Effects of acupuncture and exercise on insulin sensitivity, adipose tissue characteristics, and markers of coagulation and fibrinolysis in women with polycystic ovary syndrome: secondary analyses of a randomized controlled trial

Capsule:
We studied the effect of acupuncture and exercise on hemostatic factors, insulin sensitivity, and adipose tissue characteristics in PCOS. Acupuncture counteracted a possible prothrombotic state in women with PCOS as reflected by decreased plasminogen activator inhibitor activity.

Authors:
Elisabet Stener-Victorin, Ph.D., Fariba Baghaei, Ph.D., M.D., Göran Holm, Ph.D., M.D., Per Olof Janson, Ph.D., M.D., Gunilla Olivecrona, Ph.D., Malin Lönn, Ph.D., Louise Mannerås-Holm, Ph.D.
Volume 97, Issue 2 , Pages 501-508, February 2012

Objective:
To investigate the possible effects of low-frequency electroacupuncture (EA) and physical exercise on markers of coagulation and fibrinolysis, insulin sensitivity, and adipose tissue characteristics in women with polycystic ovary syndrome (PCOS).

Design:
Secondary analyses of a prospective, randomized controlled clinical trial.

Setting:
Department of Physiology and Department of Obstetrics and Gynecology, University of Gothenburg.

Patient(s):
Eighty-four women with PCOS were randomized.

Intervention(s):
Women with PCOS were randomized to 16 weeks of low-frequency EA (14 treatments), physical exercise (at least 3 times/wk), or no intervention.

Main Outcome Measure(s):
Anthropometrics, circulating coagulation and fibrinolytic markers, insulin sensitivity (euglycemic hyperinsulinemic clamp), hemodynamics, and adipose tissue morphology/function recorded at baseline, after 16 weeks of intervention, and after a 16-week follow-up.

Result(s):
In the low-frequency EA group, circulating plasminogen activator inhibitor 1 activity decreased by 21.8% after 16 weeks of intervention and by 31.1% at the 16-week follow-up and differed from the physical exercise and the no intervention groups. The EA group had decreases in circulating fibrinogen and tissue plasminogen activator (t-PA), sagittal diameter, and diastolic blood pressure after treatment, and fibrinogen remained lower at the 16-week follow-up. In the physical exercise group, lipoprotein lipase activity increased and diastolic blood pressure decreased after treatment, and both diastolic and systolic blood pressure were lower at follow-up. No other variables were affected.

Conclusion(s):
Low-frequency EA counteracted a possible prothrombotic state in women with PCOS, as reflected by a decrease in plasminogen activator inhibitor 1 activity. Despite within-group improvements, there were no between-group differences in anthropometric, metabolic, or hemodynamic variables after 16 weeks of EA or physical exercise at the dose/intensity studied.

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