Women With Polycystic Ovary Syndrome and Excess Body Fat Exhibit Atypical Sympathetic Autonomic Modulation That is Partially Reversed by Aerobic Physical Training

ABSTRACT Objective The aetiology of impairments in autonomic modulation of heart rate variability (HRV) in polycystic ovary syndrome (PCOS) remains unclear, as does the impact of aerobic physical training (APT) on controlling endocrine‐metabolic disorders and HRV. This is because these women often present excess body fat. Therefore, we assessed whether the dysregulation in autonomic modulation of HRV in women with PCOS is due to endocrine‐metabolic disorders and whether the combination of excess body fat with endocrine‐metabolic disorders amplifies cardiovascular autonomic deficits. We also investigated whether APT positively influences autonomic modulation of HRV in PCOS. Design Non‐randomised clinical trial. Participants Women with and without PCOS with different percentages of body fat. Measurements Participants were divided into four groups: women without PCOS with a body fat percentage between 22% and 29% (CONTROL group; 22%–29%); CONTROL (30%–37%) group; PCOS (22%–29%) group; and PCOS (30%–37%) group. Hemodynamic, metabolic, and hormonal characteristics and HRV parameters were obtained before and after 16 weeks of APT. Results The PCOS (22%–29%) group exhibited lower vagal modulation than the CONTROL (22%–29%) group. In contrast, no significant differences were observed between the CONTROL (30%–37%) and PCOS (30%–37%) groups. Furthermore, the PCOS (30%–37%) group demonstrated lower sympathetic modulation than the PCOS (22%–29%) group. After APT, the PCOS (22%–29%) group increased in vagal modulation, while the PCOS (30%–37%) group increased in sympathetic modulation. Conclusion PCOS affects vagal modulation; however, this effect may be masked at elevated levels of body fat. Additionally, the combination of excess body fat with endocrine‐metabolic dysregulation appears to reduce sympathetic modulation, possibly due to sympathetic drive hyperactivity. APT positively affected HRV in both PCOS groups.