Volume 28, Issue 4 (7-2021)                   RJMS 2021, 28(4): 84-94 | Back to browse issues page

Research code: مقاله مستخرج از رساله دکتری است
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Clinical trials code: مقاله مستخرج از رساله دکتری است

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Sadat Yaghoubi M, Abedi B, Saremi A. The effect of tabata exercise on water and metformin use on endostatin and TIMP2 in obese women with polycystic ovary syndrome. RJMS 2021; 28 (4) :84-94
URL: http://rjms.iums.ac.ir/article-1-6449-en.html
Islamic Azad University, Mahallat, Iran , abedi@iaumahallat.ac.ir
Abstract:   (1947 Views)
Background & Aims: Polycystic ovary syndrome is the most common endocrine disorder, affecting approximately 1 in 15 women worldwide (1). One of the cases that seems to be associated with polycystic ovary syndrome is angiogenesis. Angiogenesis is essential for the growth and differentiation of the human endometrium, and this process depends on the major endothelial vascular growth factor (VEGF) and its receptors, so that angiogenesis is the major feature of implantation and placenta formation (6). Progesterone has been shown to stimulate the proliferation of endometrial endothelial cells, and this proliferation may be mediated by genes involved in angiogenesis (8). In general, angiogenesis is the process of active proliferation of endothelial cells, and the formation of active vessels requires coordinated interactions between endothelial cells, the extracellular matrix, and the cells that surround them. In addition, intercellular connections must be broken. This is done by the large family of matrix metalloproteases, and inhibition of their secretion or activity can lead to tumor control in angiogenesis leading to metalloprotease inhibitors (12). But which factors influence angiogenesis is a question that has occupied the minds of researchers. Meanwhile, TIMP2 inactivates MMP9 (13). Exercise has also been shown to increase TIMP2 activity one day after exercise (14). Endostatin is another factor that is inversely related to the capillary network of the anterior buttock muscle and the left ventricular muscle of the rat. Endostatin levels are also low in the left ventricle and anterior tibialis muscle (15).
Research suggests that the most important way to prevent and treat infertility disorders in people with polycystic ovary syndrome is to control their diabetes and weight (16). Although the benefits of aerobic exercise have been proven in many studies, little research has been done on intense intermittent exercise. One type of intense intermittent exercise is the Tabata exercise (5). Numerous clinical studies have reported significant aerobic, metabolic, musculoskeletal, and psychological benefits for water sports programs and intermittent swimming exercises (22).
Considering the above and the importance of treating polycystic ovary syndrome on the one hand and the importance of angiogenesis on the other hand, the researcher intends to investigate the effect of Tabata exercise in water and metformin on endostatin and in obese women with polycystic ovary syndrome.
Methods: The present research is a quantitative and applied study that was conducted with a two-group design (experimental and control) with pre-test and post-test. The statistical population of the present study consisted of all women with a body mass index of more than 29.9 in Isfahan with polycystic ovary syndrome. 30 people were selected as a sample from the community and provided they met the inclusion criteria, which were randomly assigned to the experimental group of Tabata + metformin exercise control. Subjects then completed a personal information questionnaire and blood samples were taken after 12 hours of night fasting to determine the level of research variables. In the continuation of the experimental group, the training program consisted of 12 weeks, 3 sessions per week and each session lasted 40 minutes of Tabata training in water with a special training song for 20 minutes and 10 minutes of stretching and cooling exercises. The dose of metformin prescribed in the experimental group was 500 mgr twice a day after breakfast and dinner. 48 hours after the last training session, blood samples were taken again from all subjects. Descriptive statistics and Shapiro-Wilk tests, one-way analysis of variance and Tukey's post hoc test were used to analyze the data using SPSS / 21 software at the significance level of 0.05.
Results: The results showed that Tabata exercise in water and metformin consumption had a significant effect on endostatin factor in obese women with polycystic ovary syndrome (F = 12.782, P = 0.001). Water training post-test (P = 0.001) on the one hand and there is a significant difference between water training post-test with control pre-test (P = 0.001) and control post-test (P = 0.001) but between other groups There is no significant difference (Figure 1).
The results showed that Tabata exercise in water and metformin consumption significantly increased TIMP2 in obese women with polycystic ovary syndrome (F = 12.520, P = 0.001). Water training test (P = 0.001) on the one hand and there is a significant difference between water training post-test with control pre-test (P = 0.001) and control post-test (P = 0.001) but there is a difference between other groups. There is no significance (Figure 2).
Conclusion: Imbalance of expression of angiogenic factors plays an important role in abnormal increase of ovarian stromal blood flow in polycystic ovary syndrome. In this study, Tabata exercise program in water and metformin consumption significantly reduced serum endostatin levels. Findings from this study and other research show that exercise, unlike acute activity, has a different effect. These results indicate that the response of endostatin to exercise depends on the anthropometric characteristics and the level of readiness of the subjects. The mechanism by which endostatin is reduced in response to exercise is still unclear. But it is possible that exercise reduces the rate of metamorphosis in the extracellular matrix, and this may prevent the release of endostatin from collagen. Endostatin levels depend on factors such as gender, age, disease, history, and level of fitness (26).
Regarding the increase of TIMP-2 due to Tabata exercise in water and metformin consumption in obese women with polycystic ovary syndrome, it can be stated that although the exact mechanism of the effect of exercise on the regulation of TIMP-2 levels is not well known, but increased production Angiostatin (a potent inhibitor of angiogenesis in vivo) and the activity of cathepsin D, an enzyme required for angiostatin production, have been observed in mice (35). Also, with increasing age, the amount of oxidative stress and activation of the nuclear factor NF-κB increases (36). Therefore, it can be suggested that exercise may be one of the ways to reduce oxidative stress and increase the production of inhibitors leading to an increase in TIMP-2 in the present study.
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Type of Study: Research | Subject: Exercise Physiology

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