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Kogure GS, Verruma CG, Santana BA, Calado RT, Ferriani RA, Furtado CLM, Dos Reis RM. Obesity contributes to telomere shortening in polycystic ovary syndrome. Reprod Sci 2024; 31:1601-1609. [PMID: 38393627 DOI: 10.1007/s43032-024-01485-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/07/2024] [Indexed: 02/25/2024]
Abstract
Polycystic ovary syndrome (PCOS) is a multifactorial disorder and obesity occurs in 38% to 88% of these women. Although hyperandrogenism may contribute to telomere lengthening, increased body mass index (BMI) is associated with telomere erosion. We sought to compare leukocyte telomere length (LTL) in PCOS women with normal, overweight, and obese BMI. We evaluated the relationship between LTL and clinical variables of PCOS and inflammatory biomarkers independent of BMI. A total of 348 women (243 PCOS and 105 non-PCOS) were evaluated for anthropometric measures, total testosterone, androstenedione, estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), sex hormone-binding globulin (SHBG), free androgen index (FAI), fasting insulin and glycemia, lipid profile, homocysteine, C-reactive protein (CRP) and homeostatic model of insulin resistance (HOMA-IR). LTL was measured by qPCR. The PCOS group presented higher weight, waist circumference, BMI, testosterone, LH, fasting insulin, FAI, and HOMA-IR, and lower E2, SHBG, and fasting glycemia measures compared with the non-PCOS. When stratified by BMI, LTL was increased in all subgroups in PCOS compared to non-PCOS. However, in the PCOS group, LTL was lower in overweight (P = 0.0187) and obese (P = 0.0018) compared to normal-weight women. The generalized linear model showed that BMI, androstenedione, homocysteine, and CRP were associated with telomere biology. Women with PCOS had longer LTL, however, overweight or obesity progressively contributes to telomere shortening and may affect reproductive outcomes of PCOS, while androstenedione may increase LTL.
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Affiliation(s)
- Gislaine Satyko Kogure
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of Sao Paulo (FMRP-USP), Ribeirao Preto, Brazil
| | - Carolina Gennari Verruma
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of Sao Paulo (FMRP-USP), Ribeirao Preto, Brazil
| | - Barbara A Santana
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, 14049-900, Brazil
| | - Rodrigo T Calado
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, 14049-900, Brazil
| | - Rui Alberto Ferriani
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of Sao Paulo (FMRP-USP), Ribeirao Preto, Brazil
| | - Cristiana Libardi Miranda Furtado
- Experimental Biology Center, Universidade de Fortaleza (UNFOR), Fortaleza, Brazil.
- Graduate Program in Medical Sciences, Universidade de Fortaleza, Fortaleza, Brazil.
- Postgraduate Program in Translational Medicine, Drug Research and Development Center, Federal University of Ceará, Fortaleza, Brazil.
| | - Rosana Maria Dos Reis
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of Sao Paulo (FMRP-USP), Ribeirao Preto, Brazil.
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Kogure GS, Ribeiro VB, Mendes MC, Ferriani RA, Furtado CLM, Dos Reis RM. Dual-energy X-ray absorptiometry and adiposity index are sensitive methods to evaluate central fat accumulation in women with polycystic ovary syndrome and normal body mass index. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2023; 67:e000627. [PMID: 37249458 PMCID: PMC10665059 DOI: 10.20945/2359-3997000000627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 01/21/2023] [Indexed: 05/31/2023]
Abstract
Objective This study aimed to determine the differences in body fat distribution and central obesity indicators using dual-energy X-ray absorptiometry (DXA), adiposity indices, and anthropometric indices between women with and without polycystic ovary syndrome (PCOS). Materials and methods Clinical and laboratory examination history, including transvaginal ultrasound, fasting blood samples, anthropometric measurements, and DXA scans were conducted in 179 women with PCOS (PCOS group) and 100 without PCOS (non-PCOS group). The volunteers were grouped by body mass index (BMI): normal (18-24.9 kg/m2), overweight (25-29.9 kg/m2), or obese (>30 kg/m2). The visceral adiposity index (VAI) and lipid accumulation product (LAP) were calculated, regions of interest (ROIs) were determined, and the fat mass index (FMI) was calculated using DXA. Results VAI, LAP, ROIs, FMI, and adiposity indices by DXA were higher in women with PCOS and normal BMI. In both PCOS and non-PCOS groups, the ROIs progressively increased from normal BMI to overweight and obese, and from overweight to obese. Obese women with PCOS showed high trunk fat mass. However, obesity was not able to modify these trunk/periphery fat ratios in PCOS from overweight to higher BMI. These variables were associated with the incidence of PCOS. Conclusion In women with PCOS and normal BMI, both DXA and the adiposity indices, VAI and LAP, are more sensitive methods to evaluate total body fat and fat accumulation in the central abdominal region. It was also observed that as BMI increased, the differences in measurements between women with and without PCOS decreased.
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Affiliation(s)
- Gislaine Satyko Kogure
- Setor de Reprodução Humana, Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil,
| | | | - Maria Célia Mendes
- Setor de Reprodução Humana, Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - Rui Alberto Ferriani
- Setor de Reprodução Humana, Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - Cristiana Libardi Miranda Furtado
- Centro de Pesquisa e Desenvolvimento de Medicamentos, Programa de Pós-graduação em Ciências Médicas e Cirúrgicas, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - Rosana Maria Dos Reis
- Setor de Reprodução Humana, Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Kite C, Parkes E, Taylor SR, Davies RW, Lagojda L, Brown JE, Broom DR, Kyrou I, Randeva HS. Time to Load Up-Resistance Training Can Improve the Health of Women with Polycystic Ovary Syndrome (PCOS): A Scoping Review. Med Sci (Basel) 2022; 10:53. [PMID: 36278523 PMCID: PMC9590069 DOI: 10.3390/medsci10040053] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/15/2022] [Accepted: 09/21/2022] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Guidelines for the management of polycystic ovary syndrome (PCOS) focus on lifestyle changes, incorporating exercise. Whilst evidence suggests that aerobic exercise may be beneficial, less is known about the effectiveness of resistance training (RT), which may be more feasible for those that have low fitness levels and/or are unable to tolerate/participate in aerobic exercise. OBJECTIVES To identify the available evidence on RT in women with PCOS and to summarise findings in the context of a scoping review. ELIGIBILITY CRITERIA Studies utilising pre-post designs to assess the effectiveness of RT in PCOS; all outcomes were included. SOURCES OF EVIDENCE Four databases (PubMed, CENTRAL, CINAHL and SportDiscus) were searched and supplemented by hand searching of relevant papers/reference lists. CHARTING METHODS Extracted data were presented in tables and qualitatively synthesised. RESULTS Searches returned 42 papers; of those, 12 papers were included, relating to six studies/trials. Statistical changes were reported for multiple pertinent outcomes relating to metabolic (i.e., glycaemia and fat-free mass) and hormonal (i.e., testosterone and sex hormone-binding globulin) profiles. CONCLUSIONS There is a striking lack of studies in this field and, despite the reported statistical significance for many outcomes, the documented magnitude of changes are small and the quality of the evidence questionable. This highlights an unmet need for rigorously designed/reported and sufficiently powered trials.
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Affiliation(s)
- Chris Kite
- School of Public Health Studies, Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton WV1 1LY, UK
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry CV1 5FB, UK
| | - Elizabeth Parkes
- Chester Medical School, University of Chester, Shrewsbury SY3 8HQ, UK
| | - Suzan R. Taylor
- Chester Medical School, University of Chester, Shrewsbury SY3 8HQ, UK
| | - Robert W. Davies
- Chester Medical School, University of Chester, Shrewsbury SY3 8HQ, UK
| | - Lukasz Lagojda
- Clinical Evidence Based Information Service (CEBIS), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
| | - James E. Brown
- School of Biosciences, College of Health and Life sciences, Aston University, Birmingham B4 7ET, UK
| | - David R. Broom
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry CV1 5FB, UK
| | - Ioannis Kyrou
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry CV1 5FB, UK
- Aston Medical School, College of Health and Life Sciences, Aston University, Birmingham B4 7ET, UK
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
- Laboratory of Dietetics and Quality of Life, Department of Food Science and Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, 11855 Athens, Greece
| | - Harpal S. Randeva
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
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Buttet M, Bagheri R, Ugbolue UC, Laporte C, Trousselard M, Benson A, Bouillon-Minois JB, Dutheil F. Effect of a lifestyle intervention on telomere length: A systematic review and meta-analysis. Mech Ageing Dev 2022; 206:111694. [PMID: 35760212 DOI: 10.1016/j.mad.2022.111694] [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: 12/22/2021] [Revised: 06/22/2022] [Accepted: 06/22/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND We conducted a systematic review and meta-analysis to assess the effects of lifestyle intervention on telomere length (TL). METHOD Four databases were searched for studies reporting TL in leukocytes, before and after a lifestyle intervention. We computed random-effects meta-analysis on TL within intervention and control group after versus before intervention, and on changes in TL between groups. Sensitivity analyses and Meta-regression were conducted. RESULTS We included 20 studies in the systematic review (2995 participants, mean 50.3 years old, 77% women, 2045 following an intervention and 950 controls) and 19 in the meta-analysis. TL were similar at baseline between intervention and control groups. The physical activity ± diet group had an increase in TL (Effect size 0.17, 95%CI 0.03-0.31, p = 0.020) using changes within the intervention group, whereas TL shortened in the control group (-0.32, -0.61 to -0.02, p = 0.037). TL was longer in the physical activity ± diet intervention group (0.24, 0.08-0.40, p = 0.004) compared to controls after the intervention. Sensitivity analysis gave similar results. Meta-regressions demonstrated that combining strength and endurance exercise increased TL more than endurance alone or strength alone. CONCLUSION A lifestyle intervention with physical activity ± diet can increase telomere length, independently of population characteristics or baseline TL.
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Affiliation(s)
- Marjorie Buttet
- Université Clermont Auvergne, General medicine, F-63000 Clermont-Ferrand, France
| | - Reza Bagheri
- University of Isfahan, Exercise physiology department, Isfahan, Iran
| | - Ukadike C Ugbolue
- University of the West of Scotland, Health and Life Sciences, Institute for Clinical Exercise & Health Science, University of Strathclyde, Glasgow, Scotland, UK
| | - Catherine Laporte
- Université Clermont Auvergne, EA 7280 NPsy-Sydo, General medicine, F-63000 Clermont-Ferrand, France
| | - Marion Trousselard
- French Armed Forces, Biomedical Research Institute, IRBA, Neurophysiology of Stress, Neuroscience and Operational Constraint Department, Brétigny-sur-Orge, France; APEMAC/EPSAM, EA 4360, Ile du Saulcy, 57000 Metz, France
| | - Amanda Benson
- Swinburne University of Technology, Sport Innovation Research Group, Department of Health and Biostatistics, Melbourne, VIC 3122, Australia
| | - Jean-Baptiste Bouillon-Minois
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Emergency medicine, F-63000 Clermont-Ferrand, France.
| | - Frédéric Dutheil
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Occupational and Environmental Medicine, WittyFit, F-63000 Clermont-Ferrand, France
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A Systematic Review of the Effects of Exercise on Hormones in Women with Polycystic Ovary Syndrome. J Funct Morphol Kinesiol 2020; 5:jfmk5020035. [PMID: 33467251 PMCID: PMC7739243 DOI: 10.3390/jfmk5020035] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/26/2020] [Accepted: 05/28/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a common endocrine disorder that is characterized by menstrual irregularity and elevated serum androgens, and is often accompanied by insulin resistance. The etiology of PCOS is unknown. Lifestyle interventions and weight loss, where appropriate, remain first-line treatments for women with PCOS. Regular physical activity is recommended for women with PCOS to maintain a healthy weight and cardiovascular fitness. PURPOSE To review the evidence for the impact of various exercise interventions on hormone levels in women with PCOS. METHODS A systematic review of original studies indexed in PubMed that utilized an exercise intervention in women with PCOS and reported hormone values pre- and post-intervention. Studies in which the effects of the exercise intervention could be determined were included. RESULTS Vigorous aerobic exercise improves insulin measures in women with PCOS. Resistance or strength training may improve androgen levels, though additional studies are warranted. Studies with yoga are limited but suggest improvements in androgens. Limited information is available on the impact of exercise on adipokines and anti-Müllerian hormone, warranting further investigation. CONCLUSIONS Recommended guidelines for women with PCOS include vigorous aerobic exercise and resistance training to improve measures of insulin sensitivity and androgen levels.
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