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多组分运动计划和营养补充对接受雄激素剥夺治疗的前列腺癌男性肌肉骨骼健康的疗效(IMPACT):一项随机对照试验的研究方案

Efficacy of a multi-component exercise programme and nutritional supplementation on musculoskeletal health in men treated with androgen deprivation therapy for prostate cancer (IMPACT): study protocol of a randomised controlled trial.

作者信息

Owen Patrick J, Daly Robin M, Livingston Patricia M, Mundell Niamh L, Dalla Via Jack, Millar Jeremy L, Fraser Steve F

机构信息

Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia.

Deakin University, Faculty of Health, Geelong, Australia.

出版信息

Trials. 2017 Oct 3;18(1):451. doi: 10.1186/s13063-017-2185-z.

Abstract

BACKGROUND

Prostate cancer is the most commonly diagnosed cancer in men in developed countries. Androgen deprivation therapy (ADT) is a systemic treatment shown to increase survival in selected patients with prostate cancer. The use of ADT continues to increase for all stages and grades of prostate cancer despite known treatment-induced adverse effects. The primary aim of this study is to examine the efficacy of a targeted, multi-component resistance and impact-loading exercise programme together with a daily protein-, calcium- and vitamin D-enriched supplement on bone health in men treated with ADT for prostate cancer. Secondary aims are to determine the effects of this intervention on measures of total body and regional body composition, cardiometabolic risk, inflammatory markers, health-related quality of life and cognitive function.

METHODS

This study is a two-arm randomised controlled trial. Men currently treated with ADT for prostate cancer will be randomised to either a 52-week, community-based, exercise training and nutritional supplementation intervention (n = 51) or usual care control (n = 51). Participants will be assessed at baseline, 26 weeks and 52 weeks for all measures. The primary outcome measures are proximal femur and lumbar spine areal bone mineral density (BMD). Secondary outcomes comprise: changes in tibial and radial bone structure and strength, total body and regional body composition, muscle strength and function, as well as cardiometabolic health, catabolic/inflammatory and anabolic/anti-inflammatory cytokines, health-related quality of life and cognitive function.

DISCUSSION

This study investigates whether a multi-component intervention incorporating a targeted bone and muscle-loading programme in combination with a protein-, calcium- and vitamin D-enriched supplement can ameliorate multiple adverse effects of ADT when compared to usual care. The results will contribute to the development of exercise training and nutrition guidelines for optimising overall health in men treated with ADT for prostate cancer.

TRIAL REGISTRATION

Australia New Zealand Clinical Trial Registry (ANZCTR), ID: ACTRN12614000317695 . Registered on 25 march 2014.

摘要

背景

前列腺癌是发达国家男性中最常被诊断出的癌症。雄激素剥夺疗法(ADT)是一种全身性治疗方法,已证明可提高特定前列腺癌患者的生存率。尽管已知治疗会引起不良反应,但ADT在前列腺癌各个阶段和分级中的使用仍在持续增加。本研究的主要目的是检验一项有针对性的、多成分的抗阻力和冲击负荷运动计划,以及每日富含蛋白质、钙和维生素D的补充剂对接受ADT治疗前列腺癌的男性骨骼健康的功效。次要目的是确定该干预措施对全身和局部身体成分测量、心脏代谢风险指标、炎症标志物、健康相关生活质量和认知功能的影响。

方法

本研究是一项双臂随机对照试验。目前正在接受ADT治疗前列腺癌的男性将被随机分为两组,一组接受为期52周的基于社区的运动训练和营养补充干预(n = 51),另一组接受常规护理对照(n = 51)。所有测量指标将在基线、26周和52周时对参与者进行评估。主要结局指标是股骨近端和腰椎的骨矿物质密度(BMD)。次要结局包括:胫骨和桡骨的骨结构和强度变化、全身和局部身体成分、肌肉力量和功能,以及心脏代谢健康、分解代谢/炎症和合成代谢/抗炎细胞因子、健康相关生活质量和认知功能。

讨论

本研究调查了与常规护理相比,一项包含有针对性的骨骼和肌肉负荷计划以及富含蛋白质、钙和维生素D的补充剂的多成分干预措施是否可以改善ADT的多种不良反应。研究结果将有助于制定运动训练和营养指南,以优化接受ADT治疗前列腺癌男性的整体健康状况。

试验注册

澳大利亚新西兰临床试验注册中心(ANZCTR),编号:ACTRN12614000317695。于2014年3月25日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3102/5627417/dededbf24e34/13063_2017_2185_Fig1_HTML.jpg

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