Abstract C122: Ethnicity as a moderator of the effects of aerobic and resistance exercise on metabolic syndrome in breast cancer survivors
Bibliographic record
Abstract
Abstract Background and Purpose: Metabolic syndrome (MSY) is associated with increased risk of cardiovascular disease, type 2 diabetes, and recurrence in breast cancer survivors (BCS). MSY is 1.5 times more common in Hispanic compared to non-Hispanic women. Hispanic women in the United States are more likely to be obese and physically inactive than matched non-Hispanic counterparts, raising risk for developing MSY. Exercise mitigates MSY in BCS; however, few studies have focused on minorities. The purpose of this secondary analysis was to examine ethnicity as a moderator of the effects of a 16-week combined aerobic and resistance clinical exercise intervention on MSY and related biomarkers in BCS. Experimental Design: Sedentary, overweight or obese (BMI>25.0 kg/m2) BCS (Stage I-III; n=100) were randomized to exercise (n=50) or usual care (n=50). The exercise intervention promoted supervised, progressive moderate-vigorous (65-85% heart rate maximum) aerobic and resistance exercise thrice weekly for 16 weeks. Aerobic exercise included cycling, walking, or jogging at 65-85% maximum heart rate. Resistance exercise was performed in circuit-fashion with 3 sets of 10-15 repetitions including upper and lower body exercises at 65-70% 1-repetition maximum. MSY variables (blood pressure, waist circumference, triglycerides, glucose, and high-density lipoprotein-cholesterol) and related biomarkers (insulin, insulin resistance HOMA-IR, C-reactive protein [CRP]) were measured at baseline and post-intervention (4 months). Differences in mean changes for outcomes by ethnicity were evaluated using linear mixed-models to assess effect modification. Summary of Results: Fifty-seven Hispanic BCS and 43 non-Hispanic BCS with an average age of 53.5±10.4 years and BMI of 33.5±5.5 kg/m2 were included. Hispanic BCS were younger, of greater adiposity, had higher-stage cancers, and had worse metabolic profiles at baseline compared to non-Hispanic BCS (p<0.001). Ethnicity was found to moderate the effects of exercise training on triglycerides (mean difference, -36.4; 95% confidence interval (95% CI), -62.1-18.3; p=0.04) and glucose (mean difference, -8.6; 95% CI, -18.7-3.1; p=0.05) with Hispanic BCS exhibiting larger improvements than non-Hispanic BCS. Ethnicity moderated the effect of exercise on insulin (P for interaction=0.09), HOMA-IR (P for interaction=0.06), and CRP (P for interaction=0.05). Conclusions: Hispanic, as compared to non-Hispanic, BCS have poorer metabolic profiles, but may achieve better outcomes from exercise. To our knowledge, this is the first study to explore racial/ethnic disparities in MSY between Hispanic and non-Hispanic BCS and document differential response to exercise. Clinical exercise interventions may attenuate ethnic health disparities in BCS. Future trials should aim for diversity. Citation Format: Christina M. Dieli-Conwright, Frank C. Sweeney, Kerry S. Courneya, Debu Tripathy, Nathalie Sami, Kyuwan Lee, Thomas A. Buchanan, Darcy Spicer, Leslie Bernstein, Joanne E. Mortimer, Wendy Demark-Wahnefried. Ethnicity as a moderator of the effects of aerobic and resistance exercise on metabolic syndrome in breast cancer survivors [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C122.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".