Insulin Resistance and Polycystic Ovary Syndrome

描述(由申请人提供)： 这份职业发展建议详细说明了首席调查员获得必要的培训和经验以发展作为临床调查员的独立职业生涯的计划。通过进行拟议的研究，PI将发展技能，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。 多囊卵巢综合征是一种常见的疾病，影响高达10%的年轻女性。它的临床特征是多毛症和少/闭经。最近的研究证明，在这一人群中存在显著的胰岛素抵抗，这表明这是糖尿病和心血管疾病等长期并发症的重要易感性。发病较早且受影响较大的人群创造了一个强大的机会，可以利用生活方式变化的积极影响预防疾病。然而，与多囊卵巢综合征相关的多毛症和肥胖症可能会给改变带来心理障碍。出于这个原因，有效的管理可能需要一种量身定制的方法，考虑到心理社会问题以及新陈代谢特征。 对于这一群体来说，体育锻炼是一种理想的干预方式。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，哪种类型、持续时间和强度的运动可以最佳地降低胰岛素抵抗，而且耐受性很好，目前还没有确定。这项研究旨在通过回答以下关于多囊卵巢综合征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，在没有体重减轻的情况下，12周的中等强度运动监测计划是否显著改善了静脉葡萄糖耐量试验所测量的胰岛素敏感性？与运动对胰岛素敏感性的慢性影响相比，急性影响的相对幅度是多少？2.减少胰岛素抵抗的运动是否也会降低雄激素水平？ 3.锻炼是否能改善人们对身体形象、生活质量、压力和抑郁的认知指标？

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?