高强度运动与中等强度运动对改善患有多囊卵巢综合征和胰岛素抵抗的不活跃女性的葡萄糖代谢的影响：一项关于两种居家锻炼方案的试点随机对照试验

Vigorous vs. moderate exercise to improve glucose metabolism in inactive women with polycystic ovary syndrome and insulin resistance: a pilot randomized controlled trial of two home-based exercise routines.

作者信息

Wang Ange, Noel Martha, Christ Jacob P, Corley Jamie, Lenhart Nikolaus, Cedars Marcelle I, Huddleston Heather

机构信息

Division of Reproductive Endocrinology and Infertility, University of California San Francisco, San Francisco, California.

Reproductive Medicine Associates Northern California, San Francisco, California.

出版信息

F S Rep. 2023 Dec 22;5(1):80-86. doi: 10.1016/j.xfre.2023.12.004. eCollection 2024 Mar.

DOI:10.1016/j.xfre.2023.12.004

PMID:38524210

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10958708/

Abstract

OBJECTIVE

To study the impact of vigorous vs. moderate exercise on metabolic parameters in polycystic ovary syndrome (PCOS).

DESIGN

Randomized controlled trial.

SETTING

Unsupervised home-based exercise program.

PATIENTS

Patients with PCOS on the basis of the Rotterdam criteria with insulin resistance.

INTERVENTIONS

Participants were block randomized to a home-based exercise program of 75 minutes of vigorous exercise or 150 minutes of moderate exercise per week, for 8 weeks total.

MAIN OUTCOME MEASURES

Changes in glucose, insulin, and insulin resistance.

RESULTS

In total, 36 participants were randomized, of whom 20 completed the study. The percentage changes from baseline at 4 and 8 weeks for fasting glucose, insulin, and homeostatic model assessment for insulin resistance did not significantly differ between the groups, except for the change in the 8-week glucose level, which was more favorable in the moderate arm (8.06% [standard deviation, 6.44%] in the vigorous group compared with -0.32% [standard deviation, 4.91%] in the moderate group). The absolute values of the main outcomes (fasting glucose, insulin, and homeostatic model assessment for insulin resistance) at baseline and 4 and 8 weeks did not significantly differ between trial arms. When assessing the change from baseline at 4 and 8 weeks, overall and within each trial arm, only the 8-week fasting glucose level was significantly greater than the baseline value in the vigorous arm (93.5 [95% confidence interval, 88.7-98.3] vs. 86.8 [95% confidence interval, 81.1-92.4]).

CONCLUSIONS

Unsupervised short-term exercise programs may not achieve significant metabolic improvements in patients with PCOS, regardless of vigorous vs. moderate intensity. Future studies should investigate this question in larger sample sizes and longer or structured exercise programs.

CLINICAL TRIAL REGISTRATION NUMBER

ClinicalTrials.gov identifier, NCT02303470.

摘要

目的

研究剧烈运动与中等强度运动对多囊卵巢综合征（PCOS）患者代谢参数的影响。

设计

随机对照试验。

设置

无监督的居家运动计划。

患者

根据鹿特丹标准诊断为PCOS且伴有胰岛素抵抗的患者。

干预措施

参与者被整群随机分配至居家运动计划，一组为每周进行75分钟剧烈运动，另一组为每周进行150分钟中等强度运动，共持续8周。

主要观察指标

血糖、胰岛素及胰岛素抵抗的变化。

结果

共有36名参与者被随机分组，其中20名完成了研究。除8周时血糖水平变化外，两组在4周和8周时空腹血糖、胰岛素及胰岛素抵抗稳态模型评估相对于基线的变化百分比无显著差异，中等强度运动组的8周血糖水平变化更有利（剧烈运动组为8.06%[标准差，6.44%]，中等强度运动组为-0.32%[标准差，4.91%]）。各试验组基线及4周和8周时主要观察指标（空腹血糖、胰岛素及胰岛素抵抗稳态模型评估）的绝对值无显著差异。在评估4周和8周相对于基线的变化时，总体及各试验组内，仅剧烈运动组8周时的空腹血糖水平显著高于基线值（93.5[95%置信区间，88.7 - 98.3] vs. 86.8[95%置信区间，81.1 - 92.4]）。