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EFFECT OF WEIGHT LOSS ON BONE HEALTH IN POSTMENOPAUSAL BREAST CANCER SURVIVORS

减肥对绝经后乳腺癌幸存者骨骼健康的影响

基本信息

批准号：
8539477
负责人：
Adetunji T Toriola
金额：
$ 16.01万
依托单位：
WASHINGTON UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-09-01 至 2015-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8539477
关键词：
21 year old Address Adverse effects Aerobic Aerobic Exercise Alkaline Phosphatase Area Attention Body Weight Changes Body Weight decreased Bone Density Bone Resorption Bone remodeling Cancer Survivor Collagen Type I Collection Complement Data Dual-Energy X-Ray Absorptiometry Enrollment Exercise Goals Health Maintenance Measures Morbidity - disease rate N-telopeptide Obesity Osteogenesis Overweight Patient Self-Report Pharmaceutical Preparations Phase Physical activity Population Postmenopause Quality of life Randomized Recommendation Recovery Recurrence Regimen Research Risk Role Safety Serum Serum Markers Site Staging Treatment Protocols Universities Washington Weight maintenance regimen Weight-Bearing state Woman adverse outcome bone health bone loss bone turnover clinical practice innovation malignant breast neoplasm medical schools mortality nutrition public health relevance

项目摘要

DESCRIPTION (provided by applicant): Weight loss is known to have adverse consequences for bone health, particularly in postmenopausal women. Some research has indicated that physical activity, particularly weight-bearing activity, may offset bone loss. Breast cancer survivors may be at particular risk for adverse bone health given the bone loss associated with several treatment regimens. There is limited research on the effects of weight loss and exercise on bone health in cancer survivors. Several studies have suggested that exercise may offset bone loss in breast cancer survivors, but these studies have not included a weight loss component. Given that energy restriction is a key component to most successful weight loss regimens, understanding the role it has on bone health in postmenopausal breast cancer survivors, who are at increased risk for bone loss, is an important safety consideration. The ENERGY trial (Exercise and Nutrition to Enhance Recovery and Good health for You) is a vanguard weight loss trial of n=800 overweight and obese women age 21 and older with stage IC-IIIA breast cancer across four sites in the US (RO1CA14879). Weight loss is achieved primarily through energy restriction with concurrent emphasis on aerobic exercise to complement weight loss and promote maintenance of weight loss. Thus, it provides an ideal setting to examine the associations between weight change and physical activity with bone loss in postmenopausal breast cancer survivors. Our primary hypothesis is that weight loss and physical activity will be correlated with bone loss and remodeling among overweight and obese postmenopausal breast cancer survivors. We will examine this through the collection of supplementary data in the postmenopausal women (expected to be 75% of the n=200) enrolled in the ENERGY trial at the St. Louis site (at Washington University School of Medicine). The goal of this study is to characterize bone loss and remodeling during the primary weight loss phase (from randomization to 12 months). Our proposal is innovative in that it will be the first study to prospectively assess the effects of intentional weight loss and physical activity during weight loss, independently and together, on bone health in overweight and obese postmenopausal breast cancer survivors. This is significant as there is great attention to the need for weight management in breast cancer survivors given the adverse effects of obesity on morbidity and mortality in this population. Results on bone density can directly inform clinical practice and recommendations for women after breast cancer. Specifically, our aims are to measure the correlation between weight change and physical activity and bone loss among overweight and obese postmenopausal breast cancer survivors enrolled in a randomized controlled weight loss trial and, secondarily, to characterize the interaction between weight change and physical activity as it relates to bone loss.

描述（由申请人提供）：已知体重减轻对骨骼健康有不良后果，特别是在绝经后妇女中。一些研究表明，体力活动，特别是负重活动，可以抵消骨质流失。考虑到与几种治疗方案相关的骨丢失，乳腺癌幸存者可能处于不良骨健康的特别风险中。关于减肥和运动对癌症幸存者骨骼健康的影响的研究有限。一些研究表明，运动可能会抵消乳腺癌幸存者的骨质流失，但这些研究并没有包括减肥成分。考虑到能量限制是大多数成功减肥方案的关键组成部分，了解它对绝经后乳腺癌幸存者骨健康的作用是一个重要的安全考虑因素。ENERGY试验（运动和营养促进恢复和健康）是一项先锋减肥试验，在美国四个研究中心对n=800名21岁及以上的超重和肥胖女性进行了IC-IIIA期乳腺癌研究（RO 1CA 14879）。减肥主要通过能量限制实现，同时强调有氧运动，以补充减肥并促进减肥的维持。因此，它提供了一个理想的设置来检查绝经后乳腺癌幸存者体重变化和体力活动与骨质流失之间的关联。我们的主要假设是体重减轻和体力活动将与超重和肥胖的绝经后乳腺癌幸存者的骨丢失和骨重建相关。我们将通过收集在圣路易斯研究中心（华盛顿大学医学院）参加ENERGY试验的绝经后女性（预计为n=200的75%）的补充数据来检查这一点。本研究的目的是描述主要体重减轻阶段（从随机化至12个月）的骨丢失和重塑。我们的建议是创新的，因为这将是第一项前瞻性评估有意减肥和减肥期间的身体活动对超重和肥胖绝经后乳腺癌幸存者骨骼健康的影响的研究。这一点很重要，因为考虑到肥胖对这一人群发病率和死亡率的不利影响，人们非常关注乳腺癌幸存者的体重管理需求。骨密度的结果可以直接为乳腺癌后妇女的临床实践和建议提供信息。具体来说，我们的目的是测量体重变化和体力活动与骨质流失之间的相关性超重和肥胖的绝经后乳腺癌幸存者参加了一项随机对照减肥试验，其次，描述体重变化和体力活动之间的相互作用，因为它涉及到骨质流失。