Dynamic Change in Insulin Resistance Induced by Free Fatty Acids Is Unchanged Though Insulin Sensitivity Improves Following Endurance Exercise in PCOS

Insulin resistance (IR) is the hallmark of PCOS and it is known that exercise may decrease it. What is unknown is whether exercise may mechanistically alter the underlying IR, attenuating the dynamic lipid induced IR in insulin resistant subjects. 12 women with polycystic ovary syndrome (PCOS) and 1...

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Published inFrontiers in endocrinology (Lausanne) Vol. 9; p. 592
Main Authors Aye, Myint Myint, Butler, Alexandra E, Kilpatrick, Eric S, Kirk, Richard, Vince, Rebecca, Rigby, Alan S, Sandeman, Derek, Atkin, Stephen L
Format Journal Article
LanguageEnglish
Published Switzerland Frontiers Media S.A 05.10.2018
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Abstract Insulin resistance (IR) is the hallmark of PCOS and it is known that exercise may decrease it. What is unknown is whether exercise may mechanistically alter the underlying IR, attenuating the dynamic lipid induced IR in insulin resistant subjects. 12 women with polycystic ovary syndrome (PCOS) and 10 age and body mass index matched controls completed an 8 week supervised exercise program at 60% maximal oxygen consumption. Before and after the exercise program, all participants underwent hyperinsulinaemic euglycaemic clamps with either saline or intralipid infusions. Skewed data were log transformed and expressed as mean ± SEM. Before exercise, women with PCOS had a higher HOMA-IR and lower VO max than controls. Compared to saline, lipid infusion lowered the rate of insulin stimulated glucose disposal (M value; mg/kg/min) by 67 ± 5% (from 0.5 ± 0.03 to -0.25 ± 0.2, = 0.01) in PCOS, and by 49 ± 7% (from 0.65 ± 0.06 to 0.3 ± 0.1, = 0.01) in controls. The M value was significantly less in PCOS compared to controls for both saline ( < 0.01) and lipid ( < 0.05). Endurance exercise in PCOS improved VO max and HOMA-IR, but not weight, to those of pre-exercise control subjects. The glucose disposal rate during the lipid infusion was reduced following exercise in PCOS, indicating decreased IR (67 ± 5 vs. 50 ± 7%, = 0.02), but IR was not altered in controls (49 ± 7 vs. 45 ± 6%, = 0.58). The incrementally increased IR induced by the lipid infusion did not differ between controls and PCOS. Insulin sensitivity improved with exercise in the PCOS group alone showing that IR can be modified, though likely transiently. However, the maximal IR response to the lipid infusion did not differ within and between control and PCOS subjects, indicating that the fundamental mechanism underlying insulin resistance was unchanged with exercise. Maximal insulin resistance induced by lipid infusion determined at baseline and 8 weeks after exercise in control and PCOS women did not differ, though insulin sensitivity increased in PCOS after exercise.
AbstractList Background: Insulin resistance (IR) is the hallmark of PCOS and it is known that exercise may decrease it. What is unknown is whether exercise may mechanistically alter the underlying IR, attenuating the dynamic lipid induced IR in insulin resistant subjects. Methods: 12 women with polycystic ovary syndrome (PCOS) and 10 age and body mass index matched controls completed an 8 week supervised exercise program at 60% maximal oxygen consumption. Before and after the exercise program, all participants underwent hyperinsulinaemic euglycaemic clamps with either saline or intralipid infusions. Skewed data were log transformed and expressed as mean ± SEM. Results: Before exercise, women with PCOS had a higher HOMA-IR and lower VO 2 max than controls. Compared to saline, lipid infusion lowered the rate of insulin stimulated glucose disposal (M value; mg/kg/min) by 67 ± 5% (from 0.5 ± 0.03 to −0.25 ± 0.2, p = 0.01) in PCOS, and by 49 ± 7% (from 0.65 ± 0.06 to 0.3 ± 0.1, p = 0.01) in controls. The M value was significantly less in PCOS compared to controls for both saline ( p < 0.01) and lipid ( p < 0.05). Endurance exercise in PCOS improved VO 2 max and HOMA-IR, but not weight, to those of pre-exercise control subjects. The glucose disposal rate during the lipid infusion was reduced following exercise in PCOS, indicating decreased IR (67 ± 5 vs. 50 ± 7%, p = 0.02), but IR was not altered in controls (49 ± 7 vs. 45 ± 6%, p = 0.58). The incrementally increased IR induced by the lipid infusion did not differ between controls and PCOS. Conclusion: Insulin sensitivity improved with exercise in the PCOS group alone showing that IR can be modified, though likely transiently. However, the maximal IR response to the lipid infusion did not differ within and between control and PCOS subjects, indicating that the fundamental mechanism underlying insulin resistance was unchanged with exercise. Precis: Maximal insulin resistance induced by lipid infusion determined at baseline and 8 weeks after exercise in control and PCOS women did not differ, though insulin sensitivity increased in PCOS after exercise.
Background: Insulin resistance (IR) is the hallmark of PCOS and it is known that exercise may decrease it. What is unknown is whether exercise may mechanistically alter the underlying IR, attenuating the dynamic lipid induced IR in insulin resistant subjects. Methods: 12 women with polycystic ovary syndrome (PCOS) and 10 age and body mass index matched controls completed an 8 week supervised exercise program at 60% maximal oxygen consumption. Before and after the exercise program, all participants underwent hyperinsulinaemic euglycaemic clamps with either saline or intralipid infusions. Skewed data were log transformed and expressed as mean ± SEM. Results: Before exercise, women with PCOS had a higher HOMA-IR and lower VO2 max than controls. Compared to saline, lipid infusion lowered the rate of insulin stimulated glucose disposal (M value; mg/kg/min) by 67 ± 5% (from 0.5 ± 0.03 to -0.25 ± 0.2, p = 0.01) in PCOS, and by 49 ± 7% (from 0.65 ± 0.06 to 0.3 ± 0.1, p = 0.01) in controls. The M value was significantly less in PCOS compared to controls for both saline (p &lt; 0.01) and lipid (p &lt; 0.05). Endurance exercise in PCOS improved VO2 max and HOMA-IR, but not weight, to those of pre-exercise control subjects. The glucose disposal rate during the lipid infusion was reduced following exercise in PCOS, indicating decreased IR (67 ± 5 vs. 50 ± 7%, p = 0.02), but IR was not altered in controls (49 ± 7 vs. 45 ± 6%, p = 0.58). The incrementally increased IR induced by the lipid infusion did not differ between controls and PCOS. Conclusion: Insulin sensitivity improved with exercise in the PCOS group alone showing that IR can be modified, though likely transiently. However, the maximal IR response to the lipid infusion did not differ within and between control and PCOS subjects, indicating that the fundamental mechanism underlying insulin resistance was unchanged with exercise. Precis: Maximal insulin resistance induced by lipid infusion determined at baseline and 8 weeks after exercise in control and PCOS women did not differ, though insulin sensitivity increased in PCOS after exercise.
Background: Insulin resistance (IR) is the hallmark of PCOS and it is known that exercise may decrease it. What is unknown is whether exercise may mechanistically alter the underlying IR, attenuating the dynamic lipid induced IR in insulin resistant subjects.Methods: 12 women with polycystic ovary syndrome (PCOS) and 10 age and body mass index matched controls completed an 8 week supervised exercise program at 60% maximal oxygen consumption. Before and after the exercise program, all participants underwent hyperinsulinaemic euglycaemic clamps with either saline or intralipid infusions. Skewed data were log transformed and expressed as mean ± SEM.Results: Before exercise, women with PCOS had a higher HOMA-IR and lower VO2 max than controls. Compared to saline, lipid infusion lowered the rate of insulin stimulated glucose disposal (M value; mg/kg/min) by 67 ± 5% (from 0.5 ± 0.03 to −0.25 ± 0.2, p = 0.01) in PCOS, and by 49 ± 7% (from 0.65 ± 0.06 to 0.3 ± 0.1, p = 0.01) in controls. The M value was significantly less in PCOS compared to controls for both saline (p < 0.01) and lipid (p < 0.05). Endurance exercise in PCOS improved VO2 max and HOMA-IR, but not weight, to those of pre-exercise control subjects. The glucose disposal rate during the lipid infusion was reduced following exercise in PCOS, indicating decreased IR (67 ± 5 vs. 50 ± 7%, p = 0.02), but IR was not altered in controls (49 ± 7 vs. 45 ± 6%, p = 0.58). The incrementally increased IR induced by the lipid infusion did not differ between controls and PCOS.Conclusion: Insulin sensitivity improved with exercise in the PCOS group alone showing that IR can be modified, though likely transiently. However, the maximal IR response to the lipid infusion did not differ within and between control and PCOS subjects, indicating that the fundamental mechanism underlying insulin resistance was unchanged with exercise.Precis: Maximal insulin resistance induced by lipid infusion determined at baseline and 8 weeks after exercise in control and PCOS women did not differ, though insulin sensitivity increased in PCOS after exercise.
Insulin resistance (IR) is the hallmark of PCOS and it is known that exercise may decrease it. What is unknown is whether exercise may mechanistically alter the underlying IR, attenuating the dynamic lipid induced IR in insulin resistant subjects. 12 women with polycystic ovary syndrome (PCOS) and 10 age and body mass index matched controls completed an 8 week supervised exercise program at 60% maximal oxygen consumption. Before and after the exercise program, all participants underwent hyperinsulinaemic euglycaemic clamps with either saline or intralipid infusions. Skewed data were log transformed and expressed as mean ± SEM. Before exercise, women with PCOS had a higher HOMA-IR and lower VO max than controls. Compared to saline, lipid infusion lowered the rate of insulin stimulated glucose disposal (M value; mg/kg/min) by 67 ± 5% (from 0.5 ± 0.03 to -0.25 ± 0.2, = 0.01) in PCOS, and by 49 ± 7% (from 0.65 ± 0.06 to 0.3 ± 0.1, = 0.01) in controls. The M value was significantly less in PCOS compared to controls for both saline ( < 0.01) and lipid ( < 0.05). Endurance exercise in PCOS improved VO max and HOMA-IR, but not weight, to those of pre-exercise control subjects. The glucose disposal rate during the lipid infusion was reduced following exercise in PCOS, indicating decreased IR (67 ± 5 vs. 50 ± 7%, = 0.02), but IR was not altered in controls (49 ± 7 vs. 45 ± 6%, = 0.58). The incrementally increased IR induced by the lipid infusion did not differ between controls and PCOS. Insulin sensitivity improved with exercise in the PCOS group alone showing that IR can be modified, though likely transiently. However, the maximal IR response to the lipid infusion did not differ within and between control and PCOS subjects, indicating that the fundamental mechanism underlying insulin resistance was unchanged with exercise. Maximal insulin resistance induced by lipid infusion determined at baseline and 8 weeks after exercise in control and PCOS women did not differ, though insulin sensitivity increased in PCOS after exercise.
Author Rigby, Alan S
Sandeman, Derek
Kilpatrick, Eric S
Aye, Myint Myint
Butler, Alexandra E
Kirk, Richard
Atkin, Stephen L
Vince, Rebecca
AuthorAffiliation 3 Sidra Medical Research Centre , Doha , Qatar
5 The University of Hull, Hull York Medical School , Hull , United Kingdom
7 Weill Cornell Medicine Qatar, Education City , Doha , Qatar
1 Department of Academic Endocrinology, Diabetes and Metabolism, Hull York Medical School , Hull , United Kingdom
6 Department of Diabetes and Endocrinology, University Hospital Southampton NHS Foundation Trust , Southampton , United Kingdom
2 Diabetes Research Centre, Qatar Biomedical Research Institute , Doha , Qatar
4 Department of Sport, Health and Exercise Science, Hull York Medical School, The University of Hull , Hull , United Kingdom
AuthorAffiliation_xml – name: 3 Sidra Medical Research Centre , Doha , Qatar
– name: 1 Department of Academic Endocrinology, Diabetes and Metabolism, Hull York Medical School , Hull , United Kingdom
– name: 2 Diabetes Research Centre, Qatar Biomedical Research Institute , Doha , Qatar
– name: 4 Department of Sport, Health and Exercise Science, Hull York Medical School, The University of Hull , Hull , United Kingdom
– name: 5 The University of Hull, Hull York Medical School , Hull , United Kingdom
– name: 6 Department of Diabetes and Endocrinology, University Hospital Southampton NHS Foundation Trust , Southampton , United Kingdom
– name: 7 Weill Cornell Medicine Qatar, Education City , Doha , Qatar
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  givenname: Myint Myint
  surname: Aye
  fullname: Aye, Myint Myint
  organization: Department of Academic Endocrinology, Diabetes and Metabolism, Hull York Medical School, Hull, United Kingdom
– sequence: 2
  givenname: Alexandra E
  surname: Butler
  fullname: Butler, Alexandra E
  organization: Diabetes Research Centre, Qatar Biomedical Research Institute, Doha, Qatar
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  givenname: Eric S
  surname: Kilpatrick
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  organization: Department of Sport, Health and Exercise Science, Hull York Medical School, The University of Hull, Hull, United Kingdom
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  givenname: Rebecca
  surname: Vince
  fullname: Vince, Rebecca
  organization: Department of Sport, Health and Exercise Science, Hull York Medical School, The University of Hull, Hull, United Kingdom
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  organization: Department of Diabetes and Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
– sequence: 8
  givenname: Stephen L
  surname: Atkin
  fullname: Atkin, Stephen L
  organization: Weill Cornell Medicine Qatar, Education City, Doha, Qatar
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Keywords insulin sensitivity
PCOS
endurance exercise
insulin resistance
intralipid
Language English
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Edited by: Åke Sjöholm, Gävle Hospital, Sweden
Reviewed by: Nigel Keith Stepto, Victoria University, Australia, Australia; Geogios K. Dimitriadis, University of Warwick, United Kingdom; Sarantis Livadas, Metropolitan Hospital, Greece
This article was submitted to Diabetes, a section of the journal Frontiers in Endocrinology
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Snippet Insulin resistance (IR) is the hallmark of PCOS and it is known that exercise may decrease it. What is unknown is whether exercise may mechanistically alter...
Background: Insulin resistance (IR) is the hallmark of PCOS and it is known that exercise may decrease it. What is unknown is whether exercise may...
Background: Insulin resistance (IR) is the hallmark of PCOS and it is known that exercise may decrease it. What is unknown is whether exercise may...
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SubjectTerms Endocrinology
endurance exercise
insulin resistance
insulin sensitivity
intralipid
PCOS
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Title Dynamic Change in Insulin Resistance Induced by Free Fatty Acids Is Unchanged Though Insulin Sensitivity Improves Following Endurance Exercise in PCOS
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