Efectos de una intervención de 12 semanas de ejercicio en los niveles de hemoglobina glicada (HbA1c) en pacientes con cáncer (Effects of a 12-week exercise intervention on glycated hemoglobin (HbA1c) levels in cancer patients)

Naiara Virto; Paula Etayo-Urtasun; José Ramón  Sánchez Isla; María Soledad Arietanizbeaskoa; Nere  Mendizabal Gallastegui; Gonzalo Grandes; Borja Gutierrez; Aitor Coca; Xabier Río

doi:10.47197/retos.v48.96221

Autores

Naiara Virto Universidad de Deusto https://orcid.org/0000-0002-2850-8717
Paula Etayo-Urtasun Universidad de Deusto https://orcid.org/0000-0001-7211-6043
José Ramón Sánchez Isla Universidad de Deusto https://orcid.org/0000-0002-4873-1633
María Soledad Arietanizbeaskoa Biocruces Bizkaia Health Research Institute. https://orcid.org/0000-0001-8747-6789
Nere Mendizabal Gallastegui Biocruces Bizkaia Health Research Institute. https://orcid.org/0000-0002-3934-6362
Gonzalo Grandes Biocruces Bizkaia Health Research Institute. https://orcid.org/0000-0002-5217-6628
Borja Gutierrez Universidad de Deusto
Aitor Coca European University Gasteiz https://orcid.org/0000-0001-5355-4662
Xabier Río Universidad de Deusto https://orcid.org/0000-0001-9303-619X

DOI:

https://doi.org/10.47197/retos.v48.96221

Palavras-chave:

Oncología, Ejercicio, Composición Corporal, Entrenamiento Concurrente, Glucosa, Hemoglobina Glicada.

Resumo

A prática de exercício físico tem sido associada a um menor risco de desenvolvimento e recorrência de câncer. Da mesma forma, estudos anteriores sugerem que o exercício é eficaz na redução do risco de desenvolver distúrbios metabólicos. Portanto, esta investigação pretende avaliar os efeitos de um programa de exercícios combinados de 12 semanas na redução dos níveis de hemoglobina glicada (HbA1c) em pacientes com câncer. Para fazer isso, 22 pacientes não diabéticos foram aleatoriamente designados para uma intervenção de exercícios combinados de 12 semanas ou para o grupo controle. Avaliações iniciais e de 3 meses foram realizadas para avaliar as mudanças nos níveis de HbA1c, gordura e massa muscular esquelética nos 22 participantes que completaram o estudo. Analisando a amostra, houve melhora significativa nos níveis de HbA1c (p=0,033). Além disso, quando excluídos os maiores de 65 anos, as diferenças foram maiores (p=0,017). Embora não tenham sido encontradas diferenças significativas entre as reduções de indivíduos com diferentes níveis basais de HbA1c, aqueles com níveis mais altos reduziram os valores em 6,8% e aqueles com níveis normais em 3,6%. Além disso, nenhuma correlação foi encontrada entre reduções na HbA1c e mudanças na composição corporal. Essa intervenção de exercícios combinados de 12 semanas resultou em uma redução nos níveis de HbA1c, mas essa mudança não foi associada a mudanças na composição corporal.

Palavras-chave: Oncologia, Exercício, Composição Corporal, Treinamento Concorrente, Glicose, Hemoglobina Glicada.

Referências

American College of Sports Medicine (2018). ACSM’s guidelines for exercise testing and prescription. Philadelphia: Wolters Kluwer.

American Diabetes Association (2013). Standards of medical care in diabetes - 2013. Diabetes Care, 36(Suppl), 11-66. https://doi.org/10.2337/dc13-S011

Arietanizbeaskoa, M. S., Gil-Rey, E., Mendizabal Gallastegui, N., Garcia-Álvarez, A., De la Fuente, I., Domínguez-Martínez, S., Pablo, S., Coca, A., Gutierrez-Santamaría, B. & Grandes, G. (2020). Implementing exercise in standard cancer care (Bizi Orain hybrid exercise program): protocol for a randomized controlled trial. JMIR Research Protocols, 10, e24835.

Barua, R., Templeton, A. J., Seruga, B., Ocana, A., Amir, E., & Ethier, J. L. (2018). Hyperglycaemia and survival in solid tumours: a systematic review and meta-analysis. Clinical Oncology, 30(4), 215–224. https://doi.org/10.1016/j.clon.2018.01.003

Biolaster (n. d.). Quo-Lab Analizador Hemoglobina Glicosilada. https://www.biolaster.com/productos/Analizador-de-Hemoglobina/Quo-Lab-Analizador-Hemoglobina-Glicosidada/

Boniol, M., Dragomir, M., Autier, P., & Boyle, P. (2017). Physical activity and change in fasting glucose and HbA1c: a quantitative meta-analysis of randomized trials. Acta Diabetologica, 54(11), 983-991. https://doi.org/10.1016/j.clon.2018.01.003

Bourke, L., Stevenson, R., Turner, R., Hooper, R., Sasieni, P., Greasley, R., Morrissey, D., Loosemore, M., Fisher, A., Payne, H., Taylor, S. J. C., & Rosario, D. J. (2018). Exercise training as a novel primary treatment for localised prostate cancer: a multi-site randomised controlled phase II study. Scientific Reports, 8(1), 8374. https://doi.org/10.1016/j.clon.2018.01.003

Cavero-Redondo, I., Peleteiro, B., Álvarez-Bueno, C., Artero, E. G., Garrido-Miguel, M., & Martinez-Vizcaíno, V. (2018). The effect of physical activity interventions on glycosylated haemoglobin (HbA1c) in non-diabetic populations: a systematic review and meta-analysis. Sports Medicine, 48(5), 1151-1164. https://doi.org/10.1016/j.clon.2018.01.003

Christensen, J. F., Sundberg, A., Osterkamp, J., Thorsen-Streit, S., Nielsen, A. B., Olsen, C. K., Djurhuus, S. S., Simonsen, C., Schauer, T., Ellingsgaard, H., Østerlind, K., Krarup, P. M., Mosgaard, C., Vistisen, K., Tolver, A., Pedersen, B. K. & Hojman, P. (2019). Interval walking improves glycemic control and body composition after cancer treatment: a randomized controlled trial. The Journal of Clinical Endocrinololgy & Metabolism, 104(9), 3701–3712. https://doi.org/10.1210/jc.2019-00590

De Beer, J. C., & Liebenberg, L. (2014). Does cancer risk increase with HbA1c, independent of diabetes? British Journal of Cancer, 110(9), 2361-2368. https://doi.org/10.1210/jc.2019-00590

Dieli-Conwright, C. M., Courneya, K. S., Demark-Wahnefried, W., Sami, N., Lee, K., Sweeney, F. C., Stewart, C., Buchanan, T. A., Spicer, D., Tripathy, D., Bernstein, L., & Mortimer, J. E. (2018a). Aerobic and resistance exercise improves physical fitness, bone health, and quality of life in overweight and obese breast cancer survivors: a randomized controlled trial. Breast Cancer Research, 20(1), 124. https://doi.org/10.1186/s13058-018-1051-6

Dieli-Conwright, C. M., Parmentier, J. H., Sami, N., Lee, K., Spicer, D., Mack, W. J., Sattler F., & Mittelman, S. D. (2018b). Adipose tissue inflammation in breast cancer survivors: effects of a 16-week combined aerobic and resistance exercise training intervention. Breast Cancer Research Treatment, 168(1), 147-157. https://doi.org/10.1007/s10549-017-4576-y

Global Cancer Observatory (2020). Cancer Tomorrow. Lyon: International Agency for Research on Cancer. https://gco.iarc.fr/tomorrow/en/dataviz/bars?mode=population&years=2030&types=1

Guinan, E., Hussey, J., Broderick, J. M., Lithander, F. E., O'Donnell, D., Kennedy, M. J., & Connolly, E. M. (2013). The effect of aerobic exercise on metabolic and inflammatory markers in breast cancer survivors-a pilot study. Supportive Care in Cancer, 21(7), 1983–1992. https://doi.org/10.1007/s00520-013-1743-5

Hope, C., Robertshaw, A., Cheung, K. L., Idris, I., & English, E. (2016). Relationship between HbA1c and cancer in people with or without diabetes: a systematic review. Diabetic Medicine, 33(8), 1013-1025.

InBody (2014). InBody 770. https://www.composicion-corporal-inbody.com/InBody-770.html

Iyengar, N. M., & Jones, L. W. (2019). Development of exercise as interception therapy for cancer: a review. JAMA Oncology, 5(11), 1620-1627. https://doi.org/10.1001/jamaoncol.2019.2585

Kang, D. W., Lee, E. Y., An, K. Y., Min, J., Jeon, J. Y., & Courneya, K. S. (2018). Associations between physical activity and comorbidities in Korean cancer survivors. Journal of Cancer Survivorship, 12(4), 441-449. https://doi.org/10.1007/s00520-013-1743-5

Kang, X. Y., Xu, Q. Y., Yu, Z., Han, S. F., Zhu, Y. F., & Lv, X. (2020). The effects of physical activity on physiological markers in breast cancer survivors: a meta-analysis. Medicine, 99(20), e20231. https://doi.org/10.1007/s00520-013-1743-5

Ling, C. H., de Craen, A. J., Slagboom, P. E., Gunn, D. A., Stokkel, M. P., Westendorp, R. G., & Maier, A. B. (2011). Accuracy of direct segmental multi-frequency bioimpedance analysis in the assessment of total body and segmental body composition in middle-aged adult population. Clinical Nutrition, 30(5), 610–615. https://doi.org/10.1016/j.clnu.2011.04.001

Masuch, A., Friedrich, N., Roth, J., Nauck, M., Müller, U. A., & Petersmann, A. (2019). Preventing misdiagnosis of diabetes in the elderly: age-dependent HbA1c reference intervals derived from two population-based study cohorts. BMC Endocrine Disorders, 19(20). https://doi.org/10.1016/j.clnu.2011.04.001

Matthews, C. E., Moore, S. C., Arem, H., Cook, M. B., Trabert, B., Håkansson, N., Larsson, S. C., Wolk, A., Gapstur, S. M., Lynch, B. M., Milne, R. L., Freedman, N. D., Huang, W., Berrington de Gonzalez, A., Kitahara, C. M., Linet, M. S., Shiroma, E. J., Sandin, S., Patel, A. V., & Lee, I. (2019). Amount and intensity of leisure-time physical activity and lower cancer risk. Journal of Clinical Oncology, 38(7), 686-697. https://doi.org/10.1200/JCO.19.02407

McArdle, W. D., Katch, F. I., & Katch, V. L. (2015). Fisiología del Ejercicio: Nutrición, Rendimiento y Salud. Spain: Wolters Kluwer Health.

Raun, S. H., Buch-Larsen, K., Schwarz, P., & Sylow, L. (2021). Exercise - A panacea of metabolic dysregulation in cancer: physiological and molecular insights. International Journal of Molecular Sciences, 22(7), 3469. https://doi.org/10.3390/ijms22073469

Río, X., González-Pérez, A., Larrinaga-Undabarrena, A., & Coca, A. (2020). Analysis of quality of life parameters in a health-promoting program for a population with cardiovascular risk factors: a preliminary study. SN Comprehensive Clinical Medicine, 2, 2221–2229. https://doi.org/10.1007/s42399-020-00512-9

Rodwell, V. W., Bender, D. A., Botham, K. M., Kennelly, P. J., & Weil, P. A. (2016). Harper bioquímica ilustrada. McGraw-Hill Interamericana Editores.

Sanchez, A., Grandes, G., Cortada, J. M., Pombo, H., Balague, L., & Calderon, C. (2009). Modelling innovative interventions for optimising healthy lifestyle promotion in primary health care: "Prescribe Vida Saludable" phase I research protocol. BMC Health Services Research, 9(103). https://doi.org/10.1186/1472-6963-9-103

Schmidt, T., Schwarz, M., Van Mackelenbergh, M., Jonat, W., Weisser, B., Röcken, C., & Mundhenke, C. (2017). Feasibility study to evaluate compliance of physical activity over a long time period and its influence on the total activity score, glucose metabolism and physical and psychological parameters following breast cancer. Molecular and Clinical Oncology, 6(3), 397-402. https://doi.org/10.3892/mco.2017.1144

Sénéchal, M., Swift, D. L., Johannsen, N. M., Blair, S. N., Earnest, C. P., Lavie, C. J., & Church, T. S. (2013). Changes in body fat distribution and fitness are associated with changes in hemoglobin A1c after 9 months of exercise training: results from the HART-D study. Diabetes Care, 36(9), 2843–2849. https://doi.org/10.2337/dc12-2428

Singh, B., Hayes, S. C., Spence, R. R., Steele, M. L., Millet, G. Y., & Gergele, L. (2020). Exercise and colorectal cancer: a systematic review and meta-analysis of exercise safety, feasibility and effectiveness. International Journal of Behavioral Nutrition and Physical Activity, 17(122). https://doi.org/10.2337/dc12-2428

Sjøberg, K. A., Frøsig, C., Kjøbsted, R., Sylow, L., Kleinert, M., Betik, A. C., Shaw, C. S., Kiens, B., Wojtaszewski, J., Rattigan, S., Richter, E. A., & McConell, G. K. (2017). Exercise increases human skeletal muscle insulin sensitivity via coordinated increases in microvascular perfusion and molecular signaling. Diabetes, 66(6), 1501–1510. https://doi.org/10.2337/db16-1327

Wang, Y., Jin, B., Paxton, R. J., Yang, W., Wang, X., Jiao, Y., Yu, C., & Chen, X. (2020).The effects of exercise on insulin, glucose, IGF-axis and CRP in cancer survivors: meta-analysis and meta-regression of randomized controlled trials. European Journal of Cancer Care, 29(1), e13186. https://doi.org/10.1111/ecc.13186

World Health Organization (2022). Cancer. https://www.who.int/news-room/fact-sheets/detail/cancer.

World Health Organization (2021). Obesity and overweight. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight