Effects of exercise on insulin, IGF axis, adipocytokines, and inflammatory markers in breast cancer survivors: A systematic review and meta-analysis

Dong Woo Kang, Junga Lee, Sang-Hoon Suh, Jennifer Ligibel, Kerry S. Courneya, Justin Y. Jeon

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Background: Insulin, IGF axis, adiponectin, and inflammatory markers are associated with breast cancer. Given that physical activity improves prognosis of breast cancer survivors, we investigated the effects of exercise on these markers as potential mediators between physical activity and breast cancer. Methods: PubMed, EMBASE, CENTRAL, CINAHL, and SportDiscus were searched up to December 3, 2015, to identify randomized controlled trials (RCT) that investigated the effect of exercise on insulin, IGF axis, and cytokines in breast cancer survivors. Weighted mean difference (WMD) was calculated using either fixed-or random-effects models on the basis of the heterogeneity of the studies. Results: A total of 18 studies involving 681 breast cancer survivors were included, and these numbers were reduced for individual biomarker analyses. We found that exercise significantly reduced fasting insulin levels [WMD, μ3.46 mU/mL; 95% confidence interval (CI),-5.97 to-0.95; P = 0.007]. Furthermore, potentiallymeaningfulbutstatisticallynonsignificantchangeswere observed in insulin resistance (WMD,-0.73; 95% CI,-0.54 to 0.13; P = 0.23),adiponectin(WMD, 1.17 mg/mL;95% CI,-0.87to 3.20; P = 0.26), and C-reactive protein (WMD,-1.10 mg/L; 95% CI,-2.39to0.20; P=0.10).Subgroupanalysesshowedthatfasting insulin levels were significantly more impacted in studies in which intervention participants experienced a weight reduction (WMD,-7.10 mU/mL; 95% CI,-10.31 to-3.90; P < 0.001). Conclusions: Exercise reduces fasting insulin levels in breast cancer survivors. This may be due to exercise-induced reductions in body weight. Impact: Practitioners and clinicians may better help breast cancer prognosis be improved through exercise, anticipating physiological effects on cancer.

Original languageEnglish
Pages (from-to)355-365
Number of pages11
JournalCancer Epidemiology Biomarkers and Prevention
Volume26
Issue number3
DOIs
Publication statusPublished - 2017 Mar 1

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Adipokines
Meta-Analysis
Insulin
Breast Neoplasms
Confidence Intervals
Adiponectin
Fasting
PubMed
C-Reactive Protein
Insulin Resistance
Weight Loss
Randomized Controlled Trials
Biomarkers
Body Weight
Cytokines

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Oncology

Cite this

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title = "Effects of exercise on insulin, IGF axis, adipocytokines, and inflammatory markers in breast cancer survivors: A systematic review and meta-analysis",
abstract = "Background: Insulin, IGF axis, adiponectin, and inflammatory markers are associated with breast cancer. Given that physical activity improves prognosis of breast cancer survivors, we investigated the effects of exercise on these markers as potential mediators between physical activity and breast cancer. Methods: PubMed, EMBASE, CENTRAL, CINAHL, and SportDiscus were searched up to December 3, 2015, to identify randomized controlled trials (RCT) that investigated the effect of exercise on insulin, IGF axis, and cytokines in breast cancer survivors. Weighted mean difference (WMD) was calculated using either fixed-or random-effects models on the basis of the heterogeneity of the studies. Results: A total of 18 studies involving 681 breast cancer survivors were included, and these numbers were reduced for individual biomarker analyses. We found that exercise significantly reduced fasting insulin levels [WMD, μ3.46 mU/mL; 95{\%} confidence interval (CI),-5.97 to-0.95; P = 0.007]. Furthermore, potentiallymeaningfulbutstatisticallynonsignificantchangeswere observed in insulin resistance (WMD,-0.73; 95{\%} CI,-0.54 to 0.13; P = 0.23),adiponectin(WMD, 1.17 mg/mL;95{\%} CI,-0.87to 3.20; P = 0.26), and C-reactive protein (WMD,-1.10 mg/L; 95{\%} CI,-2.39to0.20; P=0.10).Subgroupanalysesshowedthatfasting insulin levels were significantly more impacted in studies in which intervention participants experienced a weight reduction (WMD,-7.10 mU/mL; 95{\%} CI,-10.31 to-3.90; P < 0.001). Conclusions: Exercise reduces fasting insulin levels in breast cancer survivors. This may be due to exercise-induced reductions in body weight. Impact: Practitioners and clinicians may better help breast cancer prognosis be improved through exercise, anticipating physiological effects on cancer.",
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Effects of exercise on insulin, IGF axis, adipocytokines, and inflammatory markers in breast cancer survivors : A systematic review and meta-analysis. / Kang, Dong Woo; Lee, Junga; Suh, Sang-Hoon; Ligibel, Jennifer; Courneya, Kerry S.; Jeon, Justin Y.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 26, No. 3, 01.03.2017, p. 355-365.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effects of exercise on insulin, IGF axis, adipocytokines, and inflammatory markers in breast cancer survivors

T2 - A systematic review and meta-analysis

AU - Kang, Dong Woo

AU - Lee, Junga

AU - Suh, Sang-Hoon

AU - Ligibel, Jennifer

AU - Courneya, Kerry S.

AU - Jeon, Justin Y.

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Background: Insulin, IGF axis, adiponectin, and inflammatory markers are associated with breast cancer. Given that physical activity improves prognosis of breast cancer survivors, we investigated the effects of exercise on these markers as potential mediators between physical activity and breast cancer. Methods: PubMed, EMBASE, CENTRAL, CINAHL, and SportDiscus were searched up to December 3, 2015, to identify randomized controlled trials (RCT) that investigated the effect of exercise on insulin, IGF axis, and cytokines in breast cancer survivors. Weighted mean difference (WMD) was calculated using either fixed-or random-effects models on the basis of the heterogeneity of the studies. Results: A total of 18 studies involving 681 breast cancer survivors were included, and these numbers were reduced for individual biomarker analyses. We found that exercise significantly reduced fasting insulin levels [WMD, μ3.46 mU/mL; 95% confidence interval (CI),-5.97 to-0.95; P = 0.007]. Furthermore, potentiallymeaningfulbutstatisticallynonsignificantchangeswere observed in insulin resistance (WMD,-0.73; 95% CI,-0.54 to 0.13; P = 0.23),adiponectin(WMD, 1.17 mg/mL;95% CI,-0.87to 3.20; P = 0.26), and C-reactive protein (WMD,-1.10 mg/L; 95% CI,-2.39to0.20; P=0.10).Subgroupanalysesshowedthatfasting insulin levels were significantly more impacted in studies in which intervention participants experienced a weight reduction (WMD,-7.10 mU/mL; 95% CI,-10.31 to-3.90; P < 0.001). Conclusions: Exercise reduces fasting insulin levels in breast cancer survivors. This may be due to exercise-induced reductions in body weight. Impact: Practitioners and clinicians may better help breast cancer prognosis be improved through exercise, anticipating physiological effects on cancer.

AB - Background: Insulin, IGF axis, adiponectin, and inflammatory markers are associated with breast cancer. Given that physical activity improves prognosis of breast cancer survivors, we investigated the effects of exercise on these markers as potential mediators between physical activity and breast cancer. Methods: PubMed, EMBASE, CENTRAL, CINAHL, and SportDiscus were searched up to December 3, 2015, to identify randomized controlled trials (RCT) that investigated the effect of exercise on insulin, IGF axis, and cytokines in breast cancer survivors. Weighted mean difference (WMD) was calculated using either fixed-or random-effects models on the basis of the heterogeneity of the studies. Results: A total of 18 studies involving 681 breast cancer survivors were included, and these numbers were reduced for individual biomarker analyses. We found that exercise significantly reduced fasting insulin levels [WMD, μ3.46 mU/mL; 95% confidence interval (CI),-5.97 to-0.95; P = 0.007]. Furthermore, potentiallymeaningfulbutstatisticallynonsignificantchangeswere observed in insulin resistance (WMD,-0.73; 95% CI,-0.54 to 0.13; P = 0.23),adiponectin(WMD, 1.17 mg/mL;95% CI,-0.87to 3.20; P = 0.26), and C-reactive protein (WMD,-1.10 mg/L; 95% CI,-2.39to0.20; P=0.10).Subgroupanalysesshowedthatfasting insulin levels were significantly more impacted in studies in which intervention participants experienced a weight reduction (WMD,-7.10 mU/mL; 95% CI,-10.31 to-3.90; P < 0.001). Conclusions: Exercise reduces fasting insulin levels in breast cancer survivors. This may be due to exercise-induced reductions in body weight. Impact: Practitioners and clinicians may better help breast cancer prognosis be improved through exercise, anticipating physiological effects on cancer.

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