Insulin Resistance and Polycystic Ovary Syndrome

描述（由申请人提供）： 本职业发展提案详细说明了主要研究者获得作为临床研究者独立职业所需培训和经验的计划。通过进行拟议的研究，PI将开发技能，使她能够研究运动对多囊卵巢综合征（PCOS）胰岛素抵抗的影响，这将与许多职业道路相关。 PCOS是一种常见的疾病，影响多达10%的年轻女性。临床上以多毛症和少经/闭经为特征。 最近的研究表明，在这一人群中存在显著的胰岛素抵抗，这表明长期并发症如糖尿病和心血管疾病的重要易感性。发病早和受影响人口多为利用生活方式改变的积极影响预防疾病创造了一个强大的机会。然而，与PCOS相关的多毛症和肥胖可能会造成心理障碍。出于这个原因，有效的管理可能需要一个量身定制的方法，考虑到社会心理问题以及代谢概况。 体力活动是这一群体的理想干预措施。运动可以降低胰岛素抵抗，改善心血管健康，增强幸福感。然而，运动的类型，持续时间和强度，将最佳地降低胰岛素抵抗，并且耐受性良好，尚未建立。本研究旨在通过回答以下有关PCOS女性的问题来解决这些问题：1.在一项随机对照临床试验中，12周的中等强度运动监测计划，没有体重减轻，显着改善胰岛素敏感性，通过静脉葡萄糖耐量试验测量？运动对胰岛素敏感性的急性效应与慢性效应的相对大小是多少？2.减少胰岛素抵抗的运动是否也会降低雄激素水平？ 3.运动是否能改善身体形象、生活质量、压力和抑郁的指标？

DESCRIPTION (provided by applicant): This career development proposal details a plan for the Principal Investigator to obtain the training and experience necessary to develop an independent career as a clinical investigator. By conducting the proposed study, the PI will develop skills that will enable her to study the effects of exercise on insulin resistance in polycystic ovary syndrome (PCOS), and that will be relevant to many career pathways. PCOS is a common disorder affecting up to 10% of young women. It is characterized clinically by hirsutism and oligo/amenorrhea. Recent studies have documented significant insulin resistance in this population suggesting an important predisposition to long-term complications such as diabetes and cardiovascular disease. The early onset and large affected population create a powerful opportunity to harness the positive effects of lifestyle changes for purposes of disease prevention. However, the hirsutism and obesity associated with PCOS may create psychological barriers to change. For this reason, effective management may require a tailored approach that takes into account psychosocial issues as well as metabolic profile. Physical activity is an ideal intervention for this group. Exercise reduces insulin resistance, improves cardiovascular health and enhances sense of wellbeing. However, the type, duration and intensity of exercise that will optimally reduce insulin resistance, and that is well tolerated, has not been established. This study is meant to address these issues by answering the following questions about women with PCOS: 1. In a randomized controlled clinical trial, does a 12 week program of monitored exercise of moderate intensity, without weight loss, significantly improve insulin sensitivity as measured by an intravenous glucose tolerance test? What is the relative magnitude of the acute effect compared to the chronic effect of exercise on insulin sensitivity? 2. Does exercise that reduces insulin resistance also decrease androgen levels? 3. Does exercise improve indicators of perceived body image, quality of life, stress and depression?