冲击+抗阻训练改善早绝经乳腺癌幸存者的骨骼健康和身体成分：一项随机对照试验。
Impact + resistance training improves bone health and body composition in prematurely menopausal breast cancer survivors: a randomized controlled trial.
机构信息
School of Nursing, Oregon Health & Science University, Portland, OR, USA.
出版信息
Osteoporos Int. 2013 May;24(5):1637-46. doi: 10.1007/s00198-012-2143-2. Epub 2012 Sep 21.
UNLABELLED
Our randomized controlled trial in prematurely menopausal breast cancer survivors showed that impact + resistance training prevented increases in percentage of body fat compared with controls and also improved BMD at the hip and prevented BMD loss at the spine among exercise-trained women who were menopausal for >1 year.
INTRODUCTION
Cancer treatment-related menopause worsens bone health and body composition in breast cancer survivors (BCS). We investigated whether impact + resistance training could improve bone mineral density (BMD), reduce bone turnover, build muscle, and decrease fat mass in BCS with premature menopause.
METHODS
We conducted a randomized controlled trial in 71 BCS (mean age, 46.5 years) within 5 years of treatment-related menopause. Women were randomly assigned to one of two groups: (1) impact + resistance training (prevent osteoporosis with impact + resistance (POWIR)) or (2) exercise placebo (FLEX) 3×/week for 1 year. Outcomes were hip and spine BMD (in grams per square centimeter) and body composition (percent body fat (%BF) and lean and fat mass (in kilograms)) by DXA and bone turnover markers (serum osteocalcin (in nanograms per milliliter) and urinary deoxypryrodinoline (in nanomoles per milliliter).
RESULTS
There were no significant group × time interactions for bone outcomes when using an intent-to-treat approach on the full sample. In analyses restricted to BCS who were menopausal for ≥1 year, POWIR increased BMD at the hip and slowed BMD loss at the spine compared with FLEX (femoral neck-POWIR, 0.004 ± 0.093 g/cm(2) vs. FLEX, -0.010 ± 0.089 g/cm(2); p < 0.01; spine-POWIR, -0.003 ± 0.114 g/cm(2) vs. FLEX, -0.020 ± 0.110 g/cm(2); p = 0.03). POWIR prevented increases in %BF (POWIR, 0.01 % vs. FLEX, 1.3 %; p < 0.04). Women with attendance to POWIR at ≥64 % had better improvements in %BF than women attending less often (p < 0.03).
CONCLUSION
Impact + resistance training may effectively combat bone loss and worsening body composition from premature menopause in BCS.
目的：我们的一项针对提前绝经的乳腺癌幸存者的随机对照试验表明，与对照组相比，冲击+抗阻训练可防止体脂百分比增加，并改善髋部骨密度（BMD），预防绝经 1 年以上的运动训练女性的脊柱 BMD 丢失。
介绍：与乳腺癌幸存者（BCS）相关的癌症治疗导致的绝经会使骨健康和身体成分恶化。我们研究了冲击+抗阻训练是否可以改善 BCS 中因提前绝经导致的骨密度（BMD）、减少骨转换、增加肌肉量和减少脂肪量。
方法：我们对 71 名（平均年龄 46.5 岁）接受治疗相关绝经后 5 年内的 BCS 进行了一项随机对照试验。女性被随机分配到两组之一：（1）冲击+抗阻训练（预防骨质疏松症的冲击+抗阻（POWIR））或（2）每周 3 次的运动安慰剂（FLEX），为期 1 年。使用 DXA 评估髋部和脊柱的 BMD（以每平方厘米克数表示）和身体成分（体脂百分比（%BF）和瘦体重和脂肪量（以千克表示）），并通过血清骨钙素（以纳克/毫升表示）和尿脱氧吡啶啉（以纳摩尔/毫升表示）评估骨转换标志物。
结果：在对全样本进行意向治疗分析时，骨结局没有出现显著的组×时间交互作用。在限制为绝经 1 年以上的 BCS 的分析中，与 FLEX 相比，POWIR 增加了髋部 BMD 并减缓了脊柱 BMD 丢失（股骨颈-POWIR，0.004±0.093 g/cm² 比 FLEX，-0.010±0.089 g/cm²；p<0.01；脊柱-POWIR，-0.003±0.114 g/cm² 比 FLEX，-0.020±0.110 g/cm²；p=0.03）。POWIR 防止了 %BF 的增加（POWIR，0.01%比 FLEX，1.3%；p<0.04）。参加 POWIR 的女性出勤率达到≥64%时，其体脂百分比的改善明显优于出勤率较低的女性（p<0.03）。
结论：冲击+抗阻训练可能有效地对抗 BCS 因提前绝经导致的骨丢失和身体成分恶化。
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