Scott David, Joham Anju, Teede Helena, Gibson-Helm Melanie, Harrison Cheryce, Cassar Samantha, Hutchison Samantha, Ebeling Peter R, Stepto Nigel, de Courten Barbora
Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton 3168, Victoria, Australia.
Melbourne Medical School (Western Campus) and Australian Institute of Musculoskeletal Science, The University of Melbourne and Western Health, St Albans 3021, Victoria, Australia.
Nutrients. 2016 Nov 30;8(12):774. doi: 10.3390/nu8120774.
Low vitamin D and insulin resistance are common in polycystic ovary syndrome (PCOS) and associated with higher inter- and intra-muscular adipose tissue (IMAT). We investigated associations between vitamin D, IMAT and insulin resistance in a cross-sectional study of 40 women with PCOS and 30 women without PCOS, and pre- and post-exercise in a 12-week intervention in 16 overweight participants (10 with PCOS and six without PCOS). A non-classical body mass index (BMI) threshold was used to differentiate lean and overweight women (BMI ≥ 27 kg/m²). Measurements included plasma 25-hydroxyvitamin D (25OHD), insulin resistance (glucose infusion rate (GIR; mg/m²/min), fasting glucose and insulin, and glycated haemoglobin), visceral fat, mid-thigh IMAT (computed tomography) and total body fat (dual-energy X-ray absorptiometry). Women with both PCOS and low 25OHD levels had the lowest GIR (all < 0.05). Higher IMAT was associated with lower 25OHD (B = -3.95; 95% CI -6.86, -1.05) and GIR (B = -21.3; 95% CI -37.16, -5.44) in women with PCOS. Overweight women with pre-exercise 25OHD ≥30 nmol/L had significant increases in GIR, and decreases in total and visceral fat (all < 0.044), but no associations were observed when stratified by PCOS status. Women with PCOS and low 25OHD levels have increased insulin resistance which may be partly explained by higher IMAT. Higher pre-training 25OHD levels may enhance exercise-induced changes in body composition and insulin resistance in overweight women.
低维生素D和胰岛素抵抗在多囊卵巢综合征（PCOS）中很常见，且与肌间和肌内脂肪组织（IMAT）增加有关。我们在一项横断面研究中调查了40名PCOS女性和30名非PCOS女性中维生素D、IMAT与胰岛素抵抗之间的关联，以及在一项针对16名超重参与者（10名PCOS患者和6名非PCOS患者）的12周干预中运动前后的情况。采用非经典体重指数（BMI）阈值区分瘦女性和超重女性（BMI≥27kg/m²）。测量指标包括血浆25-羟基维生素D（25OHD）、胰岛素抵抗（葡萄糖输注率（GIR；mg/m²/min）、空腹血糖和胰岛素以及糖化血红蛋白）、内脏脂肪、大腿中部IMAT（计算机断层扫描）和全身脂肪（双能X线吸收法）。同时患有PCOS和低25OHD水平的女性GIR最低（均P<0.05）。在PCOS女性中，较高的IMAT与较低的25OHD（B=-3.95；95%CI -6.86，-1.05）和GIR（B=-21.3；95%CI -37.16，-5.44）相关。运动前25OHD≥30nmol/L的超重女性GIR显著增加，总脂肪和内脏脂肪减少（均P<0.044），但按PCOS状态分层时未观察到关联。患有PCOS且25OHD水平低的女性胰岛素抵抗增加，这可能部分由较高的IMAT解释。较高的训练前25OHD水平可能会增强超重女性运动引起的身体成分和胰岛素抵抗变化。
