Effects of a home-based exercise program on the insulin-like growth factor axis in patients operated for colorectal cancer in Sweden: Results from the randomised controlled trial PHYSSURG-C. (April 2020)

• Record Type: Journal Article
• Authors: Onerup, Aron; Thörn, Sven-Egron; Angenete, Eva; Bock, David; Grybäck Gillheimer, Elin; Haglind, Eva; Nilsson, Hanna
• Is Part Of: Growth hormone & IGF research. Volume 51(2020)
• Page Start: 27
• Page End: 33
• Publication Date: 2020-04
• Subjects: Exercise -- Colorectal surgery -- Colorectal neoplasms -- Insulin-like growth factor I -- Insulin-like growth factor binding protein 3; Growth regulators -- Periodicals; Growth -- Regulation -- Periodicals; Somatomedin -- Periodicals; Somatomedins -- Periodicals; Growth Hormone -- Periodicals; Growth Substances -- Periodicals; Croissance -- Régulation -- Périodiques; Croissance -- Régulateurs -- Périodiques; Somatotrophine -- Périodiques; Somatomédine -- Périodiques; Growth -- Regulation; Growth regulators; Electronic journals; Periodicals; Electronic journals; 612.4
• DOI: 10.1016/j.ghir.2020.01.005
• Languages: English
• ISSNs: 1096-6374

Abstract

Summary: Objectives: We report results from a subgroup within the ongoing PHYSSURG-C trial with the aim to examine effects of exercise on IGF-1 and IGFBP-3 in patients undergoing colorectal cancer surgery. Design: Randomised controlled trial. Setting: A Swedish university hospital. Participants: Between 2015 and 2016, 217 patients were enrolled ( I = 106, C = 111), with 122 patients that had given blood samples at baseline and at least at one follow-up ( I = 51, C = 71). Patients 20 year or older with colorectal cancer were eligible. Exclusion criteria were emergency surgery, local surgery, language problems or inability to perform intervention. Interventions: Patients were computer-randomised to either a daily home-based aerobic exercise intervention (I), or to usual care (C). The intervention lasted two weeks before surgery and four weeks after discharge from hospital and consisted of medium-intensity aerobic exercise and inspiratory muscle training. Circulating concentrations of IGF-1 and IGFBP-3 were determined by blinded personnel at baseline, time of surgery and 4–6 weeks postoperatively. Primary and secondary outcome measures: The outcome of this subpopulation report was change in IGF-1/IGFBP-3 ratio, IGF-1 and IGFBP-3 concentrations from baseline to surgery, and 4–6 weeks postoperatively. Results: The IGF-1/IGFBP-3 ratio increased from baseline to surgery by 11% in I and 8% in C with no difference between groups (I vs. C: 1.04, 95%CI: 0.97–1.11; p = 1.000). Postoperative change was 5% in I and 3% in C with no difference between groups (I vs. C:1.03, 95%CI: 0.96–1.10; p = 1.000). Results concerning IGF-1 and IGFBP-3 also showed statistically significant dynamics over time with no difference between groups. No adverse events were reported. Conclusions: The home-based exercise program in our trial did not have any effect on IGF-1, or IGFBP-3. Trial registration: The study was registered at ClinicalTrials.gov with identifier NCT02299596 . This work was funded externally. Highlights: Randomised controlled study with large sample size, examining exercise before and after colorectal cancer surgery. The first randomised controlled trial examining effect of exercise on IGF axis in patients with current cancer. Pragmatic home-based intervention which increases external validity but reduces reliability of data on compliance. We found no effect on IGF-1/IGFBP-3 ratio or concentrations of IGF-1, IGFBP-3, or HbA1c after exercise compared to control.