To assess the efficacy of moderate-intensity exercise training and metformin on mitophagy and mitochondrial phenotype in patients with polycystic ovarian syndrome (PCOS)

Polycystic ovarian syndrome (PCOS) is the most common reproductive-endocrine disorder occurring in the young women of age group 15-45 years. These women usually present with menstrual irregularities, excessive facial hair growth, acne, infertility and rarely with baldness. Majority of the women with PCOS are obese, exhibit insulin resistance resulting in elevated levels of insulin (hyperinsulinemia), which is a key abnormality in these patients. Hyperinsulinemia results in the overproduction of androgens and subsequently leads to clinical manifestation of  PCOS, accompanied with formation of multiple cysts in the ovaries. Exercise and metformin are commonly recommended therapies for the management of PCOS, as these women display high degree of insulin resistance, and are also predisposed to develop prediabetes and diabetes. The investigators are conducting this research to explore that how exercise and metformin affects the cellular health in patients with PCOS, specifically mitophagy and mitochondrial health. Previous studies have reported the role of mitochondrial dysfunction in insulin resistance. Mitophagy involves the removal of damaged mitochondria and cellular debris, which improves cell survival and function, as mitochondria are the powerhouse of the cell. The investigators would like to explore that whether there is any association between mitophagy and mitochondrial function with symptoms of PCOS before and after exercise and metformin intervention at the transcriptional and translational level.