Effects of High Intensity Interval Training and Strength Training on Metabolic, Cardiovascular and Hormonal Outcomes in Women with Polycystic Ovary Syndrome: A Pilot Study

Abstract

BackgroundPolycystic ovary syndrome is a common endocrinopathy in reproductive-age women, and associates with insulin resistance. Exercise is advocated in this disorder, but little knowledge exists on the optimal exercise regimes. We assessed the effects of high intensity interval training and strength training on metabolic, cardiovascular, and hormonal outcomes in women with polycystic ovary syndrome.Materials and MethodsThree-arm parallel randomized controlled trial. Thirty-one women with polycystic ovary syndrome (age 27.2 ± 5.5 years; body mass index 26.7 ± 6.0 kg/m2) were randomly assigned to high intensity interval training, strength training, or a control group. The exercise groups exercised three times weekly for 10 weeks.ResultsThe main outcome measure was change in homeostatic assessment of insulin resistance (HOMA-IR). HOMA-IR improved significantly only after high intensity interval training, by -0.83 (95% confidence interval [CI], -1.45, -0.20), equal to 17%, with between-group difference (p = 0.014). After high intensity interval training, high-density lipoprotein cholesterol increased by 0.2 (95% CI, 0.02, 0.5) mmol/L, with between group difference (p = 0.04). Endothelial function, measured as flow-mediated dilatation of the brachial artery, increased significantly after high intensity interval training, by 2.0 (95% CI, 0.1, 4.0) %, between-group difference (p = 0.08). Fat percentage decreased significantly after both exercise regimes, without changes in body weight. After strength training, anti-Müllarian hormone was significantly reduced, by -14.8 (95% CI, -21.2, -8.4) pmol/L, between-group difference (p = 0.04). There were no significant changes in high-sensitivity C-reactive protein, adiponectin or leptin in any group.ConclusionsHigh intensity interval training for ten weeks improved insulin resistance, without weight loss, in women with polycystic ovary syndrome. Body composition improved significantly after both strength training and high intensity interval training. This pilot study indicates that exercise training can improve the cardiometabolic profile in polycystic ovary syndrome in the absence of weight loss.Trial RegistrationClinicalTrial.gov NCT01919281

The Role of Physical Activity in Preconception, Pregnancy and Postpartum Health

“…When measured directly with the gold standard euglycaemic clamp, intensified exercise training improved IR by 16% in overweight and obese women with PCOS, yet in BMI matched non-PCOS controls a 23% improvement was noted, emphasizing the intrinsic IR defects of the disorder. 54 Other studies using indirect measures of IR have reported a 9-30% improvement in fasting insulin 55,56 as well as in the IR indices, HOMA-IR and AUC INS , following exercise. 55,56 All previous studies have reported improvements with 12 weeks of exercise intervention, independent of the type or frequency of exercise, with 3-5 sessions per week of both moderate (40-70% VO2 max) and higher intensity interval training (95-100% VO2 max), shown to be effective.…”

“…54 Other studies using indirect measures of IR have reported a 9-30% improvement in fasting insulin 55,56 as well as in the IR indices, HOMA-IR and AUC INS , following exercise. 55,56 All previous studies have reported improvements with 12 weeks of exercise intervention, independent of the type or frequency of exercise, with 3-5 sessions per week of both moderate (40-70% VO2 max) and higher intensity interval training (95-100% VO2 max), shown to be effective. [54][55][56] Reported changes to BMI with exercise are 1.5kg/m 2 (-0.85 to -2.1kg/m 2 ) within three to six months of exercise.…”

“…55,56 All previous studies have reported improvements with 12 weeks of exercise intervention, independent of the type or frequency of exercise, with 3-5 sessions per week of both moderate (40-70% VO2 max) and higher intensity interval training (95-100% VO2 max), shown to be effective. [54][55][56] Reported changes to BMI with exercise are 1.5kg/m 2 (-0.85 to -2.1kg/m 2 ) within three to six months of exercise. [57][58][59] A higher percentage of weight loss (10.6%) has been reported in PCOS when diet is combined with exercise, 60 confirming that a larger energy deficit is more likely to lead to weight loss in line with general populations.…”

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“…24 There was also a significant improvement in body composition without reductions in the total weight of lean women, regardless of the type of training when highintensity interval aerobic physical exercise and PRT were compared. 25 These studies are pioneers in the evaluation of PRT alone, in women with PCOS, and attest that strength training can be an excellent and effective exercise option.…”

Efeitos do treinamento físico aeróbio sobre a função sexual em mulheres com síndrome dos ovários policísticos: ensaio clínico controlado

“…Norman et al, (2007) demonstraram que a diminuição de peso induzida pela dieta e /ou exercício físico promove melhorias endócrinas, metabólicas e reprodutiva em pacientes obesas com SOP. Almenning et al, (2015) encontraram redução da resistência à insulina, bem como melhora da composição corporal em mulheres com SOP. Além disso, estes exercícios utilizam grandes grupos musculares em atividades que são de natureza rítmica ou dinâmica, ocasionando o aumento da capacidade aeróbia em longo prazo.…”