Revista Brasileira de Ginecologia e Obstetrícia (Jul 2012)
Análise de força muscular e composição corporal de mulheres com Síndrome dos Ovários Policísticos Analysis of muscle strength and body composition of women with Polycystic Ovary Syndrome
Abstract
OBJETIVOS: Comparar os parâmetros metabólicos, a composição corporal e a força muscular de mulheres com Síndrome dos Ovários Policísticos (SOP) em relação a mulheres com ciclos menstruais ovulatórios. MÉTODOS: Estudo caso-controle com 27 mulheres com SOP e 28 mulheres controles com ciclos ovulatórios, com idade entre 18 e 37 anos, índice de massa corpórea entre 18 e 39,9 kg/m², que não praticassem atividade física regular. Níveis séricos de testosterona, androstenediona, prolactina, globulina carreadora dos hormônios sexuais (SHBG), insulina e glicemia foram avaliados. Índice de andrógeno livre (FAI) e resistência insulina (por HOMA) foram calculados. As voluntárias submetidas avaliação de composição corporal por dobras cutâneas e absorciometria de raio X de dupla energia (DEXA) e testes de força muscular máxima de 1-RM em três exercícios após procedimento de familiarização e de força isométrica de preensão manual. RESULTADOS: Os níveis de testosterona foram mais elevados no grupo SOP em relação ao CO (68,0±20,2 versus 58,2±12,8 ng/dL; p=0,02), assim como o FAI (282,5±223,8 versus 127,0±77,2; p=0,01), a insulina (8,4±7,0 versus 4,0±2,7 uIU/mL; p=0,01), e o HOMA (2,3±2,3 versus1,0±0,8; p=0,01). O SBHG foi inferior no grupo SOP comparado ao controle (52,5±43,3 versus 65,1±27,4 nmol/L; p=0,04). Não foram observadas diferenças significativas na composição corporal com os métodos propostos entre os grupos. O grupo SOP apresentou maior força muscular no teste de 1-RM nos exercícios supino reto (31,2±4,75 versus 27,8±3,6 kg; p=0,04) e cadeira extensora (27,9±6,2 versus 23,4±4,2 kg; p=0,01), assim como nos testes de força isométrica de preensão manual (5079,6±1035,7 versus 4477,3±69,6 kgf/m²; p=0,04). Ser portadora de SOP foi um preditor independente de aumento de força muscular nos exercícios supino reto (estimativa (E)=2,7) (p=0,04) e cadeira extensora (E=3,5) (p=0,04). Assim como o IMC no exercício de força isométrica de preensão manual do membro dominante (E=72,2) (pPURPOSE: To compare the metabolic parameters, body composition and muscle strength of women with Polycystic Ovary Syndrome (PCOS) to those of women with ovulatory menstrual cycles. METHODS: A case-control study was conducted on 27 women with PCOS and 28 control women with ovulatory cycles, aged 18 to 27 years with a body mass index of 18 to 39.9 kg/m², who did not practice regular physical activity. Serum testosterone, androstenedione, prolactin, sex hormone-binding globulin (SHBG), insulin and glycemia levels were determined. Free androgen index (FAI) and resistance to insulin (by HOMA) were calculated. The volunteers were submitted to evaluation of body composition based on skin folds and DEXA and to 1-RM maximum muscle strength tests in three exercises after familiarization procedures and handgrip isometric force was determined. RESULTS: Testosterone levels were higher in the PCOS group than in the Control Group (68.07±20.18 versus 58.20±12.82 ng/dL; p=0.02), as also were the FAI (282.51±223.86 versus 127.08±77.19; p=0.01), insulin (8.41±7.06 versus 4.05±2.73 µIU/mL; p=0.01), and HOMA (2.3±2.32 versus 1.06±0.79; p=0.01), and SBHG levels were lower (52.51±43.27 versus 65.45±27.43 nmol/L; p=0.04). No significant differences in body composition were observed between groups using the proposed methods. The PCOS group showed greater muscle strength in the 1-RM test in the bench press (31.2±4.75 versus 27.79±3.63 kg; p=0.02), and leg extension exercises (27.9±6.23 versus 23.47±4.21 kg; p=0.02) as well as handgrip isometric force (5079.61±1035.77 versus 4477.38±69.66 kgf/m², p=0.04). PCOS was an independent predictor of increase muscle strength in bench press exercises (estimate (E)=2.7) (p=0.04) and leg extension (E=3.5) (p=0.04), and BMI in the exercise of isometric handgrip (E=72.2) (p<0.01), bench press (E=0.2) (p=0.02) and arm curl (E=0.3) (p<0.01). No association was found between HOMA-IR and muscle strength. CONCLUSIONS: Women with POS showed greater muscle strength, with no difference in body composition, and IR was not associated with muscle strength performance. Muscle strength may be possibly related to high levels of androgens in these women.
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