Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, District of Columbia.
Department of Medicine, Howard University Cancer Center, Howard University, Washington, District of Columbia.
Cancer. 2018 Aug;124(16):3355-3363. doi: 10.1002/cncr.31569. Epub 2018 Jul 5.
This study examined the effects of supervised and home-based exercise interventions on changes in metabolic syndrome (MetS) according to breast cancer risk (high vs low) in black women enrolled in the Focused Intervention on Exercise to Reduce Cancer (FIERCE) trial.
Postmenopausal, obese, metabolically unhealthy black women, 45 to 65 years old, were randomized to supervised aerobic exercise (73 women), home-based walking-based exercise (69 women), or a control arm (71 women). Participants in the exercise arms underwent a 6-month intervention with study assessments conducted at the baseline and 6 months. The primary outcome measure was MetS (fasting glucose, waist circumference, blood pressure, serum triglycerides, and high-density lipoprotein [HDL]). The intervention effects on MetS, stratified by breast cancer risk as measured by the family history of breast cancer and model-based projected breast cancer risk, were examined with intent-to-treat analyses using generalized estimating equation models.
Among women with a family history of breast cancer, the exercise arms had lower mean MetS z scores, which suggested an improvement in the metabolic profile, than controls at 6 months (controls, + 0.55; home-based arm, -0.97, P < .01; supervised arm, -0.89, P < .01). Stratified analyses by projected breast cancer risk suggested similar but statistically nonsignificant findings, with those at high risk having more favorable changes in the MetS z score in the exercise arms versus the control arm. These changes were primarily attributable to changes in blood pressure, triglycerides, and HDL.
Short-term aerobic activity regimens may improve the metabolic profile and thereby reduce breast cancer risk in obese, metabolically unhealthy black women at high risk for cancer. © 2018 American Cancer Society.
本研究考察了监督和家庭为基础的锻炼干预对参与聚焦于锻炼减少癌症（FIERCE）试验的黑人女性中代谢综合征（MetS）变化的影响，这些女性按乳腺癌风险（高与低）进行分层。
绝经后、肥胖、代谢不健康的黑人女性，年龄在 45 至 65 岁之间，被随机分为监督有氧运动组（73 名女性）、家庭步行锻炼组（69 名女性）或对照组（71 名女性）。锻炼组的参与者接受了为期 6 个月的干预，在基线和 6 个月时进行研究评估。主要结局测量指标是 MetS（空腹血糖、腰围、血压、血清甘油三酯和高密度脂蛋白[HDL]）。使用广义估计方程模型，以意向治疗分析的方式，根据乳腺癌风险（通过家族乳腺癌史和基于模型的预测乳腺癌风险来衡量）对 MetS 的干预效果进行了分层分析。
在有乳腺癌家族史的女性中，与对照组相比，锻炼组在 6 个月时的 MetS z 评分平均值较低，这表明代谢谱得到了改善（对照组，+0.55；家庭锻炼组，-0.97，P<0.01；监督锻炼组，-0.89，P<0.01）。按预测乳腺癌风险进行分层分析表明，结果类似但无统计学意义，高风险组在锻炼组中比在对照组中更有利于 MetS z 评分的变化。这些变化主要归因于血压、甘油三酯和 HDL 的变化。
短期有氧运动方案可能会改善代谢谱，从而降低高癌症风险的肥胖、代谢不健康的黑人女性的乳腺癌风险。
