Abstract

The main hypothesis on the positive effects of exercise in oncological patients has been focusing on lowering the basal systemic levels of cancer risk factors such as insulin-like growth factor-1 (IGF-1) and its binding proteins (IGFBP). However, there is a paucity of data and a remarkable heterogeneity when considering the response of the IGF-1 system to exercise in breast cancer survivors (BCS). In this study we tested the hypothesis that aerobic exercise training might normalize the IGF-1 system in BCS patients with normal to high level of IGF-1. Non physically active BCS women (n=30, age 52.7 ± 7.6 years), enrolled in the MoviS ‘Movement and Health Beyond Care’ study (clinicaltrial.gov identifier: NCT04818359), at high metabolic and hormonal risk of BC recurrences performed 3-month aerobic training (2 d/week of supervised and 1 d/week of unsupervised exercise) with increase of exercise intensity (40-70% HRR) and duration (20-60 min). Circulating IGF-1 and IGFBP3 levels were measured before and after the intervention. VO2max increased by 10.1 % (mL·min-1·kg−1: before=30.7±5.7, after=33.4±6.8; p<0.001) while body mass index (kg/m2: before=26.0±5.0, after=25.5±4.7; p=0.035), glycemia (mg/dL: before=100.8±11.4, after=91.7±11.0; p<0.001) and insulin resistance (HOMA-IR score: before =2.07±1.54, after =1.53±1.11; p=0.005) decreased after training. Mean IGF-1 level did not change after training (ng/mL: before=164.3±70.9, after=166.8±57.6) while IGFBP3 level decreased (μg/mL: before=6.1±1.4, after=4.2±1.5). There was a negative correlation between pre-training IGF-1 levels and individual changes in IGF-1 after training (r=- 0.62, p<0.001). Accordingly, the IGF-1 coefficient of variation (CV) decreased after training (%: before=43.2, after=34.5). Finally, the correlation between IGF-1 and IGFBP3 levels was reduced after training (r: before=0.74, after 0.45, p<0.001). The exercise intervention modulates the IGF-1 system lowering the circulating IGF-1 variability, the IGFBP3 level and the relationship between IGF-1 and IGFBP3 among BCS patients.

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