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?

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
1K23HL004390-01A2
Application #
6541507
Study Section
Special Emphasis Panel (ZHL1-CSR-F (M2))
Program Officer
Loria, Catherine
Project Start
2002-09-15
Project End
2007-07-31
Budget Start
2002-09-15
Budget End
2003-07-31
Support Year
1
Fiscal Year
2002
Total Cost
$121,450
Indirect Cost
Name
Duke University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
071723621
City
Durham
State
NC
Country
United States
Zip Code
27705
Brown, Ann J; Setji, Tracy L; Sanders, Linda L et al. (2009) Effects of exercise on lipoprotein particles in women with polycystic ovary syndrome. Med Sci Sports Exerc 41:497-504
Setji, T L; Brown, A J (2007) Comprehensive clinical management of polycystic ovary syndrome. Minerva Med 98:175-89
Setji, Tracy L; Brown, Ann J (2007) Polycystic ovary syndrome: diagnosis and treatment. Am J Med 120:128-32
Setji, Tracy L; Holland, Nicole D; Sanders, Linda L et al. (2006) Nonalcoholic steatohepatitis and nonalcoholic Fatty liver disease in young women with polycystic ovary syndrome. J Clin Endocrinol Metab 91:1741-7
Brown, Ann J (2004) Depression and insulin resistance: applications to polycystic ovary syndrome. Clin Obstet Gynecol 47:592-6