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Randomized Controlled Trial
. 2009 Jan;18(1):306-13.
doi: 10.1158/1055-9965.EPI-08-0531.

Randomized controlled trial of aerobic exercise on insulin and insulin-like growth factors in breast cancer survivors: the Yale Exercise and Survivorship study

Melinda L Irwin  1 , Katie Varma, Marty Alvarez-Reeves, Lisa Cadmus, Andrew Wiley, Gina G Chung, Loretta Dipietro, Susan T Mayne, Herbert Yu
Affiliations
Randomized Controlled Trial

Randomized controlled trial of aerobic exercise on insulin and insulin-like growth factors in breast cancer survivors: the Yale Exercise and Survivorship study

Melinda L Irwin et al. Cancer Epidemiol Biomarkers Prev. 2009 Jan.

Abstract

Background: High insulin and insulin-like growth factor-I (IGF-I) levels may be associated with an increased breast cancer risk and/or death. Given the need to identify modifiable factors that decrease insulin, IGF-I, and breast cancer risk and death, we investigated the effects of a 6-month randomized controlled aerobic exercise intervention versus usual care on fasting insulin, IGF-I, and its binding protein (IGFBP-3) in postmenopausal breast cancer survivors.

Methods: Seventy-five postmenopausal breast cancer survivors were identified from the Yale-New Haven Hospital Tumor Registry and randomly assigned to an exercise (n = 37) or usual care (n = 38) group. The exercise group participated in 150 minutes per week of moderate-intensity aerobic exercise. The usual care group was instructed to maintain their current physical activity level. A fasting blood sample was collected on each study participant at baseline and 6 months. Blood levels of insulin and IGF were measured with ELISA.

Results: On average, exercisers increased aerobic exercise by 129 minutes per week compared with 45 minutes per week among usual care participants (P < 0.001). Women randomized to exercise experienced decreases in insulin, IGF-I, and IGFBP-3, whereas women randomized to usual care had increases in these hormones. Between-group differences in insulin, IGF-I, and IGFBP-3 were 20.7% (P = 0.089), 8.9% (P = 0.026), and 7.9% (P = 0.006), respectively.

Conclusions: Moderate-intensity aerobic exercise, such as brisk walking, decreases IGF-I and IGFBP-3. The exercise-induced decreases in IGF may mediate the observed association between higher levels of physical activity and improved survival in women diagnosed with breast cancer.

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Figures

Figure 1
Figure 1
Flow of participants through the YES Study.
See this image and copyright information in PMC

Comment in

References

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    1. Irwin ML, Ballard-Barbash R, McTiernan A, et al. Fasting C-peptide levels and breast cancer death. American Association of Cancer Research Frontiers in Cancer Prevention Meeting; December 2007; Abstract B99.
    1. Irwin ML, McTiernan A, Bernstein L, et al. Relationship of obesity and physical activity with c-peptide, leptin, and insulin-like growth factors in breast cancer survivors. Cancer Epidemiol Biomarkers Prev. 2005;14(12):2881–8. - PMC - PubMed
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