Journal of Clinical and Diagnostic Research. 2019 Aug, Vol-13(8): CC01-CC04 1 1 DOI: 10.7860/JCDR/2019/41201.13066 Original Article Physiology Section The Effect of a 16-week Home-based Aerobic Exercise Program on Serum High-sensitivity C-Reactive Protein (Hs-CRP) and Insulin Resistance in Polycystic Ovary Syndrome INTRODUCTION PCOS is the most common endocrine disorder at reproductive age (20 to 40 years of age) which affects about 10% of females [1]. PCOS prevalence has been estimated as 15.2% among Iranian women [2]. This condition, which is also called Stein-Leventhal syndrome after gynaecologists Stein and Leventhal who described the condition in 1935, is manifested by appearance of poly-cystic ovaries on ultrasound and on the other side, it is manifested by obesity, hyperandrogenism, menstrual abnormalities, and infertility [2]. Metabolic disorders including increased levels of Lutein Hormone (LH), testosterone and insulin is common in PCOS and affect health status of these patients in long-term [3]. At one end, morphological characteristics of PCOS is seen on ultrasound examination including more than 9 mm increase in ovarian size, existence of 10 or more 2-8 mm cysts in one surface, and increased stromal density. At the other side, clinical symptoms such as oligomenorrhea, hirsutism, anovulation or low ovulation and laboratory findings such as increased serum androgens, impaired glucose tolerance test and dyslipidemia are seen. PCOS is a form of ovarian hyperandrogenism. This hyperandrogenism appears during puberty but in fact, stems in childhood and even in fetal period and is due to dysregulation of androgen production by thecal cells [2,4]. The symptoms of PCOS include ovarian dysfunction, multi-cystic ovaries, biochemical hyperandrogenism, and/or clinical symptoms (hirsutism and acne). Women who suffer from this disease show metabolic abnormalities such as insulin resistance, obesity, dyslipidemia and are at risk of developing cardiovascular and Type 2 Diabetes mellitus (T2DM) as well [3]. The insulin resistance mechanism in PCOS is not known clearly; however, mild chronic inflammation has been suggested as one of the possible aetiologies [5]. Mild chronic inflammation is associated with higher than normal levels of some cytokines including Tumour Necrosis Factor-alpha (TNF-α), Interleukin-6 (IL-6), and High-Sensitivity C-Reactive Protein (Hs-CRP) [6]. Evidence shows that inflammatory biomarkers are increased in PCOS patients and there is a close association between the inflammatory markers and infertility as well as metabolic and cardiovascular complications. This shows that the process of inflammation plays an important role in insulin resistance pathogenesis in PCOS patients [7]. On the other hand, studies show that an average weight loss through limiting calorie intake is associated with improving health factors in PCOS [8]. Nevertheless, despite the well-known advantages of physical exercises in the general population, limited studies have been performed in PCOS. Based on the limited reports, it appears that physical exercise improves body preparatory status, physical preparation, fasting insulin, menstrual cycles and ovulation [9-13]. Notwithstanding, in this limited studies, the mechanism of such beneficial effects of training in PCOS patients is not clear. Most previously conducted studies focused on the effect of exercise on factors such as lipid profile and blood pressure and few studies assessed the effect of exercise on inflammation [14]. Thus, in view of the role attributed to inflammation in PCOS pathogenesis and the results of the previous studies, further studies are required to investigate the efficacy of exercise on inflammatory markers in these patients. The objective of the current study was to study the effects of a 16-week home-based aerobic exercise program on serum hs- CRP level and insulin resistance among PCOS patients. MATERIALS AND METHODS This quasi-experimental study was performed at Imam Reza Hospital, which is a University Hospital affiliated to Kermanshah NAHID MOHAMMADI JAVID 1 , NASER BEHPOUR 2 , VAHID TADIBI 3 Keywords: Exercise, Inflammation, Polycystic ovarian syndrome ABSTRACT Introduction: Polycystic Ovarian Syndrome (PCOS) is one of the most common hormonal disorders that affect 10 to 15% of women of reproductive age. Women with PCOS are at risk for complications such as pregnancy poor outcomes, insulin resistance, Type 2 Diabetes Mellitus (T2DM), metabolic syndrome, cardiovascular diseases and some malignant conditions where increase in serum C-reactive protein (CRP) level is known to be a marker. Aim: To investigate the effect of a 16-week home-based aerobic exercise program on high-sensitivity CRP (hs-CRP) and insulin resistance index in females with PCOS. Materials and Methods: In this quasi-experimental study, 24 female patients with PCOS were included and were divided into experimental (a home-based aerobic exercise program for 16 weeks) group (12 subjects) and control group (no intervention, 12 subjects). Serum hs-CRP and insulin resistance index (HOMA-IR) were measured and compared between the two groups. The paired t-test was used to compare the variables at baseline and after 16-weeks. Results: Mean (±SD) hs-CRP level in experimental group at baseline was 6.31 (±2.64) mg/L which decreased to 3.91 (±1.59) mg/L (p=0.004). Mean (±SD) HOMA-IR in the experimental group at baseline was 3.24 (±1.3) which decreased to 1.87 (±0.47) after 16-weeks. However, no significant change in hs-CRP or HOMA-IR was seen in control group. Conclusion: The home-based aerobic exercise program had a beneficial effect on improving insulin sensitivity (decrease in HOMA-IR) and reduction in hs-CRP in women with PCOS. This exercise could be recommended as a safe treatment for these patients.