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乳腺癌幸存者的心肺适能与肥胖:达到当前的身体活动推荐量真的足够吗?

Cardiorespiratory fitness and adiposity in breast cancer survivors: is meeting current physical activity recommendations really enough?

机构信息

Research Institute of Hospital 12 de Octubre ("i+12"), Madrid, Spain.

i+HeALTH, European University Miguel de Cervantes, Valladolid, Spain.

出版信息

Support Care Cancer. 2018 Jul;26(7):2293-2301. doi: 10.1007/s00520-018-4055-y. Epub 2018 Feb 5.

Abstract

PURPOSE

Breast cancer (BC) survivors are becoming increasingly predisposed to cardiovascular disease (CVD) mortality. Low cardiorespiratory fitness and physical activity (PA) levels, as well as high values of adiposity indices, contribute to CVD risk. We evaluated adiposity, cardiorespiratory profile, and PA levels in two independent cohorts of BC survivors.

METHODS

Data were collected from two groups (99% women) from different areas of Madrid (Spain): group 1, n = 110, age 51.4 ± 9.7 years, median time from diagnosis 365 days (95% confidence interval [CI], 354-401), and group 2, n = 93, age 54.7 ± 8.9 years, 1714 days (95% CI, 1502-1938). We estimated peak oxygen uptake (VO) and measured body mass index (BMI), waist circumference (WC), waist-to-hip index, and accelerometry-determined PA.

RESULTS

Both groups had values of BMI in the overweight range (25.3 ± 4.3 and 27.1 ± 5.1 kg/m, p = 0.003). Estimated VO levels were lower in group 2 than in group 1 (28.1 ± 9.1 and 23.7 ± 8.8 ml/kg/min, p < 0.001), although levels in both groups were low. Yet, the majority of participants in both groups (81 and 88%, p = 0.234) met international PA recommendations (235 ± 196 and 351 ± 173 min/week of moderate-vigorous PA, p < 0.001). Both groups had very low levels of vigorous PA. These results were essentially independent of type of treatment (anthracycline/radiotherapy).

CONCLUSIONS

We found a poor cardiorespiratory profile in two independent BC cohorts that differed in median time from diagnosis (as well in socioeconomic status), supporting the notion that implementation of PA (possibly focusing on vigorous PA) and dietary intervention is urgently needed in this patient population.

摘要

目的

乳腺癌(BC)幸存者罹患心血管疾病(CVD)死亡的风险越来越大。心肺功能储备差和体力活动(PA)水平低,以及肥胖指数高,都会增加 CVD 风险。我们评估了两个独立的 BC 幸存者队列的肥胖、心肺功能概况和 PA 水平。

方法

数据来自马德里不同地区的两个组(99%为女性):第 1 组,n=110,年龄 51.4±9.7 岁,中位诊断后时间 365 天(95%置信区间[CI],354-401);第 2 组,n=93,年龄 54.7±8.9 岁,1714 天(95%CI,1502-1938)。我们估计了峰值摄氧量(VO),并测量了体重指数(BMI)、腰围(WC)、腰臀比和加速度计确定的 PA。

结果

两组的 BMI 值均处于超重范围(25.3±4.3 和 27.1±5.1 kg/m,p=0.003)。第 2 组的估计 VO 水平低于第 1 组(28.1±9.1 和 23.7±8.8 ml/kg/min,p<0.001),尽管两组的水平都很低。然而,两组的大多数参与者(81%和 88%,p=0.234)均符合国际 PA 推荐量(235±196 和 351±173 分钟/周的中高强度 PA,p<0.001)。两组的高强度 PA 水平都非常低。这些结果基本上与治疗类型(蒽环类药物/放疗)无关。

结论

我们在两个独立的 BC 队列中发现了心肺功能储备差的情况,这些队列在诊断后中位时间(以及社会经济地位)上存在差异,这支持了在该患者群体中迫切需要实施 PA(可能侧重于高强度 PA)和饮食干预的观点。

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