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运动作为一种辅助技术能否控制超重和肥胖乳腺癌女性的炎症标志物?一项系统评价和荟萃分析。

Can exercise as a complementary technique manage inflammatory markers in women with breast cancer who are overweight and obese? A systematic review and meta-analysis.

作者信息

Tan Liang, Mei Jinyu, Tang Ruihong, Huang Duo, Qi Kai, Ossowski Zbigniew, Wang Xiaoning

机构信息

Gdansk University of Physical Education and Sport, Gdansk 80-336, Poland.

Department of Physical Education, Harbin Institute of Technology (Weihai), Weihai 264209, China.

出版信息

Complement Ther Med. 2025 Mar;88:103119. doi: 10.1016/j.ctim.2024.103119. Epub 2024 Dec 20.

Abstract

BACKGROUND

Inflammation can result in the development of breast cancer in women with overweight and obese, and also affects the outcome and prognosis of breast cancer patients, thereby decreasing the cure and survival rates of breast cancer patients. Exercise may benefit breast cancer patients as a supplement to conventional treatments. However, research on the effects of exercise on inflammatory markers in women with breast cancer who are overweight and obese remains incomplete.

OBJECTIVE

A systematic review and meta-analysis were used to study the effects of exercise on inflammatory markers in women with breast cancer who are overweight and obese.

METHOD

Literature up to May 2024 was searched from databases such as Cochrane, Embase, Pubmed, Web of Science, and EBSCO, and English-language randomized controlled trials (RCTs) that met the inclusion criteria were screened. The screening criteria were as follows (A) written in English; (B) RCT; (C) studied in women with overweight obese and breast cancer; (D) outcome measures: inflammatory markers; (E) the duration of the exercise intervention was unlimited.

RESULTS

A total of 14 articles and 1064 participants were included. Exercise significantly reduced C-reactive protein (CRP) (MD: -0.52, 95 % CI: -0.94 to -0.11; p = 0.01; heterogeneity p < 0.1), interleukin-6 (IL-6) (MD: -0.87, 95 % CI: -1.62 to -0.11; p = 0.02; heterogeneity p < 0.1), and leptin (MD: -0.92, 95 % CI: -1.71 to -0.13; p = 0.02; heterogeneity p < 0.1) levels and exercise significantly increased adiponectin levels (MD: 0.89, 95 % CI: 0.03-1.75, p = 0.04; heterogeneity p < 0.1) but had no effect on tumor necrosis factor-α (TNF-α) (MD: -0.26, 95 % CI: -0.82-0.29; p = 0.35; heterogeneity p < 0.1) and IL-10 (MD: 0.14, 95 % CI: -0.17-0.45; p = 0.37; heterogeneity p = 0.45) were not significant. In addition, subgroup analyses suggest that combination training (CE) may be the most recommended type of exercise to decrease pro-inflammatory markers, and increase anti-inflammatory markers in women with overweight obesity, and have breast cancer.

CONCLUSION

Exercise significantly reduced CRP, IL-6, and leptin levels and overall increased adiponectin levels in women with overweight obese, and breast cancer. However, the effects on TNF-α and IL-10 levels were not significant. CE may be the most recommended type of exercise for reducing pro-inflammatory factors and increasing anti-inflammatory factors. Therefore, this study considers exercise as an effective complementary approach to managing inflammatory markers in women with breast cancer who are overweight and obese. Future researchers may consider exploring the combined effects of exercise and dietary control, weight loss, and other factors, and formulate a comprehensive treatment plan accordingly.

摘要

背景

炎症可导致超重和肥胖女性患乳腺癌,还会影响乳腺癌患者的治疗结果和预后,从而降低乳腺癌患者的治愈率和生存率。运动作为传统治疗的补充,可能对乳腺癌患者有益。然而,关于运动对超重和肥胖乳腺癌女性炎症标志物影响的研究仍不完整。

目的

采用系统评价和荟萃分析研究运动对超重和肥胖乳腺癌女性炎症标志物的影响。

方法

从Cochrane、Embase、Pubmed、Web of Science和EBSCO等数据库检索截至2024年5月的文献,并筛选符合纳入标准的英文随机对照试验(RCT)。筛选标准如下:(A)英文撰写;(B)RCT;(C)研究超重肥胖且患有乳腺癌的女性;(D)结局指标:炎症标志物;(E)运动干预持续时间不限。

结果

共纳入14篇文章和1064名参与者。运动显著降低了C反应蛋白(CRP)(MD:-0.52,95%CI:-0.94至-0.11;p = 0.01;异质性p < 0.1)、白细胞介素-6(IL-6)(MD:-0.87,95%CI:-1.62至-0.11;p = 0.02;异质性p < 0.1)和瘦素(MD:-0.92,95%CI:-1.71至-0.13;p = 0.02;异质性p < 0.1)水平,运动显著增加了脂联素水平(MD:0.89,95%CI:0.03 - 1.75,p = 0.04;异质性p < 0.1),但对肿瘤坏死因子-α(TNF-α)(MD:-0.26,95%CI:-0.82 - 0.29;p = 0.35;异质性p < 0.1)和IL-10(MD:0.14,95%CI:-0.17 - 0.45;p = 0.37;异质性p = 0.45)的影响不显著。此外,亚组分析表明,联合训练(CE)可能是最推荐的运动类型,可降低超重肥胖且患有乳腺癌女性的促炎标志物,增加抗炎标志物。

结论

运动显著降低了超重肥胖且患有乳腺癌女性的CRP、IL-6和瘦素水平,并总体上增加了脂联素水平。然而,对TNF-α和IL-10水平的影响不显著。CE可能是最推荐的降低促炎因子和增加抗炎因子的运动类型。因此,本研究认为运动是管理超重和肥胖乳腺癌女性炎症标志物的有效补充方法。未来的研究人员可考虑探索运动与饮食控制、体重减轻等因素的联合作用,并据此制定综合治疗方案。

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