Altered cardiorespiratory response to exercise in overweight and obese women with polycystic ovary syndrome

Abstract

In polycystic ovary syndrome (PCOS), cardiovascular risk is increased. Peak O2 uptake (normalV˙normalO2peak) predicts the cardiovascular risk. We were the first to examine the contribution of systemic O2 delivery and arteriovenous O2 difference to normalV˙normalO2peak in overweight and obese women with PCOS. Fifteen overweight or obese PCOS women and 15 age‐, anthropometry‐, and physical activity‐matched control women performed a maximal incremental cycling exercise test. Alveolar gas exchange (volume turbine and mass spectrometry), arterial O2 saturation (pulse oximetry), and cardiac output (CO) (impedance cardiography) were monitored. Hb concentration was determined. Arterial O2 content and arteriovenous O2 difference (C(a‐v)O2) (Fick equation) were calculated. Insulin resistance was evaluated by homeostasis model assessment (HOMA‐IR). PCOS women had lower normalV˙normalO2peak than controls (40 ± 6 vs. 46 ± 5 mL/min/kg fat‐free mass [FFM], P = 0.011). Arterial O2 content was similarly maintained in the groups throughout the exercise test (P > 0.05). Linear regression analysis revealed a pronounced response of CO to increasing normalV˙normalO2 in PCOS women during the exercise test: A ∆CO/∆normalV˙normalO2 slope was steeper in PCOS women than in controls (β = 5.84 vs. β = 5.21, P = 0.004). Eventually, the groups attained similar peak CO and peak CO scaled to FFM (P > 0.05). Instead, C(a‐v)O2 at peak exercise was lower in PCOS women than in controls (13.2 ± 1.6 vs. 14.8 ± 2.4 mL O2/100 mL blood, P = 0.044). HOMA‐IR was similar in the groups (P > 0.05). The altered cardiorespiratory responses to exercise in overweight and obese PCOS women indicate that PCOS per se is associated with alterations in peripheral adjustments to exercise rather than with limitations of systemic O2 delivery.

Cardiopulmonary fitness is strongly associated with body cell mass and fat‐free mass

“…17,19,20 Batterham et al 19 have already suggested that FFM might be the best single predictor of VO2peak. In line with these theoretical considerations, previous studies that analyzed CRF, one with women with polycystic ovary syndrome 21 and another with men with type-1 diabetes, 22 used VO2peak normalized by FFM, instead of TBW, to avoid the influences of differences in body size. Moreover, a previous cross-sectional study 16 with 56 untrained healthy young men concluded that BCM was the better body composition marker for the normalization of VO2peak when compared with FFM, FM, and TBW.…”

Excesso de peso e variáveis antropométricas de risco cardiovascular em portadoras da síndrome do ovário policístico

“…O efeito da obesidade, particularmente, sobre a elevação do risco cardiovascular é ainda mais pronunciado na SOP, na qual, quando estudados marcadores inflamatórios, verificou-se elevação significativa dos mesmos em comparação a mulheres sem a síndrome, mas com IMC compatíveis (Baldani et al, 2015). O excesso de peso também exacerba anormalidades reprodutivas e disfunções metabólicas que, por sua vez, elevam o risco de diabetes e doença cardiovascular (Rissanen et al, 2016). Contudo, os mecanismos envolvidos na relação entre SOP e doença cardiovascular, ainda não são totalmente esclarecidos (Dias et al, 2015).…”

Obesity, but not hyperandrogenism or insulin resistance, predicts skeletal muscle mass in reproductive‐aged women with polycystic ovary syndrome: A systematic review and meta‐analysis of 45 observational studies

“…Studies were published between 1990 and 2020 and were conducted in Poland, 47 Turkey, 7,48,51,52,54,80,81 Congo, 82 United States, 23,27,30,45,76,[83][84][85][86][87][88][89] Oman, 39 Brazil, 5,22,49,56,[90][91][92] Italy, 55,93 Cameroon, 94 Netherlands, 44 China, 50 Denmark, 95,96 Australia, 8,46,53,97 Austria, 38,41 United Kingdom, 98,99 Finland, 100 and Greece. 33 All studies were conducted in medical centers.…”

“…33 All studies were conducted in medical centers. Most (41/45, 91.1% 5,7,8,22,27,30,33,38,39,41,44,[46][47][48][49][50][51][52][53][54][55][56]76,80,82,[84][85][86][87][88][89][90][91][92][93][94][95][96][97][98][99][100] ) had prospective and four 23,45,81,83 retrospective data collection.…”