Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, Alberta, Canada.
Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Cancer Epidemiol Biomarkers Prev. 2019 Oct;28(10):1725-1734. doi: 10.1158/1055-9965.EPI-19-0523. Epub 2019 Aug 5.
The optimal lifestyle for breast cancer prevention over the long term is unclear. We aimed to determine whether or not the amount of exercise prescribed in a year-long exercise intervention influences breast cancer biomarker levels 1 year later.
We conducted a 24-month follow-up study (2012-2014) to the Breast Cancer and Exercise Trial in Alberta (BETA), a 12-month, two-armed (1:1), two-center randomized controlled trial of exercise in 400 cancer-free, postmenopausal women. The exercise prescription was moderate-vigorous aerobic exercise, 5 days/week (3 days/week supervised) for 30 minutes/session (MODERATE) or 60 minutes/session (HIGH). Participants were asked not to change their usual diet. We used linear mixed models to compare biomarker concentrations (C-reactive protein, insulin, glucose, HOMA-IR, estrone, sex hormone binding globulin, total estradiol, and free estradiol) over time (0, 12, and 24 months) by group (MODERATE, HIGH), using group-time interactions.
After 12 months of no intervention, 24-month fasting blood samples were available for 84.0% and 82.5% of MODERATE and HIGH groups, respectively ( = 333/400). We found no evidence that 0 to 24- or 12 to 24-month biomarker changes differed significantly between randomized groups (HIGH:MODERATE ratio of mean biomarker change ranged from 0.97 to 1.06, values >0.05 for all). We found more favorable biomarker profiles among participants who experienced greater than the median fat loss during the trial.
Prescribing aerobic exercise for 300 versus 150 minutes/week for 12 months to inactive, postmenopausal women had no effects on longer-term biomarkers.
Exercise may lead to larger improvements in breast cancer biomarkers after intervention among women who also experience fat loss with exercise.
长期来看,预防乳腺癌的最佳生活方式尚不清楚。我们旨在确定一年的运动干预中规定的运动量是否会影响 1 年后乳腺癌生物标志物的水平。
我们对阿尔伯塔省乳腺癌和运动试验(BETA)进行了为期 24 个月的随访研究(2012-2014 年),这是一项为期 12 个月、双臂(1:1)、双中心的随机对照试验,针对 400 名无癌症、绝经后的女性进行了运动干预。运动方案为适度剧烈的有氧运动,每周 5 天(每周 3 天监督),每次 30 分钟(中度)或 60 分钟(高强度)。参与者被要求不要改变他们的日常饮食。我们使用线性混合模型比较了不同组别的生物标志物浓度(C 反应蛋白、胰岛素、葡萄糖、HOMA-IR、雌酮、性激素结合球蛋白、总雌二醇和游离雌二醇)随时间(0、12 和 24 个月)的变化情况(MODERATE、HIGH),使用组间时间交互作用。
在没有干预的 12 个月后,MODERATE 和 HIGH 组分别有 84.0%和 82.5%的参与者(=400/400)接受了 24 个月的空腹血样采集。我们没有发现随机分组之间 0 到 24 个月或 12 到 24 个月的生物标志物变化有显著差异的证据(HIGH:MODERATE 比值的平均生物标志物变化范围从 0.97 到 1.06,所有 值均>0.05)。我们发现,在试验期间经历了超过中位数的脂肪损失的参与者中,生物标志物的分布更为有利。
对不活跃的绝经后妇女进行 12 个月的有氧运动,每周 300 分钟与 150 分钟相比,对长期的生物标志物没有影响。
对于同时通过运动减轻脂肪的女性,运动可能会导致乳腺癌生物标志物在干预后出现更大的改善。