Woodward, Amie ORCID: https://orcid.org/0000-0002-9579-4012, Broom, David, Dalton, Caroline, Metwally, Mostafa and Klonizakis, Markos (2022) Supervised Aerobic Exercise Training and Increased Lifestyle Physical Activity to Reduce Cardiovascular Disease Risk for Women With Polycystic Ovary Syndrome: A Randomized Controlled Feasibility Trial. Journal of Physical Activity and Health, 19 (6). pp. 436-445.

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Abstract

Polycystic ovary syndrome (PCOS) is a complex, heterogeneous endocrinopathy affecting reproductive, cardiovascular, and metabolic health in up to 20% of women of reproductive age.1 According to the Rotterdam criteria, there are 3 key clinical signs/symptoms: (1) clinical/biochemical hyperandrogenism, (2) chronic anovulation/oligomenorrhea, and (3) polycystic ovaries.2 Women must present with 2 out of the 3 symptoms to receive a diagnosis. PCOS affects fertility and is characterized by various cardiovascular disease (CVD) risk factors including dyslipidemia, insulin resistance, abdominal obesity, and chronic low-grade inflammation.3,4 In addition, PCOS is associated with psychological distress and increased rates of mental health conditions.1

Meta-analyses have indicated that exercise interventions of 12 to 24 weeks in duration are effective in mitigating CVD risk factors.5,6 However, research has also highlighted the distinct deleterious effects of sedentary behavior on cardiometabolic health.7–9 This illuminates the importance of moving more often throughout the day, even when one is engaged in regular structured exercise. However, to the authors’ knowledge, no studies have been conducted to investigate the effect of increasing lifestyle physical activity (PA) and reducing sedentary behaviors in women with PCOS. This may present a novel therapeutic target to improve CVD risk in women with PCOS because it presents an alternate approach to the conventional supervised exercise intervention. This may be effective for those with less time or accessibility to interventions and reduces the burden on participants.

In addition, oxidized low-density lipoprotein (oxLDL) plays a key role in the development of atherosclerosis and is an independent risk factor for CVD.10,11 OxLDL is associated with abdominal obesity and a high total cholesterol:high-density lipoprotein (TC:HDL) ratio. These CVD risk factors are often present in women with PCOS.3,4 Despite this, to our knowledge, only 3 studies have examined the role of oxLDL in CVD in women with PCOS, and none included an exercise intervention.12–14

Before an adequately powered randomized controlled trial (RCT) measuring the efficacy of exercise and/or increased lifestyle PA on such indicators of cardiovascular health can be designed and implemented, the feasibility and acceptability of the interventions and procedures for recruitment, allocation, and outcome measurements must be assessed. In addition, the interventions must be refined, and a sample size must be calculated. Indeed, intervention studies can be undermined by unexpected, but ultimately preventable, issues in study design, conduct, and analysis.15 Thus, the Medical Research Council recommend that interventions are developed systematically, utilizing a phased approach that incorporates feasibility testing.16

Therefore, the aim of the present study was to assess the feasibility of conducting a RCT of exercise training and increased PA in women with PCOS.

Item Type:	Article
Status:	Published
DOI:	10.1123/jpah.2022-0103
Subjects:	R Medicine > RC Internal medicine > RC1200 Sports Medicine
School/Department:	School of Science, Technology and Health
Institutes:	Institute for Health and Care Improvement
URI:	https://ray.yorksj.ac.uk/id/eprint/8850

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