STUDY QUESTION Are 24-h movement composition and time reallocations between the movement behaviours (moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), sedentary behaviour (SB), and sleep) differentially associated with cardiometabolic markers in women with polycystic ovary syndrome (PCOS) relative to women without PCOS? SUMMARY ANSWER There was no difference in 24-h movement composition between the groups, although among women without PCOS, reducing SB time while increasing either MVPA or LPA time was associated with beneficial differences in cardiometabolic markers, whereas in women with PCOS beneficial differences were observed only when SB time was replaced with MVPA. WHAT IS KNOWN ALREADY Women with PCOS display lower levels of physical activity, higher sedentary time, and less total sleep than women without the syndrome. Exercise interventions among women with PCOS have shown improvements in body composition and insulin sensitivity, while the findings regarding blood pressure, insulin resistance, and lipid profiles are contradictory. STUDY DESIGN, SIZE, DURATION This study was part of a prospective, general population-based Northern Finland Birth Cohort 1966 (NFBC1966) (n = 5889 women). At the 31-year and 46-year follow-up, data collection was performed through postal and clinical examinations, including fasting blood samples and anthropometric measurements. Accelerometer data collection of 14 days (n = 2602 women) and a 2-h oral glucose tolerance test (n = 2780 women) were performed at the 46-year follow-up. Participants were identified as women with or without PCOS at age 31 (n = 1883), and the final study population included those who provided valid accelerometer data at age 46 (n = 857). PARTICIPANTS/MATERIALS, SETTING, METHODS Women with PCOS (n = 192) were identified based on the 2023 International Evidence-based Guideline, while those who exhibited no PCOS features were considered women without PCOS (controls; n = 665). Accelerometer-measured MVPA, LPA, and SB were combined with self-reported sleep to obtain 24-h compositions. Multivariable regression analysis based on compositional data analysis and isotemporal reallocations were performed to investigate the associations between 24-h movement composition and cardiometabolic markers. Isotemporal reallocations were expressed as differences (%Δ) from the sample’s mean. MAIN RESULTS AND THE ROLE OF CHANCE There was no difference in overall 24-h movement composition between women with PCOS and controls in midlife. The 24-h movement composition was associated with waist circumference, triglycerides, fasting serum insulin, and Homeostatic Model Assessment–insulin resistance (HOMA-IR) in both controls and women with PCOS. Reallocating 15 min from SB to MVPA was associated with favourable differences in cardiometabolic markers in both controls (%Δ range from −1.7 to −4.9) and women with PCOS (%Δ range from −1.9 to −8.6). Reallocating 15 min from SB to LPA was also associated with favourable differences in cardiometabolic markers among controls (%Δ range from −0.5 to −1.6) but not among women with PCOS. LIMITATIONS, REASONS FOR CAUTION The substitution technique used in this study is theoretical, which can be considered as a limitation. Other limitations of this study are the use of self-reported sleeping time and the difference in the group sample sizes. WIDER IMPLICATIONS OF THE FINDINGS These findings suggest that women with PCOS should be targeted with interventions involving physical activity of at least moderate intensity to improve their cardiometabolic health and underline the importance of developing tailored activity guidelines for women with PCOS. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by the Jenny and Antti Wihuri Foundation, Sigrid Juselius Foundation, Novo Nordisk (NNF21OC0070372), Research Council of Finland (315921/2018, 321763/2019, 6GESS 336449), Ministry of Education and Culture of Finland (OKM/54/626/2019, OKM/85/626/2019, OKM/1096/626/2020, OKM/20/626/2022, OKM/76/626/2022, and OKM/68/626/2023), and Roche Diagnostics International Ltd. L.J.M. is supported by a Veski Fellowship. M.Nu. has received funding from Fibrobesity-project, a strategic profiling project at the University of Oulu, which is supported by Research Council of Finland (Profi6 336449). NFBC1966 follow-ups received financial support from University of Oulu (Grant no. 65354, 24000692), Oulu University Hospital (Grant no. 2/97, 8/97, 24301140), Ministry of Health and Social Affairs (Grant no. 23/251/97, 160/97, 190/97), National Institute for Health and Welfare, Helsinki (Grant no. 54121), Regional Institute of Occupational Health, Oulu, Finland (Grant no. 50621, 54231), and ERDF European Regional Development Fund (Grant no. 539/2010 A31592). T.T.P. declares consulting fees from Gedeon Richter, Organon, Astellas, Roche; speaker’s fees from Gedeon Richter, Exeltis, Roche, Stragen, Merck, Organon; and travel support from Gedeon Richter. The remaining authors declare no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.

中文翻译：

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多囊卵巢综合征 （PCOS） 女性 24 小时运动行为和心脏代谢标志物：成分数据分析


研究问题 相对于没有 PCOS 的女性，多囊卵巢综合征 （PCOS） 女性的 24 小时运动组成和运动行为（中度至剧烈体力活动 （MVPA）、轻度体力活动 （LPA）、久坐行为 （SB） 和睡眠）之间的时间重新分配是否与心脏代谢标志物存在差异相关性？总结答案两组之间 24 小时运动组成没有差异，尽管在没有 PCOS 的女性中，减少 SB 时间同时增加 MVPA 或 LPA 时间与心脏代谢标志物的有益差异相关，而在患有 PCOS 的女性中，只有当 SB 时间被 MVPA 代替时才观察到有益差异。已知的是，与没有 PCOS 综合征的女性相比，患有 PCOS 的女性表现出较低的身体活动水平、较高的久坐时间和更少的总睡眠时间。PCOS 女性的运动干预显示身体成分和胰岛素敏感性有所改善，而关于血压、胰岛素抵抗和血脂水平的研究结果则相互矛盾。研究设计、规模、持续时间 本研究是 1966 年基于一般人群的前瞻性北芬兰出生队列 （NFBC1966） （n = 5889 名女性） 的一部分。在 31 年和 46 年的随访中，通过邮寄和临床检查进行数据收集，包括空腹血样和人体测量。在 46 年的随访中，进行了 14 天的加速度计数据收集 （n = 2602 名女性） 和 2 小时口服葡萄糖耐量试验 （n = 2780 名女性）。参与者被确定为 31 岁时患有或不患有 PCOS 的女性 （n = 1883），最终研究人群包括在 46 岁时提供有效加速度计数据的女性 （n = 857）。 参与者/材料、环境、方法 根据 2023 年国际循证指南确定患有 PCOS 的女性 （n = 192），而那些没有表现出 PCOS 特征的女性被认为是没有 PCOS 的女性 （对照组;n = 665）。加速度计测量的 MVPA 、 LPA 和 SB 与自我报告的睡眠相结合，以获得 24 小时的组合。进行基于成分数据分析和等时重新分配的多变量回归分析，以研究 24 h 运动成分与心脏代谢标志物之间的关联。等时重新分配表示为与样本平均值的差异 （%Δ）。主要结果和机会的作用 PCOS 女性和中年对照组的总体 24 小时运动组成没有差异。24 小时运动成分与对照组和 PCOS 女性的腰围、甘油三酯、空腹血清胰岛素和稳态模型评估-胰岛素抵抗 （HOMA-IR） 相关。从 SB 到 MVPA 重新分配 15 分钟与两个对照 （%Δ 范围从 -1.7 到 -4.9） 和 PCOS 女性 （%Δ 范围从 -1.9 到 -8.6） 的心脏代谢标志物的有利差异相关。从 SB 到 LPA 重新分配 15 分钟也与对照组之间心脏代谢标志物的有利差异相关 （%Δ 范围从 -0.5 到 -1.6），但在 PCOS 女性中则无关。局限性，谨慎的原因 本研究中使用的替代技术是理论上的，可以被认为是一个局限性。本研究的其他局限性是使用自我报告的睡眠时间和组样本量的差异。 研究结果的更广泛意义这些发现表明，PCOS 女性患者应针对性地进行干预，这些干预措施至少涉及中等强度的身体活动，以改善她们的心脏代谢健康，并强调为 PCOS 女性患者制定量身定制的活动指南的重要性。研究资金/利益争夺本研究由 Jenny 和 Antti Wihuri 基金会、Sigrid Juselius 基金会、诺和诺德 （NNF21OC0070372）、芬兰研究委员会（315921/2018、321763/2019、6GESS 336449）、芬兰教育和文化部（OKM/54/626/2019、OKM/85/626/2019、OKM/1096/626/2020、OKM/20/20/626/2022、OKM/76/626/2022 和 OKM/68/626/2023）资助，罗氏诊断国际有限公司 L.J.M. 由 Veski 奖学金支持。M.Nu。已获得奥卢大学战略分析项目 Fibrobesity-project 的资助，该项目由芬兰研究委员会 （Profi6 336449） 支持。NFBC1966随访得到了奥卢大学（批准号：65354,24000692）、奥卢大学医院（批准号：2/97、8/97、24301140）、卫生和社会事务部（批准号：23/251/97、160/97、190/97）、赫尔辛基国家卫生与福利研究所（批准号：54121）、芬兰奥卢区域职业卫生研究所（批准号：50621、54231）和 ERDF 欧洲区域发展基金（批准号：539/2010 A31592）的财政支持。T.T.P. 宣布收取 Gedeon Richter、Organon、Astellas、Roche 的咨询费;Gedeon Richter、Exeltis、Roche、Stragen、Merck、Organon 的演讲费;以及 Gedeon Richter 的差旅支持。其余作者声明没有利益冲突。试验注册号 N/A。