K et al (2006) Prevalence and predictors of the metabolic syndrome in women with polycystic ovary syndrome. J Clin Endocrinol Metab 91:48–53. doi:10.1210/jc.2005-1329
Stepto NK, Cassar S, Joham AE et al (2013) Women with polycystic ovary syndrome have intrinsic insulin resistance on euglycaemic–hyperinsulaemic clamp. Hum Reprod 28:777–784. doi:10.1093/humrep/des463
Moran LJ, Pasquali R, Teede HJ et al (2009) Treatment of obesity in polycystic ovary syndrome: a position statement of the Androgen Excess and Polycystic Ovary Syndrome Society. Fertil Steril 92:1966–1982. doi:10.1016/j.fertnstert.2008.09.018
Haskell WL, Lee IM, Pate RR et al (2007) Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation 116:1081–1093. doi:10.1161/CIRCULATIONAHA.107.185649
Tudor-Locke C, Craig CL, Brown WJ et al (2011) How many steps/day are enough? For adults. Int J Behav Nutr Phys Act 8:79. doi:10.1186/1479-5868-8-79
Dwyer T, Hosmer D, Hosmer T et al (2007) The inverse relationship between number of steps per day and obesity in a population-based sample: the AusDiab study. Int J Obes (Lond) 31:797–804. doi:10.1038/sj.ijo.0803472
Jennersjö P, Ludvigsson J, Länne T et al (2012) Pedometer-determined physical activity is linked to low systemic inflammation and low arterial stiffness in Type 2 diabetes. Diabet Med 29:1119–1125. doi:10.1111/j.1464-5491.2012.03621.x
Manjoo P, Joseph L, Dasgupta K (2012) Abdominal adiposity and daily step counts as determinants of glycemic control in a cohort of patients with type 2 diabetes mellitus. Nutr Diabetes 2:e25. doi:10.1038/nutd.2011.22
Manjoo P, Joseph L, Pilote L et al (2010) Sex differences in step count-blood pressure association: a preliminary study in type 2 diabetes. PLoS ONE 5:e14086. doi:10.1371/journal.pone.0014086
Swift DL, Johannsen NM, Tudor-Locke C et al (2012) Exercise training and habitual physical activity: a randomized controlled trial. Am J Prev Med 43:629–635. doi:10.1016/j.amepre.2012.08.024
Vigorito C, Giallauria F, Palomba S et al (2007) Beneficial effects of a three-month structured exercise training program on cardiopulmonary functional capacity in young women with polycystic ovary syndrome. J Clin Endocrinol Metab 92:1379–1384. doi:10.1210/jc.2006-2794
Nybacka Å, Carlström K, Ståhle A et al (2011) Randomized comparison of the influence of dietary management and/or physical exercise on ovarian function and metabolic parameters in overweight women with polycystic ovary syndrome. Fertil Steril 96:1508–1513. doi:10.1016/j.fertnstert.2011.09.006
Kogure GS, Miranda-Furtado CL, Silva RC et al (2016) Resistance exercise impacts lean muscle mass in women with polycystic ovary syndrome. Med Sci Sports Exerc 48:589–598. doi:10.1249/MSS.0000000000000822
Palomba S, Giallauria F, Falbo A et al (2008) Structured exercise training programme versus hypocaloric hyperproteic diet in obese polycystic ovary syndrome patients with anovulatory infertility: a 24-week pilot study. Hum Reprod 23:642–650. doi:10.1093/humrep/dem391
Thomson RL, Buckley JD, Noakes M et al (2008) The effect of a hypocaloric diet with and without exercise training on body composition, cardiometabolic risk profile, and reproductive function in overweight and obese women with polycystic ovary syndrome. J Clin Endocrinol Metab 93:3373–3380. doi:10.1210/jc.2008-0751
Hutchison SK, Stepto NK, Harrison CL et al (2011) Effects of exercise on insulin resistance and body composition in overweight and obese women with and without polycystic ovary syndrome. J Clin Endocrinol Metab 96:E48–E56. doi:10.1210/jc.2010-0828
Harrison CL, Stepto NK, Hutchison SK et al (2012) The impact of intensified exercise training on insulin resistance and fitness in overweight and obese women with and without polycystic ovary syndrome. Clin Endocrinol (Oxf) 76:351–357. doi:10.1111/j.1365-2265.2011.04160.x
Group REA-SPCW (2004) Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 81:19–25
Hatch R, Rosenfield RL, Kim MH et al (1981) Hirsutism: implications, etiology, and management. Am J Obstet Gynecol 140:815–830
Fauser BC, Tarlatzis BC, Rebar RW et al (2012) Consensus on women’s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril 97(28–38):e25. doi:10.1016/j.fertnstert.2011.09.024
Kahn HS (2005) The “lipid accumulation product” performs better than the body mass index for recognizing cardiovascular risk: a population-based comparison. BMC Cardiovasc Disord 5:26. doi:10.1186/1471-2261-5-26
Graff SK, Alves BC, Toscani MK et al (2012) Benefits of pedometer-measured habitual physical activity in healthy women. Appl Physiol Nutr Metab 37:149–156. doi:10.1139/h11-145
Tudor-Locke C, Bassett DR (2004) How many steps/day are enough? Preliminary pedometer indices for public health. Sports Med 34:1–8
Yates T, Haffner SM, Schulte PJ et al (2014) Association between change in daily ambulatory activity and cardiovascular events in people with impaired glucose tolerance (NAVIGATOR trial): a cohort analysis. Lancet 383:1059–1066. doi:10.1016/S0140-6736(13)62061-9
Alberti KG, Eckel RH, Grundy SM et al (2009) Harmonizing the metabolic syndrome: a joint interim statement of the international diabetes federation task force on epidemiology and prevention; national heart, lung, and blood institute; American heart association; world heart federation; international atherosclerosis society; and international association for the study of obesity. Circulation 120:1640–1645. doi:10.1161/CIRCULATIONAHA.109.192644
Matthews DR, Hosker JP, Rudenski AS et al (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28:412–419
Moran LJ, Ranasinha S, Zoungas S et al (2013) The contribution of diet, physical activity and sedentary behaviour to body mass index in women with and without polycystic ovary syndrome. Hum Reprod 28:2276–2283. doi:10.1093/humrep/det256
Teede HJ, Joham AE, Paul E et al (2013) Longitudinal weight gain in women identified with polycystic ovary syndrome: results of an observational study in young women. Obesity (Silver Spring) 21:1526–1532. doi:10.1002/oby.20213
Harrison CL, Lombard CB, Moran LJ et al (2011) Exercise therapy in polycystic ovary syndrome: a systematic review. Hum Reprod Update 17:171–183. doi:10.1093/humupd/dmq045
Pillay JD, van der Ploeg HP, Kolbe-Alexander TL et al (2015) The association between daily steps and health, and the mediating role of body composition: a pedometer-based, cross-sectional study in an employed South African population. BMC Public Health 15:174. doi:10.1186/s12889-015-1381-6
Lamb JD, Johnstone EB, Rousseau JA et al (2011) Physical activity in women with polycystic ovary syndrome: prevalence, predictors, and positive health associations. Am J Obstet Gynecol 204:e351–e356. doi:10.1016/j.ajog.2010.12.006
Shishehgar F, Tehrani FR, Mirmiran P et al (2016) Factors influencing physical activity in women with polycystic ovary syndrome in comparison to eumenorrheic non hirsute women. Glob J Health Sci 8:56382. doi:10.5539/gjhs.v8n10p127
Marshall SJ, Levy SS, Tudor-Locke CE et al (2009) Translating physical activity recommendations into a pedometer-based step goal: 3000 steps in 30 minutes. Am J Prev Med 36:410–415. doi:10.1016/j.amepre.2009.01.021
Ennour-Idrissi K, Maunsell E, Diorio C (2015) Effect of physical activity on sex hormones in women: a systematic review and meta-analysis of randomized controlled trials. Breast Cancer Res 17:139. doi:10.1186/s13058-015-0647-3
Daan NM, Jaspers L, Koster MP et al (2015) Androgen levels in women with various forms of ovarian dysfunction: associations with cardiometabolic features. Hum Reprod 30:2376–2386. doi:10.1093/humrep/dev195
Kravariti M, Naka KK, Kalantaridou SN et al (2005) Predictors of endothelial dysfunction in young women with polycystic ovary syndrome. J Clin Endocrinol Metab 90:5088–5095. doi:10.1210/jc.2005-0151
Coviello AD, Legro RS, Dunaif A (2006) Adolescent girls with polycystic ovary syndrome have an increased risk of the metabolic syndrome associated with increasing androgen levels independent of obesity and insulin resistance. J Clin Endocrinol Metab 91:492–497. doi:10.1210/jc.2005-1666
Corbould AM, Bawden MJ, Lavranos TC et al (2002) The effect of obesity on the ratio of type 3 17beta-hydroxysteroid dehydrogenase mRNA to cytochrome P450 aromatase mRNA in subcutaneous abdominal and intra-abdominal adipose tissue of women. Int J Obes Relat Metab Disord 26:165–175. doi:10.1038/sj.ijo.0801886
Blouin K, Richard C, Bélanger C et al (2003) Local androgen inactivation in abdominal visceral adipose tissue. J Clin Endocrinol Metab 88:5944–5950. doi:10.1210/jc.2003-030535
Nestler JE, Jakubowicz DJ, de Vargas AF et al (1998) Insulin stimulates testosterone biosynthesis by human thecal cells from women with polycystic ovary syndrome by activating its own receptor and using inositolglycan mediators as the signal transduction system. J Clin Endocrinol Metab 83:2001–2005. doi:10.1210/jcem.83.6.4886
Tolino A, Gambardella V, Caccavale C et al (2005) Evaluation of ovarian functionality after a dietary treatment in obese women with polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol 119:87–93. doi:10.1016/j.ejogrb.2004.06.043
Holte J, Bergh T, Berne C et al (1995) Restored insulin sensitivity but persistently increased early insulin secretion after weight loss in obese women with polycystic ovary syndrome. J Clin Endocrinol Metab 80:2586–2593. doi:10.1210/jcem.80.9.7673399
Yamanouchi K, Shinozaki T, Chikada K et al (1995) Daily walking combined with diet therapy is a useful means for obese NIDDM patients not only to reduce body weight but also to improve insulin sensitivity. Diabetes Care 18:775–778
Iwane M, Arita M, Tomimoto S et al (2000) Walking 10,000 steps/day or more reduces blood pressure and sympathetic nerve activity in mild essential hypertension. Hypertens Res 23:573–580
Bravata DM, Smith-Spangler C, Sundaram V et al (2007) Using pedometers to increase physical activity and improve health: a systematic review. JAMA 298:2296–2304. doi:10.1001/jama.298.19.2296
Crespo CJ, Keteyian SJ, Heath GW et al (1996) Leisure-time physical activity among US adults. Results from the Third National Health and Nutrition Examination Survey. Arch Intern Med 156:93–98
Tudor-Locke C, Leonardi C, Johnson WD et al (2011) Accelerometer steps/day translation of moderate-to-vigorous activity. Prev Med 53:31–33. doi:10.1016/j.ypmed.2011.01.014
Hoffmann DA, Carels RA (2016) Does when you eat and exercise matter? Differences in eating and physical activity patterns in overweight and obese adults. Eat Weight Disord 21:91–98. doi:10.1007/s40519-015-0214-z
Acknowledgments
This work was supported by Grants from Brazilian National Institute of Hormones and Women’s Health/Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq INCT 573747/20083), Brazil. The funding sources had no influence in the writing or decision to submit the article for publication.
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Mario, F.M., Graff, S.K. & Spritzer, P.M. Habitual physical activity is associated with improved anthropometric and androgenic profile in PCOS: a cross-sectional study. J Endocrinol Invest 40, 377–384 (2017). https://doi.org/10.1007/s40618-016-0570-1
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DOI: https://doi.org/10.1007/s40618-016-0570-1