Evaluating the Efficacy Concurrent (Aerobic-Resistance) Training Program on the Circulating Inflammatory Markers in Obese Postmenopausal Women at High-Risk of Breast Cancer: A Randomized, Parallel-Controlled and One-Center Clinical Trial

Obesity is a chronic disease induced by imbalance of energy ‎homeostasis‏ ‏which ‎has been associated with risk of menopausal estrogen-‎dependent breast cancer. The present study ‎aimed to examine the effect of 12-‎week concurrent (aerobic-resistance) training on the inflammation marker [Estradiol, Tumor Necrosis Factor-α (TNF-α), Interleukin-6(IL-6)] and ‎physical performance (VO2max, balance, flexibility and strength) in ‎obese postmenopausal women.‎

Our research was an unblinded randomized controlled clinical trial. Thirty sedentary and obese postmenopausal women were recruited [age 45–55years, overweight or obese (BMI >25 kg/m2), and inactive (<150 min/week of physical activity) and had an elevated Gail 5-year risk score of breast cancer (>1.66%)] and randomly divided into concurrent training (CT, n=12) and control group (CG, n=13).The ‎participant’s ‎took part in a 12-week supervised intervention training 5 days/week, (each session ‎of which ‎involved 60 minutes of strength training and 30 minutes of aerobic training). Blood ‎samples ‎were taken from the volunteers to measure estradiol and TNF-α and IL-6. Physical ‎function (strength, VO2max, flexibility and balance) ‎were evaluated pre, mid and post-‎intervention. Quantitative expression was evaluated using 2-∆∆ct method and REST software. ‎ANOVA tests ‎with Bonferroni correction were used to compare the groups at a significance level ‎of α<0.05.‎

In response to training, total fat mass (FM) , ‏lean body mass(LBM) and ‏waist circulation(WC)‏ ‏in the concurrent training group improved significantly compared with the control group (P < 0.05). The CT group experienced a reduction in FM (-7.73%; ‎P ‎‎<0.05) and an increase in LBM (2.5%; P <0.05).A significant decrease in the expression of IL-6 (P=0.004) and TNF-α (P=0.0013) was observed in the experimental group compared to the control group. There was no significant difference in estradiol levels in the experimental group compared to the control (P>0.05). VO2max (P=0.001), balance (P=0.001), strength [hand grip (32.7%), leg strength (31.4%)] and flexibility (P=0.002), in the experimental group increased significantly compared to the control group.

The concurrent training and exercise-induced fat mass loss appears to slow the ‎increase of pro ‎inflammatory cytokines in postmenopausal women that is an established risk ‎factor of breast cancer. ‎Thus, this study provides additional evidences to the intricate interaction ‎among estradiol, ‎inflammatory cytokines, adipose tissue and muscle mass in postmenopausal ‎women.‎