Effect of a Tabata Exercise Session in Water on TSP-1 and TIMP-3 and Insulin Resistance in Obese Women with Polycystic Ovary Syndrome

Background &

Polycystic ovary syndrome is one of the common endocrine diseases that affects 5-10% of women of reproductive age. The purpose of this research was to explain the effect of Tabata training in water on TSP-1 and TIMP-3 and insulin resistance in obese women with polycystic ovary syndrome.

To conduct this semi-experimental research, 30 women with a BMI greater than 29.9 in Isfahan city were selected and randomly divided into two experimental groups (metformin + Tabata exercise) (15 people) and control (metformin) (15 people). The Tabata training program consisted of 3 sessions per week for 40 minutes (10 minutes of warm-up, 20 minutes of exercise and 10 minutes of cooling down) consisting of 4-minute periods (20 seconds of activity and 10 seconds of rest) for 12 weeks. Subjects also took 500 mg metformin twice a day after breakfast and dinner. To measure the research variables, blood was taken after 12 to 14 hours of fasting and in two stages before and 48 hours after the last training session. To analyze the data, Shapiro-Wilk tests, one-way analysis of variance and Tukey's post hoc tests were used. People with endocrine diseases, untreated thyroid, Cushing's syndrome (a type of metabolic syndrome in which high levels of glucocorticoids lead to insulin resistance in muscle tissue, liver and fat tissue), congenital adrenal hyperplasia, suspected ovarian or adrenal tumor , heart patients, use of oral contraceptive pills, progestin and hormone induction (Inplanol), use of hormone therapy or herbal medicines during the last 2 months, use of acupuncture during the last 2 months, exercise during Last 2 months, pregnancy, history of abortion or childbirth in the last 6 weeks, history of breastfeeding in the last 4 months, having bariatric surgery in the last 12 months, unwillingness to fill out the consent form to enter the study, patients with or with a history of Cervical, endometrial, or breast cancer were excluded from the study.
After selecting the sample, the subjects completed the personal information questionnaire and blood was drawn after 12 hours of overnight fasting to determine the level of insulin resistance factors, TSP-1 and TIMP-3. Then the experimental group did the training program including 12 weeks, 3 sessions per week and each session lasted 40 minutes and also used metformin. But the control group only took metformin. The exercise protocol consisted of 10 minutes of walking forwards, backwards, sideways, and jogging in the shallow part of the pool (where the water level is below the neck) and then doing stretching exercises. Then, Tabata training was performed with a special training song for 20 minutes and 10 minutes of stretching and cooling down. 48 hours after the last training session, blood was drawn again from all subjects. Also, in order to comply with ethical considerations at the end of the research, the treatment protocols in the form of manuals were provided to the control group so that they can use it if they wish. Similar to protocols on land, in water intensity interval training programs, participants complete "very hard" bouts with "easy" recovery periods, and due to the higher viscosity and density of water, large movements with increased speed will have greater resistance to water flow. He said that this leads to the creation of an ideal environment for increasing work efficiency and energy consumption. Also, metformin is a biguanide drug and is sensitive to insulin. This drug is able to limit the secretion of insulin and its increase. It also reduces the amount of androgen secretion that is secreted from the ovary and adrenal gland. Therefore, metformin seems to be an effective drug in patients with PCOS, especially in those who are resistant to clomiphene. Metformin improves the menstrual cycle in patients with the syndrome and causes an increase in the sensitivity of the response of drugs effective in stimulating ovulation, especially in women with PCOS resistant to clomiphene citrate, and leads to a decrease in obesity.

The results showed that exercise caused a significant decrease in insulin resistance and a significant increase in TSP-1 and TIMP-3 in the experimental group. The results showed that 12 weeks of Tabata training in water has a significant effect on insulin resistance in obese women with polycystic ovary syndrome (P=0.0001, f3.59=11.097). Also, the results of Tukey's post hoc test showed that there is a significant difference between the pre-test of the water training group and the control post-test group and the post-test of the water training group with test control group , but does not have there is a significant difference between the other groups.
In this study, it was found that 12 weeks of Tabata training in water has a significant effect on TIMP-3 in obese women with polycystic ovary syndrome (P=0.0001, f3,59=20/270). Also, the results of Tukey's post hoc test showed that there is a significant difference between the pre-test of the water exercise group and the post-test of the water exercise group and between the post-test of the water exercise group and the control but  pre-test and the control post-test, There is no significant difference between the other groups.
In the present study, it was found that 12 weeks of Tabata training in water has a significant effect on TSP-1 in obese women with polycystic ovary syndrome (P=0.0001, f3,59=111/20). Also, the results of Tukey's post hoc test showed that there is a significant difference between the pre-test of the water exercise group and the post-test of the water exercise group and between the post-test of the water exercise group and the control.but pre-test and the control post-test, There is no significant difference between the other groups.

The results of the present study confirm the effect of Tabata exercise in water along with metformin on the factors involved in angiogenesis and insulin resistance in women with polycystic ovary syndrome.