The Prostate Cancer Active Lifestyle Study (PALS): A randomized controlled trial of diet and exercise in overweight and obese men on active surveillance.

Autor: Wright JL; Department of Urology, University of Washington School of Medicine, Seattle, Washington, USA.; Fred Hutchinson Cancer Center, Seattle, Washington, USA.; Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA., Schenk JM; Fred Hutchinson Cancer Center, Seattle, Washington, USA., Gulati R; Fred Hutchinson Cancer Center, Seattle, Washington, USA., Beatty SJ; Fred Hutchinson Cancer Center, Seattle, Washington, USA., VanDoren M; Fred Hutchinson Cancer Center, Seattle, Washington, USA., Lin DW; Department of Urology, University of Washington School of Medicine, Seattle, Washington, USA.; Fred Hutchinson Cancer Center, Seattle, Washington, USA., Porter MP; Department of Urology, University of Washington School of Medicine, Seattle, Washington, USA.; Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA., Morrissey C; Department of Urology, University of Washington School of Medicine, Seattle, Washington, USA., Dash A; Department of Urology, University of Washington School of Medicine, Seattle, Washington, USA.; Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA., Gore JL; Department of Urology, University of Washington School of Medicine, Seattle, Washington, USA.; Fred Hutchinson Cancer Center, Seattle, Washington, USA., Etzioni R; Fred Hutchinson Cancer Center, Seattle, Washington, USA., Plymate SR; Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA.; Geriatric Research Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA., Neuhouser ML; Fred Hutchinson Cancer Center, Seattle, Washington, USA.
Jazyk: angličtina
Zdroj: Cancer [Cancer] 2024 Jun 15; Vol. 130 (12), pp. 2108-2119. Date of Electronic Publication: 2024 Feb 14.
DOI: 10.1002/cncr.35241
Abstrakt: Background: Active surveillance (AS) is increasingly used to monitor patients with lower risk prostate cancer (PCa). The Prostate Cancer Active Lifestyle Study (PALS) was a randomized controlled trial to determine whether weight loss improves obesity biomarkers on the causal pathway to progression in patients with PCa on AS.
Methods: Overweight/obese men (body mass index >25 kg/m 2 ) diagnosed with PCa who elected AS were recruited. The intervention was a 6-month, individually delivered, structured diet and exercise program adapted from the Diabetes Prevention Program with a 7% weight loss goal from baseline. Control participants attended one session reviewing the US Dietary and Physical Activity Guidelines. The primary outcome was change in glucose regulation from baseline to the end of the 6-month intervention, which was measured by fasting plasma glucose, C-peptide, insulin, insulin-like growth factor 1, insulin-like growth factor binding protein-3, adiponectin, and homeostatic model assessment for insulin resistance.
Results: Among 117 men who were randomized, 100 completed the trial. The mean percentage weight loss was 7.1% and 1.8% in the intervention and control arms, respectively (adjusted between-group mean difference, -6.0 kg; 95% confidence interval, -8.0, -4.0). Mean percentage changes from baseline for insulin, C-peptide, and homeostatic model assessment for insulin resistance in the intervention arm were -23%, -16%, and -25%, respectively, compared with +6.9%, +7.5%, and +6.4%, respectively, in the control arm (all p for intervention effects ≤ .003). No significant between-arm differences were detected for the other biomarkers.
Conclusions: Overweight/obese men with PCa undergoing AS who participated in a lifestyle-based weight loss intervention successfully met weight loss goals with this reproducible lifestyle intervention and experienced improvements in glucose-regulation biomarkers associated with PCa progression.
(© 2024 American Cancer Society.)
Databáze: MEDLINE
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