耶鲁女性癌症幸存者健身干预试验：心血管和生理结果。
The Yale Fitness Intervention Trial in female cancer survivors: Cardiovascular and physiological outcomes.
作者信息
Knobf M Tish, Jeon Sangchoon, Smith Barbara, Harris Lyndsay, Thompson Siobhan, Stacy Mitchel R, Insogna Karl, Sinusas Albert J
机构信息
Yale University School of Nursing, USA.
Michigan State University, USA.
出版信息
Heart Lung. 2017 Sep-Oct;46(5):375-381. doi: 10.1016/j.hrtlng.2017.06.001. Epub 2017 Aug 10.
BACKGROUND
Induced premature menopause and cardio-toxic therapy increase cardiovascular disease risk in female cancer survivors.
OBJECTIVE
To compare the effects of a 12 month aerobic-resistance fitness center intervention to home based physical activity on cardiovascular function and metabolic risk factors.
METHODS
Subjects (N = 154) who had completed primary and/or adjuvant chemotherapy (past 3 years) were randomized to a fitness center intervention or a home based group. The fitness center intervention was a structured thrice weekly aerobic (30 min brisk walking treadmill in target heart range) combined with resistance (30 min of lower body strength training) exercise program, supervised for the first 6 months. The home based group received national guidelines for 30 min moderate intensity exercise most days of the week. Fasting serum samples were collected at baseline, 6 and 12 months for insulin, glucose, lipids and hemoglobin A-1C. A graded exercise stress test was also performed at baseline and 6 months.
RESULTS
The majority of subjects were white (85.7%), had breast cancer (83.1%) and the average age was 51.9 years. Subjects in the fitness center intervention had significantly improved time on treadmill (p = .039), improved heart rate recovery at 1 min (p = .028), greater MET minutes/week (p ≤ .0001), a trend for improved insulin resistance (p = .067) and stable insulin levels (p = .045) compared to the home based physical activity group.
CONCLUSIONS
Exercise represents a potential cardiac risk reduction intervention for cancer survivors. CLINICAL TRIALS.GOV: NCT01102985.
背景
诱导性过早绝经和心脏毒性治疗会增加女性癌症幸存者患心血管疾病的风险。
目的
比较为期12个月的有氧-抗阻健身中心干预与居家体育活动对心血管功能和代谢风险因素的影响。
方法
将已完成初次和/或辅助化疗（过去3年）的受试者（N = 154）随机分为健身中心干预组或居家组。健身中心干预是一个结构化的每周三次的有氧运动（在目标心率范围内在跑步机上快走30分钟）与抗阻运动（30分钟下肢力量训练）相结合的运动项目，前6个月有监督。居家组接受每周大多数日子进行30分钟中等强度运动的国家指南。在基线、6个月和12个月时采集空腹血清样本，检测胰岛素、葡萄糖、血脂和糖化血红蛋白A-1C。在基线和6个月时还进行了分级运动应激试验。
结果
大多数受试者为白人（85.7%），患有乳腺癌（83.1%），平均年龄为51.9岁。与居家体育活动组相比，健身中心干预组的受试者在跑步机上的运动时间显著改善（p = 0.039），1分钟时的心率恢复改善（p = 0.028），每周代谢当量分钟数更多（p≤0.0001），胰岛素抵抗有改善趋势（p = 0.067），胰岛素水平稳定（p = 0.045）。
结论
运动是癌症幸存者潜在的降低心脏风险的干预措施。临床试验注册编号：NCT01102985。
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