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艾伯塔省身体活动与乳腺癌预防试验:绝经后女性进行为期一年的运动干预后的性激素变化。

Alberta physical activity and breast cancer prevention trial: sex hormone changes in a year-long exercise intervention among postmenopausal women.

机构信息

Alberta Health Services, Calgary, Alberta, Canada.

出版信息

J Clin Oncol. 2010 Mar 20;28(9):1458-66. doi: 10.1200/JCO.2009.24.9557. Epub 2010 Feb 16.

Abstract

PURPOSE

We examined how an aerobic exercise intervention influenced circulating estradiol, estrone, sex hormone-binding globulin (SHBG), androstenedione, and testosterone levels, which may be involved in the association between physical activity and breast cancer risk.

METHODS

A two-center, two-arm randomized controlled trial of exercise was conducted in 320 postmenopausal, sedentary women age 50 to 74 years. Participants were randomly assigned to a 1-year aerobic exercise intervention of 225 min/wk (n = 160) or to a control group who maintained their usual level of activity (n = 160). Baseline, 6-month, and 12-month assessments of estrone, estradiol, androstenedione, and testosterone were quantified by radioimmunoassay after extraction, and SHBG was quantified by an immunometric assay. Intent-to-treat analyses were performed using linear mixed models.

RESULTS

Blood data were available on 309 women (96.6%) at 12 months. Women in the intervention group exercised an average of 3.6 d/wk for 178 min/wk. At 12 months, statistically significant reductions in estradiol (treatment effect ratio [TER] = 0.93; 95% CI, 0.88 to 0.98) and free estradiol (TER = 0.91; 95% CI, 0.87 to 0.96) and increases in SHBG (TER = 1.04; 95% CI, 1.02 to 1.07) were observed in the exercise group compared with the control group. No significant differences in estrone, androstenedione, and testosterone levels were observed between exercisers and controls at 12 months.

CONCLUSION

This trial found that previously sedentary postmenopausal women can adhere to a moderate- to vigorous-intensity exercise program that results in changes in estradiol and SHBG concentrations that are consistent with a lower risk for postmenopausal breast cancer.

摘要

目的

我们研究了有氧运动干预如何影响循环雌二醇、雌酮、性激素结合球蛋白(SHBG)、雄烯二酮和睾酮水平,这些因素可能与体力活动和乳腺癌风险之间存在关联。

方法

一项为期 1 年、涉及 320 名绝经后、久坐不动的 50 至 74 岁女性的两中心、两臂随机对照试验进行了运动干预。参与者被随机分配到有氧运动干预组(每周 225 分钟,n=160)或对照组(保持其平时的活动水平,n=160)。在基线、6 个月和 12 个月时,通过放射免疫分析(经过提取后)定量检测雌酮、雌二醇、雄烯二酮和睾酮,并用免疫计量测定法定量检测 SHBG。采用线性混合模型进行意向治疗分析。

结果

12 个月时,309 名女性(96.6%)的血液数据可用。干预组的女性平均每周运动 3.6 天,每周运动 178 分钟。在 12 个月时,与对照组相比,运动组的雌二醇(治疗效果比 [TER] = 0.93;95%置信区间,0.88 至 0.98)和游离雌二醇(TER = 0.91;95%置信区间,0.87 至 0.96)水平显著降低,而 SHBG(TER = 1.04;95%置信区间,1.02 至 1.07)水平显著升高。与对照组相比,12 个月时,雌酮、雄烯二酮和睾酮水平在运动者和对照组之间无显著差异。

结论

本试验发现,以前久坐不动的绝经后妇女可以坚持进行适度到剧烈强度的运动计划,从而改变雌二醇和 SHBG 浓度,使绝经后乳腺癌的风险降低。

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