The Jean Hailes Clinical Research Unit, School of Public Health, Monash University, Clayton, Victoria, Australia.
J Clin Endocrinol Metab. 2011 Jan;96(1):E48-56. doi: 10.1210/jc.2010-0828. Epub 2010 Oct 6.
Polycystic ovary syndrome (PCOS) is an insulin-resistant (IR) state. Visceral fat (VF) is independently associated with IR.
The objectives of the study were to explore mechanisms underpinning IR by assessing the effect of exercise training on IR and body composition in overweight PCOS and non-PCOS women.
This was a prospective exercise intervention study.
The study was conducted at an academic medical center. Participants included 20 overweight PCOS and 14 overweight non-PCOS women.
The intervention included 12 wk of intensified aerobic exercise (3 h/wk).
IR on euglycemic hyperinsulinemic clamp, body composition including abdominal visceral and sc fat distribution by computer tomography and lipids was measured.
PCOS subjects were more IR (P = 0.02) and had more VF (P = 0.04 age adjusted) than non-PCOS women. In PCOS women, IR correlated with VF (r = -0.78, P < 0.01). With exercise training, both groups maintained weight but within PCOS, VF (-12.0 cm(2), P = 0.03) and within non-PCOS abdominal sc fat (-40.2 cm(2), P = 0.02) decreased. Despite exercise-induced improvement in IR within PCOS (+27.9 mg · m(-2) · min(-1), P = 0.03), no relationship with decreased VF (r = -0.08, P = 0.84) and no differential changes in IR and VF between groups were noted. Triglycerides decreased within PCOS (-0.27 mmol/liter, P = 0.02) and decreased differentially between groups (P < 0.01).
Higher IR was related to increased VF in PCOS, suggesting an etiological role for VF in intrinsic IR in PCOS; however, changes with exercise intervention did not support a causal relationship. Triglycerides were modulated more by exercise training in PCOS than non-PCOS women. Within-group exercise-induced reductions in cardiometabolic risk factors including IR, triglycerides, and VF in PCOS were observed without significant weight loss and if confirmed in future controlled trials, suggest weight loss should not be the sole focus of exercise programs.
多囊卵巢综合征（PCOS）是一种胰岛素抵抗（IR）状态。内脏脂肪（VF）与 IR 独立相关。
本研究旨在通过评估运动训练对超重 PCOS 和非 PCOS 女性的 IR 和身体成分的影响，探讨 IR 的潜在机制。
这是一项前瞻性运动干预研究。
该研究在一家学术医疗中心进行。参与者包括 20 名超重的 PCOS 患者和 14 名超重的非 PCOS 患者。
干预措施包括 12 周的强化有氧运动（每周 3 小时）。
在正常血糖高胰岛素钳夹试验中评估 IR，通过计算机断层扫描评估身体成分，包括腹部内脏和皮下脂肪分布，以及血脂。
与非 PCOS 女性相比，PCOS 患者的 IR 更严重（P = 0.02），且 VF 更多（P = 0.04，年龄调整后）。在 PCOS 女性中，IR 与 VF 呈正相关（r = -0.78，P < 0.01）。运动训练后，两组体重均保持不变，但 PCOS 组的 VF（-12.0 cm²，P = 0.03）和非 PCOS 组的腹部皮下脂肪（-40.2 cm²，P = 0.02）减少。尽管 PCOS 患者的 IR 运动诱导改善（+27.9 mg·m⁻²·min⁻¹，P = 0.03），但与 VF 减少无关（r = -0.08，P = 0.84），两组之间的 IR 和 VF 也没有差异变化。PCOS 患者的甘油三酯水平降低（-0.27 mmol/L，P = 0.02），且两组之间的差异具有统计学意义（P < 0.01）。
在 PCOS 中，较高的 IR 与增加的 VF 相关，这表明 VF 在 PCOS 中具有内在 IR 的病因学作用；然而，运动干预的变化并不支持因果关系。与非 PCOS 女性相比，PCOS 女性的甘油三酯更多地受到运动训练的调节。在 PCOS 中，观察到运动诱导的心血管代谢危险因素（包括 IR、甘油三酯和 VF）降低，而体重没有明显减轻，如果在未来的对照试验中得到证实，这表明减肥不应成为运动计划的唯一重点。
