College of Medicine, Penn State University, Hershey, Pennsylvania.
Department of Public Health Sciences, Penn State University, Hershey, Pennsylvania.
Cancer Epidemiol Biomarkers Prev. 2021 Jun;30(6):1048-1062. doi: 10.1158/1055-9965.EPI-20-1029. Epub 2021 Mar 18.
Adiponectin, leptin, and pro- and anti-inflammatory cytokines are implicated in breast cancer risk and recurrence. Weight loss, via the dynamic interplay of energy balance through exercise and/or caloric restriction, decreases risk of breast cancer recurrence.
We investigated the effects of lifestyle modifications (exercise only, or combined caloric restriction and exercise) on adipokines, IL2, IL6, IL8, IL10, C-reactive protein (CRP), and TNFα biomarkers in breast cancer survivors. Searches were completed in June and July of 2019 to identify randomized controlled trials that met inclusion criteria. Weighted mean difference was calculated using random- or fixed-effects models based on the heterogeneity of the studies.
2501 records were identified, with 30 ultimately meeting inclusion criteria of the systematic review; 21 studies provided data suitable for meta-analysis. We observed leptin levels were significantly reduced in the exercise-only group compared with sedentary control [WMD -5.66; 95% confidence interval (CI), -11.0 to -0.33; = 0.04].
Leptin may be a primary mediator of exercise-induced improvements in breast cancer recurrence.
This is the first review and meta-analysis to examine combined exercise and caloric restriction programs in breast cancer survivors. Future studies should further examine combined programs and their efficacy for altering leptin.
脂联素、瘦素和促炎及抗炎细胞因子都与乳腺癌风险和复发有关。通过运动和/或热量限制来平衡能量，从而实现体重减轻，可降低乳腺癌复发的风险。
我们研究了生活方式改变（仅运动或联合热量限制和运动）对乳腺癌幸存者的脂联素、IL2、IL6、IL8、IL10、C 反应蛋白（CRP）和 TNFα 生物标志物的影响。研究检索于 2019 年 6 月至 7 月完成，以确定符合纳入标准的随机对照试验。根据研究的异质性，使用随机或固定效应模型计算加权均数差。
共确定了 2501 条记录，其中 30 条最终符合系统评价的纳入标准；21 项研究提供了适合荟萃分析的数据。我们观察到仅运动组的瘦素水平与久坐对照组相比显著降低[WMD -5.66；95%置信区间（CI），-11.0 至 -0.33； = 0.04]。
瘦素可能是运动引起乳腺癌复发改善的主要介质。
这是第一项审查和荟萃分析，研究了联合运动和热量限制方案对乳腺癌幸存者的影响。未来的研究应进一步研究联合方案及其改变瘦素的效果。
