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一项为期 1 年的身体活动干预对长期儿童癌症幸存者心血管健康的影响:一项随机对照试验(SURfit)。

Effect of a 1-year physical activity intervention on cardiovascular health in long-term childhood cancer survivors-a randomised controlled trial (SURfit).

机构信息

Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway.

Center for Psychiatric Rehabilitation, Universitäre Psychiatrische Dienste Bern (UPD) and University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.

出版信息

Br J Cancer. 2023 Oct;129(8):1284-1297. doi: 10.1038/s41416-023-02410-y. Epub 2023 Aug 31.

Abstract

BACKGROUND

This randomised controlled trial (RCT) assessed the effect of a 1-year, partially supervised, physical activity (PA) intervention on a cardiovascular disease (CVD) risk score in adult survivors of childhood cancer.

METHODS

We included childhood cancer survivors ≥16 y at enrolment, <16 y at diagnosis and ≥5 y in remission. The intervention group was asked to perform an additional ≥2.5 h of intense physical activity/week, controls continued exercise as usual; assessments were performed at baseline, 6 months (T6) and 12 months (T12). The primary endpoint was change in a CVD risk score (average z-score of waist circumference, blood pressure, fasting glucose, inverted high-density lipoprotein cholesterol, triglycerides, and inverted cardiorespiratory fitness) from baseline to T12. We performed intention-to-treat (ITT, primary) and 3 per protocol analyses.

RESULTS

We randomised 151 survivors (44% females, 30.4 ± 8.6 years). We found a significant and robust reduction of the CVD risk score in the intervention compared to the control group at T6 and T12 across all analyses; with a difference in the reduction of the CVD risk z-score of -0.18 (95% confidence interval -0.29 to -0.06, P = 0.003) at T12 in favour of the intervention group (ITT analysis).

CONCLUSIONS

This RCT showed that a long-term PA intervention can reduce CVD risk in long-term survivors of childhood cancer.

TRIAL REGISTRATION

Clinicaltrials.gov: NCT02730767.

摘要

背景

这项随机对照试验(RCT)评估了为期 1 年、部分监督的体力活动(PA)干预对儿童癌症成年幸存者心血管疾病(CVD)风险评分的影响。

方法

我们纳入了在入组时≥16 岁、诊断时<16 岁且缓解期≥5 年的儿童癌症幸存者。干预组被要求每周额外进行≥2.5 小时的剧烈体力活动,对照组继续按常规进行锻炼;评估在基线、6 个月(T6)和 12 个月(T12)进行。主要终点是从基线到 T12 时 CVD 风险评分(腰围、血压、空腹血糖、高密度脂蛋白胆固醇倒置、甘油三酯和心肺适应力的平均 z 评分)的变化。我们进行了意向治疗(ITT,主要)和 3 个方案分析。

结果

我们随机分配了 151 名幸存者(44%为女性,30.4±8.6 岁)。我们发现,在所有分析中,干预组在 T6 和 T12 时与对照组相比,CVD 风险评分显著且稳健地降低;干预组在 CVD 风险 z 评分的降低方面存在差异,在 T12 时为 -0.18(95%置信区间 -0.29 至 -0.06,P=0.003),有利于干预组(ITT 分析)。

结论

这项 RCT 表明,长期 PA 干预可以降低儿童癌症长期幸存者的 CVD 风险。

试验注册

Clinicaltrials.gov:NCT02730767。

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