Effects of an exercise and hypocaloric healthy eating intervention on indices of psychological health status, hypothalamic-pituitary-adrenal axis regulation and immune function after early-stage breast cancer: a randomised controlled trial.
Effects of an exercise and hypocaloric healthy eating intervention on indices of psychological health status, hypothalamic-pituitary-adrenal axis regulation and immune function after early-stage breast cancer: a randomised controlled trial.
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DOI：
10.1186/bcr3643
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发表时间：
2014-04-14
期刊：
影响因子：
--
通讯作者：
Coleman RE
中科院分区：
文献类型：
--
作者：
Saxton JM;Scott EJ;Daley AJ;Woodroofe M;Mutrie N;Crank H;Powers HJ;Coleman RE
许多妇女在诊断出乳腺癌后会经历情绪困扰、抑郁和焦虑。心理压力和抑郁症与下丘脑-垂体-肾上腺（HPA）轴失调有关，可能会对免疫系统功能产生不利影响并影响生存。本研究探讨了生活方式干预对早期乳腺癌治疗后超重女性心理健康状况、HPA轴调节和免疫功能指标的影响。共有85名3至18个月前接受乳腺癌治疗的妇女被随机分配到6个月的运动和低热量健康饮食计划加上常规护理或仅常规护理（对照组）。干预组的妇女每周接受三次有监督的锻炼和个性化的饮食建议，并辅以每周的营养研讨会。在基线和6个月随访时评估抑郁症状（Beck抑郁量表第二版：BDI-II）、感知压力（感知压力量表：PSS）、唾液皮质醇昼夜节律、炎性细胞因子（IL-6和肿瘤坏死因子-α）、白细胞表型计数、自然杀伤（NK）细胞毒性和促有丝分裂刺激后的淋巴细胞增殖。与对照组相比，干预组在6个月随访时抑郁症状有所减轻（校正平均差异，95%置信区间（95%CI）：-3.12，-1.03至-5.26; P = 0.004），但PSS评分无显著下降（-2.07，-4.96至0.82; P = 0.16）。与单独常规护理相比，生活方式干预也对唾液皮质醇昼夜节律产生了显着影响，6个月随访时早晨唾液皮质醇增加（P <0.04）证明了这一点，表明HPA轴调节发生了变化。6个月随访时，对照组女性的总白细胞、中性粒细胞和淋巴细胞计数高于干预组（P ≤0.05），而两组之间的NK细胞计数（P = 0.46）、NK细胞毒性（P = 0.85）或淋巴细胞增殖反应（P = 0.11）无差异。我们的研究结果表明，生活方式干预导致抑郁症状减少和HPA轴调节正常化。这些变化可能对从早期乳腺癌治疗中恢复的妇女的长期生存具有重要意义。当前对照试验：ISRCTN 08045231
Many women experience emotional distress, depression and anxiety after a diagnosis of breast cancer. Psychological stress and depression have been associated with hypothalamic-pituitary-adrenal (HPA) axis dysregulation that may adversely affect immune system functioning and impact upon survival. This study investigated the effects of a lifestyle intervention on indices of psychological health status, HPA axis regulation and immune function in overweight women recovering from early-stage breast cancer treatment. A total of 85 women treated for breast cancer 3 to 18 months previously were randomly allocated to a 6-month exercise and hypocaloric healthy eating program plus usual care or usual care alone (control group). Women in the intervention group received three supervised exercise sessions per week and individualized dietary advice, supplemented by weekly nutrition seminars. Depressive symptoms (Beck Depression Inventory version II: BDI-II), perceived stress (Perceived Stress Scale: PSS), salivary diurnal cortisol rhythms; inflammatory cytokines (IL-6 and Tumor necrosis factor-α), leukocyte phenotype counts, natural killer (NK) cell cytotoxicity and lymphocyte proliferation following mitogenic stimulation were assessed at baseline and 6-month follow up. Compared with the control group, the intervention group exhibited a reduction in depressive symptoms (adjusted mean difference, 95% confidence intervals (95% CI): −3.12, −1.03 to −5.26; P = 0.004) at the 6-month follow-up but no significant decrease in PSS scores (−2.07, −4.96 to 0.82; P = 0.16). The lifestyle intervention also had a significant impact on diurnal salivary cortisol rhythm compared with usual care alone, as evidenced by an increase in morning salivary cortisol at the 6-month follow-up (P <0.04), indicating a change in HPA axis regulation. Women in the control group had higher total leukocyte, neutrophil and lymphocyte counts in comparison to the intervention group at the 6-month follow-up (P ≤0.05), whereas there was no difference in NK cell counts (P = 0.46), NK cell cytotoxicity (P = 0.85) or lymphocyte proliferation responses (P = 0.11) between the two groups. Our results show that the lifestyle intervention resulted in a reduction in depressive symptoms and a normalisation of HPA axis regulation. Such changes could have important implications for long-term survival in women recovering from early-breast cancer treatment. Current Controlled Trials: ISRCTN08045231
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DOI：
10.1186/1479-5868-8-118
发表时间：
2011-10-25
期刊：
The international journal of behavioral nutrition and physical activity
影响因子：
--
作者：
Imayama I;Alfano CM;Kong A;Foster-Schubert KE;Bain CE;Xiao L;Duggan C;Wang CY;Campbell KL;Blackburn GL;McTiernan A
通讯作者：
McTiernan A
影响因子：
5
作者：
COHEN, S;KAMARCK, T;MERMELSTEIN, R
通讯作者：
MERMELSTEIN, R
影响因子：
4.7
作者：
Anderson, George;Maes, Michael;Berk, Michael
通讯作者：
Berk, Michael
影响因子：
3.1
作者：
Demark-Wahnefried, Wendy;Case, L. Douglas;Shaw, Edward
通讯作者：
Shaw, Edward
DOI：
10.1158/1055-9965.epi-11-0634
发表时间：
2012-01
期刊：
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
影响因子：
--
作者：
Craft LL;Vaniterson EH;Helenowski IB;Rademaker AW;Courneya KS
通讯作者：
Courneya KS