Ligibel Jennifer A, Campbell Nancy, Partridge Ann, Chen Wendy Y, Salinardi Taylor, Chen Haiyan, Adloff Kristie, Keshaviah Aparna, Winer Eric P
Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Channing Laboratory, Boston, MA, USA.
J Clin Oncol. 2008 Feb 20;26(6):907-12. doi: 10.1200/JCO.2007.12.7357.
Accumulating data suggest that exercise may affect breast cancer risk and outcomes. Studies have demonstrated that high levels of insulin, often seen in sedentary individuals, are associated with increased risk of breast cancer recurrence and death. We sought to analyze whether exercise lowered insulin concentrations in breast cancer survivors.
One hundred one sedentary, overweight breast cancer survivors were randomly assigned either to a 16-week cardiovascular and strength training exercise intervention or to a usual care control group. Fasting insulin and glucose levels, weight, body composition, and circumference at the waist and hip were collected at baseline and 16 weeks.
Baseline and 16-week measurements were available for 82 patients. Fasting insulin concentrations decreased by an average of 2.86 microU/mL in the exercise group (P = .03), with no significant change in the control group (decrease of 0.27 microU/mL, P = .65). The change in insulin levels in the exercise group seemed greater than the change in controls, but the comparison did not reach statistical significance (P = .07). There was a trend toward improvement in insulin resistance in the exercise group (P = .09) but no change in fasting glucose levels. The exercise group also experienced a significant decrease in hip measurements, with no change in weight or body composition.
Participation in an exercise intervention was associated with a significant decrease in insulin levels and hip circumference in breast cancer survivors. The relationship between physical activity and breast cancer prognosis may be mediated, in part, through changes in insulin levels and/or changes in body fat or fat deposition.
越来越多的数据表明，运动可能会影响乳腺癌风险和预后。研究表明，久坐不动的人常出现的高水平胰岛素与乳腺癌复发和死亡风险增加有关。我们试图分析运动是否能降低乳腺癌幸存者的胰岛素浓度。
101名久坐、超重的乳腺癌幸存者被随机分配到为期16周的心血管和力量训练运动干预组或常规护理对照组。在基线和16周时收集空腹胰岛素和葡萄糖水平、体重、身体成分以及腰围和臀围。
82名患者有基线和16周时的测量数据。运动组空腹胰岛素浓度平均降低2.86微单位/毫升（P = 0.03），对照组无显著变化（降低0.27微单位/毫升，P = 0.65）。运动组胰岛素水平的变化似乎大于对照组，但比较未达到统计学显著性（P = 0.07）。运动组胰岛素抵抗有改善趋势（P = 0.09），但空腹血糖水平无变化。运动组臀围也显著减小，体重和身体成分无变化。
参与运动干预与乳腺癌幸存者胰岛素水平和臀围显著降低有关。身体活动与乳腺癌预后之间的关系可能部分通过胰岛素水平变化和/或身体脂肪或脂肪沉积变化来介导。
