Absent Exercise-Induced Improvements in Fat Oxidation in Women With Polycystic Ovary Syndrome After High-Intensity Interval Training

Sofie Lionett, Ida Almenning Kiel, Ragnhild Røsbjørgen, Stian Lydersen, Steen Larsen, Trine Moholdt, Sofie Lionett, Ida Almenning Kiel, Ragnhild Røsbjørgen, Stian Lydersen, Steen Larsen, Trine Moholdt

Abstract

Background: Polycystic ovary syndrome (PCOS) and metabolic inflexibility are linked to insulin resistance, and women with PCOS appear to be metabolic inflexible in the rested, insulin-stimulated state. Exercise training is a primary lifestyle intervention in PCOS. Exercise training improves whole-body fat oxidation during submaximal exercise in healthy women, yet little is known about the effect on this outcome in women with PCOS. Methods: We measured whole-body fat oxidation rates during sub maximal exercise before and after 16 weeks of high-intensity interval training (HIT) in women with PCOS randomly allocated to either: low- or high-volume HIT (n = 41; low-volume HIT, 10 × 1 min work bouts at maximal, sustainable intensity and high-volume HIT, 4 × 4 min work bouts at 90-95% of maximal heart rate) or non-exercise control (n = 23), and in women without PCOS (Non-PCOS) allocated to low- or high volume HIT (n = 15). HIT was undertaken three times weekly. In a subset of women with and without PCOS, we measured mitochondrial respiration in abdominal and gluteal subcutaneous adipose tissue using high-resolution respirometry, as well as fat cell sizes in these tissues. Results: At baseline, women with PCOS had lower whole-body fat oxidation and mitochondrial respiration rates in abdominal adipose tissue compared to Non-PCOS. Peak oxygen uptake (mL/min/kg) increased in women with PCOS (~4%, p = 0.006) and Non-PCOS (~6%, p = 0.003) after 16 weeks of HIT. Whole-body fat oxidation only improved in Non-PCOS after HIT. No changes were observed in mitochondrial respiration and cell size in abdominal and gluteal adipose tissue after HIT in either group of women. Conclusion: We observed exercise-induced improvements in whole-body fat oxidation during submaximal exercise in Non-PCOS, but not in women with PCOS, after 16 weeks of HIT, suggesting metabolic inflexibility in women with PCOS. Clinical Trial Registration: www.clinicaltrials.gov, identifier NCT02419482 and NCT02943291.

Keywords: adipose tissue; cardiorespiratory fitness; cell size; endocrinology; exercise; insulin resistance; metabolic flexibility; mitochondrial respiration.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2021 Lionett, Kiel, Røsbjørgen, Lydersen, Larsen and Moholdt.

Figures

Figure 1
Figure 1
Study protocol. The testing days included: abdominal and gluteal subcutaneous adipose tissue biopsies, fasting blood sampling, VO2peak, submaximal exercise test to measure fat oxidation rates, body composition measures, and waist and hip circumference. The adipose tissue was used to measure mitochondrial respiration and cell size. The testing days were repeated after a 16 weeks intervention period of either performing high-intensity interval training or no exercise. PCOS, Polycystic ovary syndrome; Non-Ex, no exercise; HIT, high-intensity interval training; LV-HIT, low-volume high-intensity interval training; HV-HIT, high-volume high-intensity interval training; VO2peak, peak oxygen uptake. Created with BioRender.com.
Figure 2
Figure 2
Comparisons between women with PCOS and non-PCOS women at baseline. Whole-body fat oxidation during submaximal exercise (A,B), oxygen flux with complex I + II linked substrates in subcutaneous abdominal (C) and gluteal adipose tissue (D), and abdominal (E) and gluteal (F) adipose tissue cell size in non-PCOS (blue bars) and women with PCOS (black bars). The bars and error bars represent estimated means and SE based on linear mixed models.
Figure 3
Figure 3
Effects of 16 weeks of non-exercise or high-intensity interval training. Whole-body fat oxidation during submaximal exercise (A,B), oxygen flux with complex I + II linked substrates in subcutaneous abdominal (C) and gluteal adipose tissue (D), and abdominal (E) and gluteal (F) adipose tissue cell size in Non-PCOS HIT (blue bars), PCOS Non-Ex (gray bars), and PCOS HIT (red bars) after the 16 weeks intervention. The bars and error bars represent estimated means and SE based on linear mixed models. P-values are for within-group comparisons after 16 weeks of high-intensity interval training.

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