McTiernan Anne, Tworoger Shelley S, Rajan Kumar B, Yasui Yutaka, Sorenson Bess, Ulrich Cornelia M, Chubak Jessica, Stanczyk Frank Z, Bowen Deborah, Irwin Melinda L, Rudolph Rebecca E, Potter John D, Schwartz Robert S
Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, and Department of Epidemiology, School of Public Health, University of Washington, Seattle, USA.
Cancer Epidemiol Biomarkers Prev. 2004 Jul;13(7):1099-105.
Postmenopausal women with elevated circulating androgen concentrations have an increased risk of developing breast cancer, yet interventions to reduce androgen levels have not been identified. We examined the effects of a 12-month moderate intensity exercise intervention on serum androgens. The study was a randomized clinical trial in 173 sedentary, overweight (body mass index > or = 24.0 kg/m(2), body fat > 33%), postmenopausal women, ages 50 to 75 years, not using hormone therapy and living in the Seattle, WA area. The exercise intervention included facility-based and home-based exercise (45 minutes, 5 days per week of moderate intensity sports/recreational exercise). A total of 170 (98.3%) women completed the study, with exercisers averaging 171 minutes per week of exercise. Women in the exercise and control groups experienced similar, nonsignificant declines in most androgens. Among women who lost >2% body fat, testosterone and free testosterone concentrations fell by 10.1% and 12.2% between baseline and 12 months in exercisers compared with a decrease of 1.6% and 8.0% in controls (P = 0.02 and 0.03 compared with exercisers, respectively). Concentrations of testosterone and free testosterone among exercisers who lost between 0.5% and 2% body fat declined by 4.7% and 10.4%. In controls who lost this amount of body fat, concentrations of testosterone and free testosterone declined by only 2.8% and 4.3% (P = 0.03 and 0.01 compared with exercisers, respectively). In summary, given similar levels of body fat loss, women randomized to a 12-month exercise intervention had greater declines in testosterone and free testosterone compared with controls. The association between exercise and breast cancer risk may be partly explained by the effects of exercise on these hormones.
循环雄激素浓度升高的绝经后女性患乳腺癌的风险增加,但尚未确定降低雄激素水平的干预措施。我们研究了为期12个月的中等强度运动干预对血清雄激素的影响。该研究是一项随机临床试验,对象为173名久坐不动、超重(体重指数≥24.0kg/m²,体脂>33%)、年龄在50至75岁之间、未使用激素疗法且居住在华盛顿州西雅图地区的绝经后女性。运动干预包括基于健身设施和居家的运动(45分钟,每周5天的中等强度体育/休闲运动)。共有170名(98.3%)女性完成了研究,运动组女性平均每周运动171分钟。运动组和对照组女性的大多数雄激素水平均出现了相似的、不显著的下降。在体脂减少>2%的女性中,运动组女性的睾酮和游离睾酮浓度在基线至12个月期间分别下降了10.1%和12.2%,而对照组分别下降了1.6%和8.0%(与运动组相比,P值分别为0.02和0.03)。体脂减少0.5%至2%的运动组女性的睾酮和游离睾酮浓度分别下降了4.7%和10.4%。在体脂减少量相同的对照组女性中,睾酮和游离睾酮浓度仅下降了2.8%和4.3%(与运动组相比,P值分别为0.03和0.01)。总之,在体脂减少程度相似的情况下,随机接受为期12个月运动干预的女性的睾酮和游离睾酮下降幅度大于对照组。运动与乳腺癌风险之间的关联可能部分归因于运动对这些激素的影响。