Weight Loss Intervention for Breast Cancer Survivors: A Systematic Review.
Weight Loss Intervention for Breast Cancer Survivors: A Systematic Review.
复制标题
乳腺癌幸存者的减肥干预：系统评价。
DOI：
10.1007/s12609-013-0113-0
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发表时间：
2013-09
影响因子：
0.9
通讯作者：
Irwin M
中科院分区：
文献类型：
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作者：
Playdon M;Thomas G;Sanft T;Harrigan M;Ligibel J;Irwin M
确定减肥干预对乳腺癌幸存者的有效性。从2012年10月到2013年3月，Pubmed检索了将体重或体重减轻作为主要结局的减肥干预试验。其中15项研究被纳入本综述。在纳入的15项研究中，14项研究结果具有统计学意义的体重减轻，10项研究获得临床意义的体重减轻≥5%。提供了使用几种减肥干预方法（电话、面对面、个人、团体）的可行性证据。成功的干预采用了综合方法，包括饮食、身体活动和行为改变。减肥可改善心血管危险因素和葡萄糖稳态指标。然而，没有足够的证据来确定这种干预措施导致成功减肥的成分，或者确定影响与乳腺癌预后相关的生物标志物所必需的减肥。少数随机对照试验有几个局限性，包括研究样本量小，缺乏6个月以上的随访。随访时间较长的干预显示体重恢复，表明考虑促进长期体重维持的策略的重要性。对乳腺癌幸存者进行减肥干预可以导致具有统计学意义和临床意义的体重减轻，但许多研究的干预研究数量有限，样本量小，随访时间短，限制了我们对乳腺癌诊断后最有效的减肥干预得出结论的能力。迄今为止的研究结果令人鼓舞，但减肥对乳腺癌复发和死亡率的影响，以及对新诊断为乳腺癌的妇女预防体重增加的研究，还需要进行。
To determine the effectiveness of weight loss intervention for breast cancer survivors. From October 2012 until March 2013, Pubmed was searched for weight loss intervention trials that reported body weight or weight loss as a primary outcome. Fifteen of these studies are included in this review. Of the 15 studies included, 14 resulted in statistically significant weight loss and 10 obtained clinically meaningful weight loss of ≥5 % from baseline. Evidence was provided of the feasibility of using several methods of weight loss intervention (telephone, in person, individual, group). Successful intervention used a comprehensive approach, with dietary, physical activity, and behavior modification components. Weight loss improved cardiovascular risk factors and markers of glucose homeostasis. However, there is insufficient evidence to identify the components of this intervention that led to successful weight loss, or to determine the weight loss necessary to affect biomarkers linked to breast cancer prognosis. The small number of randomized controlled trials shared several limitations, including small study sample sizes and lack of follow-up beyond 6 months. Intervention with longer follow-up revealed weight regain, showing the importance of considering strategies to promote long-term weight maintenance. Weight loss intervention for breast cancer survivors can lead to statistically significant and clinically meaningful weight loss, but the limited number of interventional studies, small sample sizes, and short duration of follow-up in many studies limit our ability to draw conclusions regarding the most efficacious weight-loss intervention after a breast cancer diagnosis. The findings to date are encouraging, but research on the effect of weight loss on breast cancer recurrence and mortality, and on prevention of weight gain for women newly diagnosed with breast cancer, is needed.