School of Physical Education, Sport and Exercise Sciences, University of Otago, PO Box 56, Dunedin, New Zealand.
Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, 27599, USA.
Breast Cancer. 2019 Nov;26(6):729-737. doi: 10.1007/s12282-019-00975-2. Epub 2019 May 13.
Breast cancer treatment may increase non-cancer related mortality risk due to unintended cardiovascular consequences. The aim of this study was to investigate the strongest correlate of cardiovascular health (CVH) in female breast cancer survivors, cardiorespiratory fitness or fatness.
Fifty-one women (59 ± 9 years, BMI 26.4 ± 4.8 kg/m) previously diagnosed and treated for primary breast cancer were assessed using pulse wave analysis to determine central arterial wave reflection (augmentation index, AIx) and central systolic blood pressure (cSBP). A composite Z score calculated which incorporated central double product and AIx, as an indicator of CVH. Dual energy X-ray absorptiometry was used to obtain total body fat percentage (BF%). Cardiorespiratory fitness was determined using the single-stage walk test to predict maximal oxygen uptake ([Formula: see text]).
Linear regression analysis revealed that fitness was associated with AIx after adjusting for BF %, age and time post-treatment completion (β = - 0.271, p = 0.010). A significant association between BF% and AIx after adjusting for fitness and age was found (β = 0.166, p = 0.0005); however, this association was lost when time post-treatment was included in the model (β = 0.166, p = 0.167). Both fitness (β = - 0.347, p = 0.0005) and BF% (β = 0.333, p = 0.013) were independently associated with CVH in the fully adjusted model.
This study provides evidence for an association between cardiorespiratory fitness and cardiovascular health in female breast cancer survivors. While fatness may be associated with cardiovascular health, it appears to be more strongly associated with age.
乳腺癌治疗可能会由于意外的心血管后果而增加非癌症相关的死亡率。本研究的目的是探讨女性乳腺癌幸存者心血管健康(CVH)最强的相关因素,即心肺功能或肥胖。
51 名女性(59±9 岁,BMI 26.4±4.8kg/m²)曾被诊断和治疗过原发性乳腺癌,使用脉搏波分析来确定中心动脉反射波(增强指数,AIx)和中心收缩压(cSBP)。计算了一个综合 Z 评分,该评分纳入了中心双乘积和 AIx,作为 CVH 的指标。双能 X 射线吸收法用于获得全身脂肪百分比(BF%)。心肺功能使用单阶段步行测试来预测最大摄氧量([Formula: see text])。
线性回归分析显示,在调整 BF%、年龄和治疗完成后时间后,体能与 AIx 相关(β=-0.271,p=0.010)。在调整了体能和年龄后,发现 BF%与 AIx 之间存在显著的相关性(β=0.166,p=0.0005);然而,当将治疗后时间纳入模型时,这种相关性就消失了(β=0.166,p=0.167)。在完全调整的模型中,体能(β=-0.347,p=0.0005)和 BF%(β=0.333,p=0.013)都与 CVH 独立相关。
本研究为女性乳腺癌幸存者的心肺功能与心血管健康之间的关联提供了证据。虽然肥胖可能与心血管健康有关,但它似乎与年龄的关系更为密切。