The Centre of Inflammation and Metabolism, Department of Infectious Diseases, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, Denmark.
Endocr Relat Cancer. 2013 Aug 19;20(5):621-32. doi: 10.1530/ERC-12-0393. Print 2013 Oct.
Insulin resistance and changes in body composition are side effects of androgen deprivation therapy (ADT) given to prostate cancer patients. The present study investigated whether endurance training improves insulin sensitivity and body composition in ADT-treated prostate cancer patients. Nine men undergoing ADT for prostate cancer and ten healthy men with normal testosterone levels underwent 12 weeks of endurance training. Primary endpoints were insulin sensitivity (euglycemic-hyperinsulinemic clamps with concomitant glucose-tracer infusion) and body composition (dual-energy X-ray absorptiometry and magnetic resonance imaging). The secondary endpoint was systemic inflammation. Statistical analysis was carried out using two-way ANOVA. Endurance training increased VO2max (ml(O2)/min per kg) by 11 and 13% in the patients and controls respectively (P<0.0001). The patients and controls demonstrated an increase in peripheral tissue insulin sensitivity of 14 and 11% respectively (P<0.05), with no effect on hepatic insulin sensitivity (P=0.32). Muscle protein content of GLUT4 (SLC2A4) and total AKT (AKT1) was also increased in response to the training (P<0.05 and P<0.01 respectively). Body weight (P<0.0001) and whole-body fat mass (FM) (P<0.01) were reduced, while lean body mass (P=0.99) was unchanged. Additionally, reductions were observed in abdominal (P<0.01), subcutaneous (P<0.05), and visceral (P<0.01) FM amounts. The concentrations of plasma markers of systemic inflammation were unchanged in response to the training. No group × time interactions were observed, except for thigh intermuscular adipose tissue (IMAT) (P=0.01), reflecting a significant reduction in the amount of IMAT in the controls (P<0.05) not observed in the patients (P=0.64). In response to endurance training, ADT-treated prostate cancer patients exhibited improved insulin sensitivity and body composition to a similar degree as eugonadal men.
胰岛素抵抗和身体成分的变化是雄激素剥夺疗法（ADT）治疗前列腺癌患者的副作用。本研究旨在探讨耐力训练是否能改善 ADT 治疗的前列腺癌患者的胰岛素敏感性和身体成分。9 名接受 ADT 治疗的前列腺癌患者和 10 名睾酮水平正常的健康男性接受了 12 周的耐力训练。主要终点是胰岛素敏感性（高血糖-高胰岛素钳夹试验伴葡萄糖示踪剂输注）和身体成分（双能 X 射线吸收法和磁共振成像）。次要终点是全身炎症。统计分析采用双因素方差分析。耐力训练使患者和对照组的最大摄氧量（ml（O2）/min/kg）分别增加了 11%和 13%（P<0.0001）。患者和对照组的外周组织胰岛素敏感性分别增加了 14%和 11%（P<0.05），而对肝胰岛素敏感性没有影响（P=0.32）。肌肉 GLUT4（SLC2A4）和总 AKT（AKT1）的蛋白含量也随着训练而增加（P<0.05 和 P<0.01）。体重（P<0.0001）和全身脂肪量（FM）（P<0.01）减少，而瘦体重（P=0.99）不变。此外，腹部（P<0.01）、皮下（P<0.05）和内脏（P<0.01）FM 量也减少。全身炎症的血浆标志物浓度对训练无反应。除了大腿肌间脂肪组织（IMAT）（P=0.01）外，未观察到组间时间的相互作用，这反映了对照组的 IMAT 量显著减少（P<0.05），而患者则没有（P=0.64）。对耐力训练的反应，ADT 治疗的前列腺癌患者表现出与正常睾丸功能男性相似的胰岛素敏感性和身体成分改善。
