Immunoregulation Research Center, Shahed University, Tehran 1417953836, Iran; Department of Exercise Physiology, Sport Sciences Research Institute, Tehran 1587958711, Iran.
Department of Physical Education and Sport Sciences, Faculty of Human Sciences, Shahed University, Tehran 1417953836, Iran.
J Sport Health Sci. 2023 Nov;12(6):674-689. doi: 10.1016/j.jshs.2023.07.001. Epub 2023 Jul 8.
As the effectiveness of breast cancer treatment has improved, a growing number of long-term breast cancer survivors are seeking help for unique health problems. These patients may be at increased risk of cardiovascular disease due to the side effects of treatment. The positive impact of most types of exercise has been repeatedly reported in people with cancer, but the most effective exercise approaches for maximum beneficial adaptations remain controversial. Thus, this study aimed to compare the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on inflammatory indices, adipokines, metabolic markers, body composition, cardiorespiratory fitness, and quality of life in breast cancer patients during adjuvant endocrine therapy.
Thirty non-metastatic breast cancer patients during adjuvant endocrine therapy who had been treated with chemotherapy and/or radiotherapy were recruited from Iran and randomized to HIIT, MICT, or control groups for a supervised exercise intervention that took place 3 times a week for 12 weeks. The training intensity was determined based on the peak oxygen uptake (VO), and the volume of training was matched in HIIT and MICT based on the VO. Body composition, functional capacity, cardiorespiratory fitness, metabolic indices, sex hormones, adipokines, and inflammatory markers were assessed before and after the intervention.
The VO increased by 16.8% in the HIIT group in comparison to baseline values (mean difference = 3.61 mL/kg/min). HIIT significantly improved the VO compared to control (mean difference = 3.609 mL/kg/min) and MICT (mean differences = 2.974 mL/kg/min) groups. Both HIIT (mean difference = 9.172 mg/dL) and MICT (mean difference = 7.879 mg/dL) interventions significantly increased high-density lipoprotein cholesterol levels compared to the control group. The analysis of covariance showed that physical well-being significantly improved in MICT compared to control group (mean difference = 3.268). HIIT significantly improved the social well-being compared to the control group (mean difference = 4.412). Emotional well-being subscale was significantly improved in both MICT (mean difference = 4.248) and HIIT (mean difference = 4.412) compared to the control group. Functional well-being scores significantly increased in HIIT group compared with control group (mean difference = 3.35) . Significant increase were also observed in total functional assessment of cancer therapy-General scores in both HIIT (mean difference = 14.204) and MICT groups (mean difference = 10.036) compared with control group. The serum level of suppressor of cytokine signaling 3 increased significantly (mean difference = 0.09 pg/mL) in the HIIT group compared to the baseline. There were no significant differences between groups for body weight, body mass index, fasting blood glucose, insulin resistance, sex hormone binding globulin, total cholesterol, low-density lipoprotein cholesterol, adipokines, interleukin-6, tumor necrosis factor-α, or interleukin-10.
HIIT can be used as a safe, feasible, and time-efficient intervention to improve cardiovascular fitness in breast cancer patients. Both HIIT and MICT modalities enhance quality of life. Further large-scale studies will help determine whether these promising results translate into improved clinical and oncological outcomes.
随着乳腺癌治疗效果的提高,越来越多的长期乳腺癌幸存者正在寻求解决独特的健康问题。由于治疗的副作用,这些患者可能面临更高的心血管疾病风险。大多数类型的运动对癌症患者的积极影响已被反复报道,但对于最大程度地获得有益适应的最有效运动方法仍存在争议。因此,本研究旨在比较高强度间歇训练(HIIT)和中等强度持续训练(MICT)对接受辅助内分泌治疗的乳腺癌患者的炎症指标、脂肪因子、代谢标志物、身体成分、心肺功能和生活质量的影响。
从伊朗招募了 30 名接受过化疗和/或放疗的非转移性乳腺癌患者,并将其随机分为 HIIT、MICT 和对照组,进行为期 12 周、每周 3 次的监督运动干预。训练强度根据峰值摄氧量(VO)确定,HIIT 和 MICT 中的训练量根据 VO 进行匹配。在干预前后评估身体成分、功能能力、心肺功能、代谢指标、性激素、脂肪因子和炎症标志物。
与基线相比,HIIT 组的 VO 增加了 16.8%(平均差异=3.61 毫升/公斤/分钟)。与对照组相比,HIIT 显著提高了 VO(平均差异=3.609 毫升/公斤/分钟)和 MICT(平均差异=2.974 毫升/公斤/分钟)组。与对照组相比,HIIT(平均差异=9.172 毫克/分升)和 MICT(平均差异=7.879 毫克/分升)干预均显著提高了高密度脂蛋白胆固醇水平。协方差分析显示,与对照组相比,MICT 组的身体幸福感显著提高(平均差异=3.268)。与对照组相比,HIIT 组的社会幸福感显著改善(平均差异=4.412)。与对照组相比,MICT(平均差异=4.248)和 HIIT(平均差异=4.412)组的情绪幸福感亚量表均显著改善。与对照组相比,HIIT 组的功能幸福感评分显著增加(平均差异=3.35)。HIIT(平均差异=14.204)和 MICT(平均差异=10.036)组的癌症治疗一般功能评估总分也显著增加。与基线相比,HIIT 组的细胞因子信号转导抑制剂 3 血清水平显著升高(平均差异=0.09 皮克/毫升)。各组间体重、体重指数、空腹血糖、胰岛素抵抗、性激素结合球蛋白、总胆固醇、低密度脂蛋白胆固醇、脂肪因子、白细胞介素-6、肿瘤坏死因子-α或白细胞介素-10 均无显著差异。
HIIT 可作为一种安全、可行且高效的干预措施,用于提高乳腺癌患者的心血管健康水平。HIIT 和 MICT 均可提高生活质量。进一步的大规模研究将有助于确定这些有希望的结果是否转化为改善临床和肿瘤学结局。