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      Moderate increases in daily step count are associated with reduced IL6 and CRP in women with PCOS

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          Abstract

          Aims

          Physical activity has been proposed to be an effective non-pharmacological method of reducing systemic inflammation and therefore may prove particularly efficacious for women with polycystic ovary syndrome (PCOS) who have been shown to have high levels of inflammation and an increased risk of type 2 diabetes (T2DM) and cardiovascular disease (CVD). Therefore, the aim of the present study was to assess whether modest changes in daily step count could significantly reduce levels of inflammatory markers in women with PCOS.

          Subjects and Methods

          Sixty-five women with PCOS were assessed at baseline and again at 6 months. All had been provided with an accelerometer and encouraged to increase activity levels. Multivariate linear regression analyses (adjusted for age, ethnicity, baseline step count, change in BMI and change in accelerometer wear-time) were used to assess changes in daily step count against clinical and research biomarkers of inflammation, CVD and T2DM.

          Results

          Mean step count/day at baseline was 6337 (±270). An increase in step count (by 1000 steps) was associated with a 13% reduction in IL6 (β: −0.81 ng/L; 95% CI, −1.37, −0.25, P = 0.005) and a 13% reduction in CRP (β: −0.68 mg/L; 95% CI, −1.30, −0.06, P = 0.033). Additionally, there was a modest decrease in BMI (β: 0.20 kg/m 2; 95% CI, −0.38, −0.01, P = 0.038). Clinical markers of T2DM and CVD were not affected by increased step count.

          Conclusions

          Modest increases in step count/day can reduce levels of inflammatory markers in women with PCOS, which may reduce the future risk of T2DM and CVD.

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          Most cited references23

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          Consensus on women's health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group.

          Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in females, with a high prevalence. The etiology of this heterogeneous condition remains obscure, and its phenotype expression varies. Two widely cited previous ESHRE/ASRM sponsored PCOS consensus workshops focused on diagnosis (published in 2004) and infertility management (published in 2008), respectively. The present third PCOS consensus report summarizes current knowledge and identifies knowledge gaps regarding various women's health aspects of PCOS. Relevant topics addressed-all dealt with in a systematic fashion-include adolescence, hirsutism and acne, contraception, menstrual cycle abnormalities, quality of life, ethnicity, pregnancy complications, long-term metabolic and cardiovascular health, and finally cancer risk. Additional, comprehensive background information is provided separately in an extended online publication. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
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            Interleukin-6 induces cellular insulin resistance in hepatocytes.

            Interleukin (IL)-6 is one of several proinflammatory cytokines that have been associated with insulin resistance and type 2 diabetes. A two- to threefold elevation of circulating IL-6 has been observed in these conditions. Nonetheless, little evidence supports a direct role for IL-6 in mediating insulin resistance. Here, we present data that IL-6 can inhibit insulin receptor (IR) signal transduction and insulin action in both primary mouse hepatocytes and the human hepatocarcinoma cell line, HepG2. This inhibition depends on duration of IL-6 exposure, with a maximum effect at 1-1.5 h of pretreatment with IL-6 in both HepG2 cells and primary hepatocytes. The IL-6 effect is characterized by a decreased tyrosine phosphorylation of IR substrate (IRS)-1 and decreased association of the p85 subunit of phosphatidylinositol 3-kinase with IRS-1 in response to physiologic insulin levels. In addition, insulin-dependent activation of Akt, important in mediating insulin's downstream metabolic actions, is markedly inhibited by IL-6 treatment. Finally, a 1.5-h preincubation of primary hepatocytes with IL-6 inhibits insulin-induced glycogen synthesis by 75%. These data suggest that IL-6 plays a direct role in insulin resistance at the cellular level in both primary hepatocytes and HepG2 cell lines and may contribute to insulin resistance and type 2 diabetes.
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              The technology of accelerometry-based activity monitors: current and future.

              This paper reviews accelerometry-based activity monitors, including single-site first-generation devices, emerging technologies, and analytical approaches to predict energy expenditure, with suggestions for further research and development. The physics and measurement principles of the accelerometer are described, including the sensor properties, data collections, filtering, and integration analyses. The paper also compares these properties in several commonly used single-site accelerometers. The emerging accelerometry technologies introduced include the multisensor arrays and the combination of accelerometers with physiological sensors. The outputs of accelerometers are compared with criterion measures of energy expenditure (indirect calorimeters and double-labeled water) to develop mathematical models (linear, nonlinear, and variability approaches). The technologies of the sensor and data processing directly influence the results of the outcome measurement (activity counts and energy expenditure predictions). Multisite assessment and combining accelerometers with physiological measures may offer additional advantages. Nonlinear approaches to predict energy expenditure using accelerometer outputs from multiple sites and orientation can enhance accuracy. The development of portable accelerometers has made objective assessments of physical activity possible. Future technological improvements will include examining raw acceleration signals and developing advanced models for accurate energy expenditure predictions.

                Author and article information

                Journal
                Endocr Connect
                Endocr Connect
                EC
                Endocrine Connections
                Bioscientifica Ltd (Bristol )
                2049-3614
                December 2018
                21 November 2018
                : 7
                : 12
                : 1442-1447
                Affiliations
                [1 ]NIHR Leicester-Loughborough Diet , Lifestyle and Physical Activity Biomedical Research Unit, University Hospitals of Leicester, Leicester General Hospital, Leicester, UK
                [2 ]The Leicester Diabetes Centre , University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, UK
                [3 ]Diabetes Research Centre , University of Leicester, Leicester General Hospital, Leicester, UK
                [4 ]Department of Diabetes and Endocrinology , Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, UK
                [5 ]Diabetes and Endocrinology Department , Kettering General Hospital NHS Foundation Trust, Kettering, UK
                Author notes
                Correspondence should be addressed to H Mani: hamidreza.mani@ 123456kgh.nhs.uk
                Article
                EC-18-0438
                10.1530/EC-18-0438
                6301194
                30475222
                386ae413-8056-460d-97a0-4429ec9acc4e
                © 2018 The authors

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 07 November 2018
                : 21 November 2018
                Categories
                Research

                polycystic ovary syndrome,interleukin 6,c-reactive protein,inflammation,step count,accelerometer,physical activity

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