Effects of Aerobic and Resistance Exercise on Metabolic Syndrome, Sarcopenic Obesity, and Circulating Biomarkers in Overweight or Obese Survivors of Breast Cancer: A Randomized Controlled Trial
Effects of Aerobic and Resistance Exercise on Metabolic Syndrome, Sarcopenic Obesity, and Circulating Biomarkers in Overweight or Obese Survivors of Breast Cancer: A Randomized Controlled Trial
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DOI：
10.1200/jco.2017.75.7526
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发表时间：
2018-03-20
影响因子：
45.3
通讯作者：
Mortimer, Joanne E.
中科院分区：
文献类型：
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作者：
Dieli-Conwright, Christina M.;Courneya, Kerry S.;Mortimer, Joanne E.
研究目的代谢综合征与乳腺癌幸存者心血管疾病、2型糖尿病和乳腺癌复发风险增加相关。这项随机对照试验评估了为期16周的有氧运动和抗阻运动联合干预对代谢综合征、肌肉减少性肥胖和血清生物标志物在不同种族、久坐不动、超重或肥胖的乳腺癌幸存者中的作用。运动组每周3次，进行有监督的中到高强度（65%到85%的最大心率）有氧和抗阻运动，持续16周。在基线、干预后（4个月）和3个月随访（仅运动）时测量代谢综合征Z评分（主要结局）、肌肉减少性肥胖和血清生物标志物。对干预的依从性为95%，91%的参与者可进行干预后评估。与常规护理相比，运动干预后代谢综合征z评分显著改善（组间差异，-4.4; 95%CI，-5.9至-2.7; P <0.001）。与常规治疗相比，干预后肌营养不良性肥胖（非骨密度指数，P = 0.001;体重指数，P = 0.001）和循环生物标志物，包括胰岛素（P = 0.002）、IGF-1（P = 0.001）、瘦素（P = 0.001）和脂联素（P = 0.001）显著改善。在3个月的随访中，运动组的所有代谢综合征变量与基线相比仍有显著改善（P < .01）。结论在久坐、超重或肥胖的乳腺癌幸存者的种族多样性样本中，阻力和有氧运动联合有效地减弱了代谢综合征、肌肉减少性肥胖和相关生物标志物。我们的研究结果表明，有针对性的运动处方改善乳腺癌幸存者的代谢综合征，并支持将监督临床运动计划纳入乳腺癌治疗和生存护理计划。(C)2018年美国临床肿瘤学会
PurposeMetabolic syndrome is associated with an increased risk of cardiovascular disease, type 2 diabetes, and breast cancer recurrence in survivors of breast cancer. This randomized controlled trial assessed the effects of a 16-week combined aerobic and resistance exercise intervention onmetabolic syndrome, sarcopenic obesity, and serum biomarkers among ethnically diverse, sedentary, overweight, or obese survivors of breast cancer.MethodsEligible survivors of breast cancer (N = 100) were randomly assigned to exercise (n = 50) or usual care (n = 50). The exercise group participated in supervised moderate-to-vigorous-65% to 85% of heart rate maximum-aerobic and resistance exercise three times per week for 16 weeks. Metabolic syndrome z-score (primary outcome), sarcopenic obesity, and serum biomarkers were measured at baseline, postintervention (4 months), and 3-month follow-up (exercise only).ResultsParticipants were age 53 +/- 10.4 years, 46% were obese, and 74% were ethnicminorities. Adherence to the intervention was 95%, and postintervention assessments were available in 91% of participants. Postintervention metabolic syndrome z-score was significantly improved in exercise versus usual care (between-group difference, -4.4; 95% CI, -5.9 to -2.7; P < .001). Sarcopenic obesity (appendicular skeletal mass index, P = .001; body mass index, P = .001) and circulating biomarkers, including insulin (P = .002), IGF-1 (P = .001), leptin (P = .001), and adiponectin (P = .001), were significantly improved postintervention compared with usual care. At 3-month follow-up, all metabolic syndrome variables remained significantly improved compared with baseline in the exercise group (P < .01).ConclusionCombined resistance and aerobic exercise effectively attenuated metabolic syndrome, sarcopenic obesity, and relevant biomarkers in an ethnically diverse sample of sedentary, overweight, or obese survivors of breast cancer. Our findings suggest a targeted exercise prescription for improving metabolic syndrome in survivors of breast cancer and support the incorporation of supervised clinical exercise programs into breast cancer treatment and survivorship care plans. (C) 2018 by American Society of Clinical Oncology