六个月的有氧运动和抗阻训练对接受雄激素剥夺治疗的老年前列腺癌男性患者代谢指标和骨密度的影响。

Effects of six months of aerobic and resistance training on metabolic markers and bone mineral density in older men on androgen deprivation therapy for prostate cancer.

作者信息

Papadopoulos Efthymios, Mina Daniel Santa, Culos-Reed Nicole, Durbano Sara, Ritvo Paul, Sabiston Catherine M, Krahn Murray, Tomlinson George, O'Neill Meagan, Iqbal Amna, Timilshina Narhari, Matthew Andrew, Warde Padraig, Alibhai Shabbir M H

机构信息

Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5S 2W6, Canada; Department of Supportive Care, University Health Network, Toronto, ON M5G 2C4, Canada.

出版信息

J Geriatr Oncol. 2020 Sep;11(7):1074-1077. doi: 10.1016/j.jgo.2020.02.013. Epub 2020 Mar 3.

DOI:10.1016/j.jgo.2020.02.013

PMID:32143995

Abstract

BACKGROUND

Androgen deprivation therapy (ADT) for prostate cancer (PCa) is associated with metabolic perturbations and declines in bone mineral density (BMD). Exercise interventions provide multiple health benefits to older men on ADT; however, their effect on metabolic biomarkers and BMD remains unclear.

METHODS

A secondary analysis of a phase II randomized controlled trial was conducted to assess the effect of a six-month moderate-intensity aerobic and resistance exercise program on metabolic biomarkers and BMD in men on ADT. Participants were randomized to three different exercise delivery models: personal training; supervised group exercise; or home-based exercise. Analysis of metabolic biomarkers (lipid profile and glucose) was conducted at baseline, six and twelve months. BMD of the lumbar spine, femoral neck and hip were assessed at baseline and twelve months. Both within- and between-group analyses of change scores adjusted for baseline values were performed.

RESULTS

Forty-eight men (mean age 69.8y) were enrolled. Baseline values of metabolic biomarkers and BMD were comparable between groups and the three groups were combined for the primary analysis. At six months, no changes in metabolic biomarkers were found; however, at twelve months low-density lipoprotein (+0.28 mmol/L; 95%CI, 0.04 to 0.51) and total cholesterol (+0.31 mmol/L; 95%CI, 0.00 to 0.61) were significantly increased from baseline. No changes were found in BMD. In a secondary between-group analysis, no improvements were observed for any metabolic biomarker or BMD measurement.

CONCLUSIONS

Different exercise prescription parameters (modality and intensity) or combined diet/exercise interventions may be needed to foster favorable metabolic and skeletal adaptations during ADT.

摘要

背景

前列腺癌（PCa）的雄激素剥夺疗法（ADT）与代谢紊乱和骨矿物质密度（BMD）下降有关。运动干预对接受ADT的老年男性有多种健康益处；然而，其对代谢生物标志物和BMD的影响仍不清楚。

方法

对一项II期随机对照试验进行二次分析，以评估为期六个月的中等强度有氧和抗阻运动计划对接受ADT男性的代谢生物标志物和BMD的影响。参与者被随机分配到三种不同的运动实施模式：个人训练；监督下的团体运动；或居家运动。在基线、六个月和十二个月时对代谢生物标志物（血脂谱和血糖）进行分析。在基线和十二个月时评估腰椎、股骨颈和髋部的BMD。对调整了基线值的变化分数进行组内和组间分析。

结果

招募了48名男性（平均年龄69.8岁）。各组之间代谢生物标志物和BMD的基线值具有可比性，三组合并进行主要分析。在六个月时，未发现代谢生物标志物有变化；然而，在十二个月时，低密度脂蛋白（+0.28 mmol/L；95%CI，0.04至0.51）和总胆固醇（+0.31 mmol/L；95%CI，0.00至0.61）较基线显著增加。BMD未发现变化。在二次组间分析中，未观察到任何代谢生物标志物或BMD测量值有改善。