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Exercise Training in Polycystic Ovarian Syndrome Enhances Flow-Mediated Dilation in the Absence of Changes in Fatness

Sprung, Victoria S.1; Cuthbertson, Daniel J.2; Pugh, Christopher J. A.1,3; Aziz, Nabil4; Kemp, Graham J.5; Daousi, Christina2; Green, Daniel J.1,3; Cable, Nigel Timothy1; Jones, Helen1

Medicine & Science in Sports & Exercise: December 2013 - Volume 45 - Issue 12 - p 2234–2242
doi: 10.1249/MSS.0b013e31829ba9a1
Clinical Sciences

Introduction Polycystic ovarian syndrome (PCOS) is associated with an adverse cardiovascular disease (CVD) profile. A surrogate marker for CVD risk is endothelial dysfunction. Limited studies exist examining the cardiovascular and metabolic effects of exercise in PCOS and specifically its impact on endothelial function. Therefore, the aim of the current study was to investigate the impact of exercise on endothelial function, in parallel with body composition, insulin resistance, and cardiopulmonary fitness in PCOS.

Methods Ten women with PCOS (27 yr, 95% confidence interval [CI] = 23–32; 31 kg·m−2, 95% CI = 28–34) completed a 16-wk exercise (EX) program, and seven women with PCOS (29 yr, 95% CI = 24–35; 35 kg·m−2, 95% CI = 31–40) undertook conventional care (CC) following lifestyle advice. Brachial artery endothelial function was assessed pre- and postintervention using flow-mediated dilation adjusted for variability in baseline diameter. Visceral and abdominal subcutaneous adipose tissue was assessed using whole-body magnetic resonance imaging and 1H magnetic resonance spectroscopy quantified liver fat. Cardiorespiratory fitness, glycemic control, hormone, and lipid profiles were also assessed. Data were analyzed using covariate-controlled generalized estimating equations.

Results At follow-up, EX improved flow-mediated dilation by 3.6% (95% CI = 0.5–6.7, P = 0.03) more than CC. There was a parallel improvement in cardiorespiratory fitness of 4.7 mL·kg−1·min−1 (95% CI = 1.4–7.9, P < 0.001) with EX versus CC. These changes were not explained by changes in visceral adipose tissue, subcutaneous adipose tissue, liver fat or insulin resistance.

Conclusions Supervised exercise in women with PCOS improves endothelial function, an adaptation associated with reduced CVD risk. This change occurs independent of changes in body weight or composition. The success of public health interventions in this patient group should not be solely judged by weight loss.

1Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UNITED KINGDOM; 2Department of Diabetes and Endocrinology, University Hospital Aintree, Liverpool, UNITED KINGDOM; 3School of Sports Science, Exercise and Health, University of Western Australia, Crawley, Western Australia, AUSTRALIA; 4Department of Gynaecology, Liverpool Women’s Hospital, Liverpool, UNITED KINGDOM; and, 5Magnetic Resonance and Image Analysis Research Centre and Department of Musculoskeletal Biology, University of Liverpool, UNITED KINGDOM

Address for correspondence: Helen Jones, Ph.D., Research Institute for Sport and Exercise Sciences, Tom Reilly Building, Liverpool John Moores University, Byrom Street Campus, Liverpool, L3 3AF, United Kingdom; E-mail:

Submitted for publication October 2012.

Accepted for publication May 2013.

© 2013 American College of Sports Medicine