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Werner L, van der Schouw YT, de Kat AC. A systematic review of the association between modifiable lifestyle factors and circulating anti-Müllerian hormone. Hum Reprod Update 2024; 30:262-308. [PMID: 38402486 DOI: 10.1093/humupd/dmae004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 01/21/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND Levels of anti-Müllerian hormone (AMH) are known to be associated with lifestyle determinants such as smoking and oral contraception (OC) use. When measuring AMH in clinical practice, it is essential to know which factors may influence circulating levels or ovarian reserve in general. OBJECTIVE AND RATIONALE To date, there is no systematic review or summarizing consensus of the nature and magnitude of the relation between AMH and modifiable lifestyle factors. The purpose of this review was to systematically assess the evidence on association of lifestyle behaviors with circulating AMH levels. SEARCH METHODS We performed a pre-registered systematic review of publications in Embase and PubMed on the lifestyle factors BMI, smoking, OC use, alcohol consumption, caffeine consumption, physical activity, and waist-hip ratio (WHR) in relation to circulating AMH levels up to 1 November 2023. The search strategy included terms such as 'Anti-Mullerian hormone', 'lifestyle', and 'women'. Studies were considered eligible if the association between at least one of the lifestyle factors of interest and AMH was assessed in adult women. The quality of included studies was assessed using the Study Quality Assessment Tools of the National Heart, Lung, and Blood Institute. The results were presented as ranges of the most frequently used association measure for studies that found a significant association in the same direction. OUTCOMES A total of 15 072 records were identified, of which 65 studies were eligible for inclusion, and 66.2% of the studies used a cross-sectional design. The majority of studies investigating BMI, smoking, OC use, and physical activity reported significant inverse associations with AMH levels. For WHR, alcohol, and caffeine use, the majority of studies did not find an association with AMH. For all determinants, the effect measures of the reported associations were heterogeneous. The mean difference in AMH levels per unit increase in BMI ranged from -0.015 to -0.2 ng/ml in studies that found a significant inverse association. The mean difference in AMH levels for current smokers versus non-smokers ranged from -0.4 to -1.1 ng/ml, and -4% to -44%, respectively. For current OC use, results included a range in relative mean differences in AMH levels of -17% to -31.1%, in addition to a decrease of 11 age-standardized percentiles, and an average decrease of 1.97 ng/ml after 9 weeks of OC use. Exercise interventions led to a decrease in AMH levels of 2.8 pmol/l to 13.2 pmol/l after 12 weeks in women with polycystic ovary syndrome or a sedentary lifestyle. WIDER IMPLICATIONS Lifestyle factors are associated with differences in AMH levels and thus should be taken into account when interpreting individual AMH measurements. Furthermore, AMH levels can be influenced by the alteration of lifestyle behaviors. While this can be a helpful tool for clinical and lifestyle counseling, the nature of the relation between the observed differences in AMH and the true ovarian reserve remains to be assessed. REGISTRATION NUMBER PROSPERO registration ID: CRD42022322575.
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Affiliation(s)
- Lotte Werner
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Yvonne T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Annelien C de Kat
- Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands
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Baradwan S, Al-Shalhoub F, Alshahrani MS, Himayda S, AlSghan R, Sabban H, Ahmad IH, Sayed MFME, Mohamad EO, AlAmodi AA, Abdelhakim AM, Shaheen K. Effects of letrozole alone or in combination with gonadotropins on ovulation induction and clinical pregnancy in women with polycystic ovarian syndrome: a systematic review and meta-analysis of randomized controlled trials. Hormones (Athens) 2024:10.1007/s42000-024-00531-4. [PMID: 38280115 DOI: 10.1007/s42000-024-00531-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 01/17/2024] [Indexed: 01/29/2024]
Abstract
OBJECTIVE To compare letrozole in combination with gonadotropins versus letrozole monotherapy in ovulation induction and clinical pregnancy among infertile women with polycystic ovarian syndrome (PCOS). METHODS Several databases were searched for available clinical trials from inception until March 2023. We selected randomized controlled trials (RCTs) that compared sequential letrozole/gonadotropin versus letrozole alone among infertile women who met the Rotterdam criteria for PCOS. RevMan software was used to perform our meta-analysis. Our primary outcomes were ovulation and clinical pregnancy rates. Our secondary outcomes were endometrial thickness, number of mature follicles (diameter ≥ 18 mm), and incidence of miscarriage and ovarian hyperstimulation syndrome (OHSS). RESULTS Six RCTs were retrieved with a total number of 723 patients. The ovulation and clinical pregnancy rates were significantly higher among the letrozole/gonadotropin group versus the letrozole monotherapy group (p < 0.001). In addition, there were significant improvements in endometrial thickness and number of mature follicles in the letrozole/gonadotropin group. There were no significant differences between the two groups regarding incidence of miscarriage and ovarian hyperstimulation syndrome. CONCLUSION Letrozole in combination with gonadotropin is superior to letrozole alone in improving ovulation induction and clinical pregnancy among PCOS patients. More trials are required to confirm our findings.
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Affiliation(s)
- Saeed Baradwan
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Faisal Al-Shalhoub
- Department of Obstetrics and Gynecology, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Majed Saeed Alshahrani
- Department of Obstetrics and Gynecology, Faculty of Medicine, Najran University, Najran, Saudi Arabia
| | - Samah Himayda
- Department of Obstetrics and Gynecology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Rayan AlSghan
- Department of Obstetrics and Gynecology, Maternity and Children Hospital, Al-Kharj, Saudi Arabia
| | - Hussein Sabban
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
- Department of Obstetrics and Gynecology, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Inass Hassan Ahmad
- Department of Endocrinology and Metabolism, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | | | - Entesar Omar Mohamad
- Department of Endocrinology and Metabolism, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Abdulhadi A AlAmodi
- College of Health Sciences and Public Health, Jackson State University, Jackson, MS, USA
| | - Ahmed Mohamed Abdelhakim
- Kasralainy Faculty of Medicine, Cairo University, 395 Portsaid Street, Bab El-Kalq, Cairo, 11638, Egypt.
| | - Kareem Shaheen
- Department of Obstetrics and Gynecology, Faculty of Medicine, Minia University, Minia, Egypt
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Weng Y, Zhang Y, Wang D, Wang R, Xiang Z, Shen S, Wang H, Wu X, Wen Y, Wang Y. Exercise-induced irisin improves follicular dysfunction by inhibiting IRE1α-TXNIP/ROS-NLRP3 pathway in PCOS. J Ovarian Res 2023; 16:151. [PMID: 37525261 PMCID: PMC10388501 DOI: 10.1186/s13048-023-01242-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 07/17/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Excessive production of androgen drives oxidative stress (OS) and inflammasome activation in ovarian granulosa cells (GCs). Therefore, the induced follicular developmental disorder is the major cause of infertility in women with polycystic ovary syndrome (PCOS). Exercise-induced upregulation of irisin is capable of regulating metabolism by reducing OS and inflammation. Exercise has been shown to alleviate a range of PCOS symptoms, including maintaining a normal menstrual cycle, in several clinical trials. METHODS Female Sprague-Dawley (SD) rats and primary ovarian cells were treated with two different androgens, dehydroepiandrosterone (DHEA) and dihydrotestosterone (DHT), to simulate a hyperandrogenic environment, followed by eight weeks of exercise training and irisin intervention. The levels of reactive oxygen species (ROS), tissue inflammation and fibrosis were examined using hematoxylin and eosin (H&E) staining, western blot, quantitative real-time PCR (qRT-PCR), dichlorofluorescein diacetate (DCF-DA) probe detection, immunofluorescence staining, immunohistochemistry, and Sirius red staining. RESULTS Exercise for eight weeks improved polycystic ovarian morphology and decreased the levels of inflammation, OS, and fibrosis in PCOS rats. Hyperandrogen increased ROS production in ovarian cells by inducing endoplasmic reticulum stress (ERS) and activating the inositol-requiring enzyme 1α (IRE1α)-thioredoxin-interacting protein (TXNIP)/ROS-NOD-like receptor family pyrin domain containing 3 (NLRP3) signaling pathway, further enhancing the levels of inflammation. Irisin suppressed the expression of IRE1α and its downstream targets, thus improving the ovarian dysfunction of PCOS rats induced by hyperandrogen. CONCLUSION Exercise can alleviate various phenotypes of PCOS rats induced by DHEA, and its therapeutic effect may be mediated by secreting beneficial myokines. IRE1α may be an important target of irisin for reducing OS and inflammation, thereby improving ovarian fibrosis.
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Affiliation(s)
- Yajing Weng
- State Key Laboratory of Analytical Chemistry for Life Science & Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, 210093, China
| | - Yaling Zhang
- School of Medicine, Jiaxing University, Jiaxing, 314001, China
| | - Daojuan Wang
- Department of Pain, Medical School, The Affiliated Drum Tower Hospital, Nanjing University, Nanjing, 210008, China
| | - Rong Wang
- State Key Laboratory of Analytical Chemistry for Life Science & Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, 210093, China
| | - Zou Xiang
- Department of Health Technology and Informatics, Hong Kong Polytechnic University, Hong Kong, 999077, China
| | - Shanmei Shen
- Department of Endocrinology, Medical School, The Affiliated Drum Tower Hospital, Nanjing University, Nanjing, 210093, China
| | - Hongwei Wang
- State Key Laboratory of Analytical Chemistry for Life Science & Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, 210093, China
| | - Xiaoke Wu
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 150040, China.
| | - Yanting Wen
- State Key Laboratory of Analytical Chemistry for Life Science & Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, 210093, China.
| | - Yong Wang
- State Key Laboratory of Analytical Chemistry for Life Science & Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, 210093, China.
- Nanjing University (Suzhou) High-Tech Institute, Suzhou, 215123, China.
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Santos WLL, da Silva Pinheiro C, de Oliveira Santos R, da Silva ACA, Severo JS, Mendes PHM, de Sousa LC, de Sousa OMC, Dos Santos BLB, de Oliveira KBV, Freitas AK, Torres-Leal FL, Dos Santos AA, da Silva MTB. Physical exercise alleviates oxidative stress in brown adipose tissue and causes changes in body composition and nutritional behavior in rats with polycystic ovary syndrome. Life Sci 2023; 325:121754. [PMID: 37156395 DOI: 10.1016/j.lfs.2023.121754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/28/2023] [Accepted: 05/02/2023] [Indexed: 05/10/2023]
Abstract
AIM Polycystic Ovary Syndrome (PCOS) is a very common endocrine disorder in women. We investigate the effect of physical exercise on body composition, nutritional parameters, and oxidative stress in rats with PCOS. METHODS Female rats were into three groups: Control, PCOS, and PCOS + Exercise. PCOS was induced by letrozole (1 mg/kg via p.o.) for 21 days consecutively. Physical exercise was swimming, for 21 consecutive days, 1 h/day with 5 % load. In all groups, we assessed the nutritional and murinometric parameters, body composition, thermography, and oxidative stress in brown adipose tissue (BAT) and peri-ovarian adipose tissue (POAT). KEY FINDINGS In PCOS we observed an increase (P < 0.05) in body weight vs. the Control group. But, the PCOS + Exercise group prevent this weight gain (P < 0.05). The temperature in BAT, decrease (P < 0.05) in the PCOS group vs. Control group. PCOS + Exercise prevented this reduction (P < 0.05) in BAT temperature vs. PCOS groups. We observed decreases (P < 0.05) in Lee Index and BMI in POS + Exercise vs. PCOS group. In PCOS rats, we observed an increase (P < 0.05) in murinometric (SRWG, EI, and FE) and body composition parameters (TWB, ECF, ICF, and FFM) vs. the Control group. The PCOS + Exercise prevents (P < 0.05) these changes in all groups, compared with PCOS. Regarding the BAT, we observe an increase (P < 0.05) in MPO and MDA levels in the PCOS vs. Control group. PCOS + Exercise prevents (P < 0.05) these increases vs. the PCOS group. SIGNIFICANCE PCOS modifies body composition, and nutritional parameters, and induces changes in oxidative stress in BAT. Physical exercise prevented these alterations.
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Affiliation(s)
- Wenna Lúcia Lima Santos
- Graduate Program in Food and Nutrition, Federal University of Piaui, Teresina, PI, Brazil; Laboratory of Exercise and Gastrointestinal Tract - Department of Physical Education, Federal University of Piaui, Teresina, PI, Brazil
| | - Clailson da Silva Pinheiro
- Laboratory of Exercise and Gastrointestinal Tract - Department of Physical Education, Federal University of Piaui, Teresina, PI, Brazil; Graduate Program in Pharmacology, Federal University of Piaui, Teresina, PI, Brazil
| | | | - Alda Cassia Alves da Silva
- Laboratory of Exercise and Gastrointestinal Tract - Department of Physical Education, Federal University of Piaui, Teresina, PI, Brazil; Graduate Program in Pharmacology, Federal University of Piaui, Teresina, PI, Brazil
| | - Juliana Soares Severo
- Graduate Program in Food and Nutrition, Federal University of Piaui, Teresina, PI, Brazil; Laboratory of Exercise and Gastrointestinal Tract - Department of Physical Education, Federal University of Piaui, Teresina, PI, Brazil
| | - Pedro Henrique Moraes Mendes
- Laboratory of Exercise and Gastrointestinal Tract - Department of Physical Education, Federal University of Piaui, Teresina, PI, Brazil
| | - Luiza Carolinda de Sousa
- Laboratory of Exercise and Gastrointestinal Tract - Department of Physical Education, Federal University of Piaui, Teresina, PI, Brazil
| | - Olga Maria Castro de Sousa
- Laboratory of Exercise and Gastrointestinal Tract - Department of Physical Education, Federal University of Piaui, Teresina, PI, Brazil
| | | | | | - António Klingem Freitas
- Department of Physiology and Pharmacology, Federal University of Ceará, Fortaleza, CE, Brazil
| | | | | | - Moises Tolentino Bento da Silva
- Graduate Program in Food and Nutrition, Federal University of Piaui, Teresina, PI, Brazil; Laboratory of Exercise and Gastrointestinal Tract - Department of Physical Education, Federal University of Piaui, Teresina, PI, Brazil; Graduate Program in Pharmacology, Federal University of Piaui, Teresina, PI, Brazil; Laboratory of Physiology. Department of Immuno-Physiology and Pharmacology. Institute of the Biomedical Science Abel Salazar - ICBAS, Center for Drug Discovery and Innovative Medicines (MedInUP), University of Porto, Porto, Portugal.
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Kazeminia M, Rajati F, Rajati M. The effect of exercise on anti-Mullerian hormone levels in patients with polycystic ovary syndrome: a systematic review and meta-analysis. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2022. [DOI: 10.1186/s43043-022-00121-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Polycystic ovary syndrome (PCOS) is considered as the most common endocrinopathy among women of childbearing age and the most important cause of anovulatory infertility. The present study aimed to estimate the pooled effect of exercise on anti-Mullerian hormone (AMH) levels in PCOS women using systematic review and meta-analysis.
Main body
The present study was conducted according to the PRISMA guidelines from 2011 to October 2021. All published studies, which met the inclusion criteria, were searched in SID, MagIran, Embase, PubMed, Scopus, Web of Science (WoS) databases, and Google Scholar motor engine using related MeSH/Emtree terms, which were combined with free text word. Finally, 12 articles were included in the meta-analysis. As a result of the combination of the studies, after exercise, AMH level in the intervention group significantly decreased up to 0.517 ± 0.169 more than that in the control group (P ˂ 0.05). The results of subgroup analysis demonstrated that the effect of resistance training for 16 weeks was higher on women with body mass index (BMI) (≥ 25 kg/m2) and AMH (≥ 10 ng/mL) before the intervention. GRADEpro software was used to grade the level of evidence.
Conclusion
This systematic review and meta-analysis showed that either strength exercise or aerobic exercise decrease the AMH level in PCOS women. It seems more duration of the exercise has a more potential advantage to reduce the AMH levels in women with PCOS. Although the results graded by very low-quality evidence, it is recommended to include exercise in the treatment programs of PCOS patients.
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Catalpol attenuates polycystic ovarian syndrome by regulating sirtuin 1 mediated NF-κB signaling pathway. Reprod Biol 2022; 22:100671. [PMID: 35905692 DOI: 10.1016/j.repbio.2022.100671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 05/26/2022] [Accepted: 06/27/2022] [Indexed: 11/21/2022]
Abstract
Oxidative stress plays a central role in polycystic ovary syndrome (PCOS). Catalpol (CAT) is the active ingredient of Rehmannia glutinosa Libosch which has therapeutic effect on PCOS. However, little is known about the mechanism of CAT in PCOS. PCOS rats were induced by subcutaneous injection of dehydroepiandrosteronec for four weeks and then were treated with CAT (50 mg/kg) or carboxyl methyl cellulose (the solvent of CAT) or normal saline for another 4 weeks. Histopathological observation of ovarian tissues, the levels of testosterone, estradiol and progesterone in rat plasma samples, the oxidative stress related-indexes and the expressions of NF-κB pathway-related proteins were determined. KGN cell (human ovarian granulosa cell line) was used as PCOS cell model and was transfected with siSIRT1 in the presence of CAT. The viability, proliferation and apoptosis of cells and the levels of SIRT1 and NF-κB pathway-related proteins were measured. CAT lessened the anthropometric indices and improved ovarian damage in PCOS model rats, and reduced the levels of testosterone, estradiol, progesterone and MDA, increased GSH content, and elevated the activities of catalase, GSH-Px and SOD in ovarian tissues of PCOS model rats. CAT up-regulated SIRT1 level and inhibited the activation of NF-κB signaling pathway in PCOS rat model and KGN cells. Silencing SIRT1 increased the viability and proliferation, whilst decreased the apoptosis of CAT-treated KGN cells. Silencing SIRT1 counteracted the effect of CAT on the level of oxidative stress-related factors and NF-κB signaling pathway in KGN cells. CAT attenuated PCOS by regulating SIRT1 mediated NF-κB signaling pathway.
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Scarfò G, Daniele S, Fusi J, Gesi M, Martini C, Franzoni F, Cela V, Artini PG. Metabolic and Molecular Mechanisms of Diet and Physical Exercise in the Management of Polycystic Ovarian Syndrome. Biomedicines 2022; 10:biomedicines10061305. [PMID: 35740328 PMCID: PMC9219791 DOI: 10.3390/biomedicines10061305] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/25/2022] [Accepted: 05/30/2022] [Indexed: 01/27/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is an endocrine systemic disorder mainly characterized by a hormonal and metabolic disbalance that leads to oligo/anovulation, hyperandrogenism and the formation of ovarian cysts. Despite the progress that has been reached in its diagnosis and management, little is known about the molecular mechanisms and signaling pathways underlying the pathogenic mechanisms. In this sense, recent research has suggested that the influence of multiple factors, including age, environment, lifestyle and the disease state environment can change the clinical presentation of PCOS via epigenetic modifications. Variants in the genes encoding for proteins involved in steroidogenesis and glucose homeostasis play a crucial role in the development of the disease. Other genes involved in inflammation and cell proliferation seem to undergo an epigenetic control. Moreover, lifestyle factors influence the PCOS course and prognosis, including diet and physical activity, which are fundamental in reducing oxidative stress, inflammation and in improving metabolic and hormonal parameters. In the present review, literature evidence on molecular and epigenetic mechanisms related to PCOS etiology will be discussed, with a particular attention on the positive influence of diet and physical activity as nonpharmacological ways of intervention in the management of the disease.
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Affiliation(s)
- Giorgia Scarfò
- Division of General Medicine, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (G.S.); (J.F.); (F.F.)
| | - Simona Daniele
- Department of Pharmacy, University of Pisa, 56126 Pisa, Italy;
- Correspondence: (S.D.); (P.G.A.); Tel.: +39-050-2219608 (S.D.); +39-050-554104 (P.G.A.)
| | - Jonathan Fusi
- Division of General Medicine, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (G.S.); (J.F.); (F.F.)
| | - Marco Gesi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy;
| | - Claudia Martini
- Department of Pharmacy, University of Pisa, 56126 Pisa, Italy;
| | - Ferdinando Franzoni
- Division of General Medicine, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (G.S.); (J.F.); (F.F.)
| | - Vito Cela
- Division of Gynecology and Obstetrics, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy;
| | - Paolo Giovanni Artini
- Division of Gynecology and Obstetrics, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy;
- Correspondence: (S.D.); (P.G.A.); Tel.: +39-050-2219608 (S.D.); +39-050-554104 (P.G.A.)
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Effects of high-intensity interval training and strength training on levels of testosterone and physical activity among women with polycystic ovary syndrome. Obstet Gynecol Sci 2022; 65:368-375. [PMID: 35443556 PMCID: PMC9304438 DOI: 10.5468/ogs.22002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 03/22/2022] [Indexed: 11/08/2022] Open
Abstract
Objective Polycystic ovary syndrome is a diverse endocrine disorder characterized by hyperandrogenism and ovulatory dysfunction. Hyperandrogenism affects body morphology, resulting in excess weight (overweight or obesity). This study aimed to evaluate the efficacy of high-intensity interval training on serum testosterone levels, body fat percentage, and level of physical activity among women with polycystic ovary syndrome. Methods Fifty participants were enrolled in the study and randomly allocated into two groups. Group A performed high-intensity interval training on alternate days per week (total of 12 weeks) and group B performed strength training on alternate days per week (total of 12 weeks). Baseline and 12th-week assessments included serum testosterone levels, body fat percentage using the skinfold method, and level of physical activity assessed using the International Physical Activity Questionnaire. Results After 12 weeks of intervention, both groups showed significant improvements in all the outcomes. However, group A (high intensity interval training) showed statistically significant results compared to group B (strength training) in lowering serum testosterone levels (P=0.049) and body fat percentage (P=0.001) and increasing physical activity levels (P=0.006). Conclusion After 12 weeks of exercise, both exercises benefited the participants; however, high-intensity interval training specifically was found to be a more effective exercise regimen than strength training in reducing serum testosterone levels and body fat percentage and enhancing levels of physical activity in women with polycystic ovary syndrome.
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The Effect of Exercise on Cardiometabolic Risk Factors in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031386. [PMID: 35162403 PMCID: PMC8835550 DOI: 10.3390/ijerph19031386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/10/2022] [Accepted: 01/17/2022] [Indexed: 01/06/2023]
Abstract
Background: Polycystic Ovary Syndrome (PCOS), a common endocrine disorder in women of reproductive age, increases the risk for cardiometabolic morbidity. While regular exercise is effective in reducing cardiometabolic risk, women with PCOS may experience condition-specific barriers to exercise thereby limiting its efficacy. Aim: To determine the effect of exercise on cardiometabolic risk factors in women with PCOS. Methods: Five databases (Cochrane, EMBASE, Medline, Scopus and SPORTDiscus) were searched up to December of 2021. Eligible studies included: a randomised controlled design; participants with a diagnosis of PCOS; aerobic and/or resistance exercise intervention lasting ≥4 weeks; cardiometabolic outcomes. Meta-analyses were performed to determine the effect of exercise versus non-exercising control on cardiometabolic outcomes. Results: Of the 4517 studies screened, 18 studies were analysed involving 593 participants. When compared with control, exercise significantly improved cardiorespiratory fitness (weighted mean difference {WMD} = 4.00 mL/kg/min, 95% CI: 2.61 to 5.40, p < 0.001) and waist circumference (WMD = −1.48 cm, 95% CI: −2.35 to −0.62, p = 0.001). Systolic blood pressure, fasting blood glucose, insulin resistance, and lipid profiles remained unchanged. Conclusions: Regular exercise may improve cardiorespiratory fitness and waist circumference in women with PCOS. Further large-scale studies are required to determine whether exercise interventions improve various biochemical and anthropometric parameters in women with PCOS and more severe cardiometabolic abnormalities.
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Richards CT, Meah VL, James PE, Rees DA, Lord RN. HIIT'ing or MISS'ing the Optimal Management of Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of High- Versus Moderate-Intensity Exercise Prescription. Front Physiol 2021; 12:715881. [PMID: 34483969 PMCID: PMC8415631 DOI: 10.3389/fphys.2021.715881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 07/19/2021] [Indexed: 01/16/2023] Open
Abstract
Introduction: Polycystic Ovary syndrome (PCOS) is a metabolic disorder associated with increased cardiovascular disease risk. Exercise is an effective treatment strategy to manage symptoms and reduce long-term health risk. High-intensity interval training (HIIT) has been suggested as a more efficient exercise mode in PCOS; however, it is not clear whether HIIT is superior to moderate intensity steady state exercise (MISS). Methods: We synthesized available data through a systematic review and meta-analysis to compare the effectiveness of isolated HIIT and MISS exercise interventions. Our primary outcome measures were cardiorespiratory fitness and insulin resistance, measured using V˙O2max and HOMA-IR respectively. Results: A total of 16 studies were included. Moderate-quality evidence from 16 studies identified significant improvements in V˙O2max following MISS (Δ = 1.081 ml/kg/min, p < 0.001, n = 194), but not HIIT (Δ = 0.641 ml/kg/min, p = 0.128, n = 28). Neither HIIT nor MISS improved HOMA-IR [(Δ = −0.257, p = 0.374, n = 60) and (Δ = −0.341, p = 0.078, n = 159), respectively]. Discussion: A significant improvement in V˙O2max was evident following MISS, but not HIIT exercise in women with PCOS. This contrasts with previous literature in healthy and clinical cohorts that report superior benefits of HIIT. Therefore, based on available moderate-quality evidence, HIIT exercise does not provide superior outcomes in V˙O2max compared with MISS, although larger high-quality interventions are needed to fully address this. Additional dietary/pharmacological interventions may be required in conjunction with exercise to improve insulin sensitivity.
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Affiliation(s)
- Cory T Richards
- School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Victoria L Meah
- Program for Pregnancy and Postpartum Health, Faculty of Kinesiology, Sport, and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, AB, Canada
| | - Philip E James
- School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - D Aled Rees
- Neuroscience and Mental Health Research Institute, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Rachel N Lord
- School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
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The association between the levels of anti-Müllerian hormone (AMH) and dietary intake in Iranian women. Arch Gynecol Obstet 2021; 304:687-694. [PMID: 34021805 DOI: 10.1007/s00404-021-06098-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 05/11/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE This paper aimed to assess the association between AMH with dietary intake of adult women referred to the infertility clinic of Al-Zahra Hospital in Rasht, Iran. METHODS This cross-sectional study was performed on 234 adult women referred to the infertility clinic of Al-Zahra Hospital, Rasht, Iran. The participants were categorized into two groups based on their AMH levels. Participants' data on lifestyle and anthropometry as well as blood samples were collected. Dietary intakes were assessed by a validated food frequency questionnaire (FFQ). RESULTS Serum AMH concentration was negatively associated with the intake of fast foods (P = 0.002) and saturated fats (P = 0.040). These associations remained significant after adjustments for age, rural or urban location, and education. Additional adjustments for body mass index (BMI) and physical activity did not change the results. The results remained significant after further adjustments for menstrual age, menstrual pattern, and oral contraceptive pills. CONCLUSION Fast foods and saturated fats were significantly associated with lower AMH concentrations and modifying the amount of these dietary components may be an important strategy for increasing the reservation of ovaries in women. Future longitudinal studies are warranted to confirm these findings and to identify the underlying mechanisms.
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The Treatment with Complementary and Alternative Traditional Chinese Medicine for Menstrual Disorders with Polycystic Ovary Syndrome. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:6678398. [PMID: 34055020 PMCID: PMC8149243 DOI: 10.1155/2021/6678398] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 04/02/2021] [Accepted: 04/13/2021] [Indexed: 12/17/2022]
Abstract
Polycystic ovary syndrome (PCOS) is a frequent gynecological female endocrinopathy, characterized by chronic anovulation, hyperandrogenism, and insulin resistance (IR). Menstrual disorders are one of the main clinical manifestations of PCOS. Other symptoms include hirsutism and/acne. At present, the treatment of PCOS with irregular menstruation is mainly based on oral contraceptives, but there are some side effects and adverse reactions. In recent years, more and more attention has been paid to the complementary and alternative medicine (CAM), which has been widely used in clinical practice. Modern Western medicine is called "conventional medicine" or "orthodox medicine," and the complementary and alternative medicine is called "unconventional medicine" or "unorthodox medicine." CAM includes traditional medicine and folk therapy around the world. Around 65-80% of world health management business is classified into traditional medicine by the World Health Organization, which is used as alternative medicine in Western countries. In our country, Chinese medicine, acupuncture, and other therapies are commonly used due to their significant efficacy and higher safety. Therefore, this review aims to summarize and evaluate the mechanisms and the effect of current complementary replacement therapy in the treatment of menstrual disorders caused by PCOS, so as to provide guidance for the following basic and clinical research.
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