Exercise Decreases Plasma Total Homocysteine in Overweight Young Women with Polycystic Ovary Syndrome

Abstract

Women with polycystic ovary syndrome (PCOS) have a clustering of cardiovascular risk factors, such as obesity, lipid abnormalities, impaired glucose tolerance, insulin resistance, and hypertension. Exercise is reported to lower the incidence of cardiac events. The effect of exercise on plasma homocysteine concentrations, an independent cardiovascular risk factor, has not been previously reported in women with PCOS. We examined the effects of exercise on plasma total homocysteine concentrations in young overweight or obese PCOS women [age (mean +/- SD), 30.6 +/- 6.6 yr; body mass index, 35.49 +/- 7.57 kg/m(2)]. Twenty-one women consented to a 6-month exercise program; 12 women (exercisers) adhered to the program, whereas 9 (nonexercisers) did not. In both groups of women, the following parameters were recorded at baseline and 6 months: body mass index, waist-to-hip ratio, and aerobic capacity (maximal oxygen consumption); blood samples were taken after an overnight fast for plasma total homocysteine, insulin, and other biochemical parameters. A significant decrease in plasma total homocysteine concentrations (P < 0.001) and waist-to-hip ratio (P = 0.041) and a significant increase in maximal oxygen consumption (P = 0.019) were recorded at 6 months, compared with baseline in the exercise group. This decrease in homocysteine was not explained by changes in anthropometric or biochemical parameters. In contrast, no significant changes in any of the variables were observed in the nonexercise group. Our study has provided the first evidence that regular exercise significantly lowers plasma homocysteine in young overweight or obese women with PCOS, a group at increased risk of premature atherosclerosis. The precise mechanism by which exercise is associated with a reduction in homocysteine remains to be elucidated.

What do we know about homocysteine and exercise? A review from the literature

“…Folate, vitamin B 12 and B 6 are involved in the transsulfuration pathway and vitamin B 6 participates in the remethylation reaction [6] (Figure 1). The enzyme methionine synthase is involved in the remethylation reaction and conversion of homocysteine to methionine requires both folate and vitamin B 12 as coenzymes [7]. Moreover, vitamin B 6 acts as a coenzyme for the enzymes cystathionine-β-synthase and cystathionine-γ-lyase in the transsulfuration pathway to convert homocysteine to cysteine.…”

“…But there is also a huge variety in the methodology applied among all the studies, hence, there is difficulty to reach an agreement [5]. Some researchers have demonstrated reduced tHcy concentrations after a training period [12,13]; others have related high PA levels and cardiorespiratory fitness with lower homocysteine concentrations [14,15]. In contrast, some studies have shown higher tHcy concentrations after acute exercise, training period or after a specific sport competition [16][17][18].…”

“…Low cardiorespiratory fitness seems to be associated with high tHcy; in contrast, the relation of PA levels and tHcy needs further research. Regarding biomarkers related to tHcy and exercise, some studies showed an increase of folate, vitamin B 12 , and creatine after acute exercise that could to be due to requirement of protein turnover and an increased metabolic demand of vitamin-B.…”

Exercise prevents hyperhomocysteinemia in a dietary folate-restricted mouse model

“…owing in large part to the variations in study design and exercise regimes [7][8][9][10][11][12][13][14][15]. Moreover, 82 discrepancies within these human studies, including B-vitamin and subject training status, as 83 well as variations in mode, intensity, and duration of test exercises, limit the strength of their 84 conclusions [16,17].…”

Statins in the Treatment of Polycystic Ovary Syndrome

“…The dyslipidemia of PCOS is characterized by elevated plasma levels of cholesterol, low density lipoproteins (LDL), very low density lipoproteins (VLDL), and triglycerides with concomitantly reduced concentrations of high density lipoproteins (HDL) [52][53][54][55] . Homocysteine levels are also higher in women with PCOS compared to controls [56][57][58][59] , and hyperhomocysteinemia represents another independent risk factor for the development of cardiovascular disease 60 . Moderate hyperhomocysteinemia predisposes individuals to endothelial dysfunction via a mechanism involving increased oxidative stress 61 .…”