身体活动降低罹患乳腺癌风险的生物学机制研究进展

Research Advancement on the Biological Mechanism of Physical Activity on Reducing Risk of Breast Cancer

乳腺癌是目前我国发病率较高的癌症类型,直接关系到众多女性的健康。科学预防乳腺癌的发生是控制乳腺癌发病率的重要途径。已有的流行病学研究证明,身体活动可以显著降低罹患乳腺癌的风险。通过综合近年来国际主流文献对身体活动干预乳腺癌发生的机制研究,阐述身体活动干预乳腺癌的可能的生物学途径,尤其是对乳腺癌生物标记物的干预效果,这些生物指标主要包括身体质量指数、雌/雄激素、胰岛素耐受、脂肪因子以及TNF-α、IL-6等炎症因子。女性长期进行中等强度以上的锻炼,可以通过控制体重、减少脂肪、降低循环雌激素水平、改善胰岛素耐受、调控脂肪因子以及拮抗炎症因子等生物学途径预防乳腺癌的发生。由于雌激素代谢、胰岛素敏感性、脂肪因子合成等均与脂肪组织有关,因此,通过身体活动控制体重是预防乳腺癌的核心。建议重视长期跟踪实验及对多种人群的干预研究;在实验中需对身体活动的类型及运动强度、持续时间等进行详细阐述,进一步改进评估方法。

Breast cancer, directly related to many women＇s health, is now one ot cancer types with higher incidence in China. To control the incidence of breast cancer, it is important to prevent carcinogenesis of breast cancer scientifically. Accumulating epidemiologic evidence has supported a protective role of physical activity in breast cancer. This report provides an updated review of the literature on the hypothesized biological mechanisms in the association between physical activity and breast cancer, an overview of how physical activity can affect women＇ s physiological functions and biomarkers that influencing the risk of breast cancer. We summarized mainly these proposed biomarkers, namely, body mass index （ BMI）, estrogens, androgens, adipokines, insulin resistance, and inflammatory factors, such as TNF-α, IL-6. The beneficial effects on the risk of breast cancer could be achieved by moderate to vigorous activity performed regularly, which probably through proposed mechanisms including BM1 control, reduction in circulating estrogen, impact on insulin resistance, and anti-inflammatory effects. While adipose tissue is associated with a number of biological pathways, including metabolism of estrogen, sensibility to insulin and production of adipokines, it is critical to control weight through physical activity for beast cancer prevention. Future studies should conduct more welldesigned studies for long-term exercise trials and for assessment across varied populations. There is also a need to specify type, intensity and duration of physical activity by improving measurement tools.