Work package 1: The study of women with polycystic ovary syndrome (PCOS) – University of Copenhagen

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Work package 1

The study of women with polycystic ovary syndrome (PCOS)

Work package-leader: Bente Kiens

Work package 1 will evaluate the effects of physical activity on health (physical, mental as well as social well-bring) in lean women (age 20-35y) with PCOS.

The physiological focus will be on changes in insulin sensitivity and understanding of the underlying molecular events leading to impaired insulin action in these women.

By follow-up studies of these women we will furthermore investigate if participation in closely controlled training and diet studies will result in life style changes after the interventions.

BackgroundTil toppen

A common condition affecting women is the polycystic ovary syndrome (PCOS) (Moran et al 2011). PCOS is associated with reproductive disorders (e.g. menstrual irregularity, infertility, and increased pregnancy complications), psychological disturbances like impaired quality of life, increased anxiety and depression. Moreover, PCOS is associated with increased risk of type 2 diabetes and cardiovascular disease (Goodarzi et al, 2011, Rofey et al 2009, Himelein et al, 1999). The odds of metabolic disturbances are 2-4 times as high for women with PCOS compared with controls. Obesity worsens the symptoms of PCOS and weight management is proposed as an initial treatment strategy. However, ~10% of lean women have PCOS and therefore other strategies than weight loss must be considered. It is still unsolved whether and how lifestyle changes (exercise and diet) affect the different abnormalities in lean women with PCOS (Moran et al 2011). Insulin resistance is proposed as a key pathophysiological feature of PCOS contributing to both the metabolic and reproductive disturbances and 50-70% of women with PCOS have insulin resistance beyond that predicted by their body mass index (BMI) (Goodarzi et al, 2011). The molecular mechanisms of insulin resistance in PCOS are not well described but our preliminary data suggest an association between abnormalities in lipid metabolism and insulin resistance in lean women with PCOS. Furthermore, the metabolic abnormalities are likely related to the increased levels of androgen hormones found in these patients.

Til toppen Overall aim

The aim of the project is to elucidate the effects of physical activity on health (physical, mental as well as social well-bring) in lean women with PCOS.

Hypotheses

  • Physical activity will improve lipid turnover, hormonal abnormalities and ameliorate insulin resistance in lean patients with PCOS.
  • Physical activity will improve health (physical, mental as well as social well-bring) and improve adherence to a more healthy lifestyle in lean patients with PCOS.

Til toppen Design

Thirty lean, untrained, premenopausal women with PCOS (age: 20-35 yrs, BMI: 19-25) will be randomized into two groups: one group serves as controls and one group follows a controlled, supervised training regime for 4 month. In addition, 15 lean, age-matched women without PCOS and of similar fitness status as the PCOS serve as controls and are allocated to the supervised training program. After the intervention period the PCOS will be followed for 1 year in order to evaluate their lifestyle changes. The exercise program will consist of varied types of physical activity combining endurance training, high intensity interval training and strength training 3 times/week. The diet will be well controlled and evaluated in terms of dietary eating pattern, energy balance and diet composition. Before, during (2 month) and after (4 and 15 month) the intervention period, the subjects will undergo basic physiological, psychological and sociological evaluations allowing for comparison of women between the different work packages. Of in depth analyses in this work package, insulin sensitivity will be measured by the euglycemic clamp technique, blood will be collected and biopsies will be obtained from skeletal muscle and adipose tissue. Molecular signaling mechanisms will be studied by the use of appropriate laboratory methods, which all are established in the laboratory of the researchers and are further developed in WP5. Furthermore, qualitative studies (e.g. interviews and observations) will be conducted in subpopulations to gain psychological and sociological insight in the background and intervention responses in these women.


ReferencesTil toppen

Goodarzi, M-O., Domesic, D.A., Chazenbalk,G. and Azziz R. (2011) Polycystic ovary syndrome: Etiology, pathogenesis and diagnosis. Nat Rev Endocrinol 7, 219-231.

Himelein M.J., Thatcher S.S. (1999). Polycystisk ovary syndrome and mental health. Obsteric. Gynecologic Survey. 61, 723-732.

Moran, L.J., Hutchison,S.K., Norman, R.J. and Teede, H.J. (2011). Cochrane Database Syst Rev. 2011 Jul 6;(7)

Rofey, D. L., Szigethy, E. M., Noll, R. B., Dahl, R. E., lobst, E. and Arslanian, S. A. (2009). Cognitive-Behavioral Therapy for Physical and Emotional Disturbances in Adolescents with Polycystic Ovary Syndrome: A Pilot Study. J. Pediatr. Psychol. 34, 156-163.


Time ScheduleTil toppen

Spring 2013
  • Finalisation of detailed scientific project plan
  • Application for Ethical approval
  • Recruitment of subjects
Spring 2014
  • First part of Intervention study (group 1)
  • Recruitment of subjects
Autumn 2014
  • Intervention study continued (group 2)
  • Follow up on intervention group 1
  • Recruitment of subjects
Spring 2015
  • Intervention study continued (group 3+4)
  • Follow up on intervention group 2
  • Recruitment of subjects
Autumn 2015
  • Intervention study continued group 5
  • Follow up on intervention group 3+4
  • Analysis of samples and data
Spring 2016
  • Follow up on intervention group 5
  • Analysis of samples and data

Researchers

Til toppen Researchers, work package 1