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  • 1
    Keywords: SUPPORT ; DISEASE ; RISK ; PROTEIN ; INDEX ; REDUCTION ; BODY-WEIGHT ; TRIAL ; HUMANS ; WOMEN ; OBESITY ; FAT ; C-REACTIVE PROTEIN ; TRENDS ; POSTMENOPAUSAL WOMEN ; exercise ; SERUM ; WEIGHT ; INTERLEUKIN-6 ; methods ; anthropometry ; OVERWEIGHT ; female ; INCREASED RISK ; BMI ; Aged ; Middle Aged ; WAIST CIRCUMFERENCE ; CONTROLLED-TRIAL ; WEIGHT-LOSS ; 3 ; INVESTIGATE ; C-REACTIVE-PROTEIN ; Abdominal ; *Exercise Therapy ; *Postmenopause ; AEROBIC EXERCISE ; C-Reactive Protein/*analysis ; Obesity/*physiopathology ; Serum Amyloid A Protein/analysis
    Abstract: PURPOSE: To investigate the effect of a yearlong moderate-intensity aerobic exercise intervention on C-reactive protein (CRP), serum amyloid A (SAA), and interleukin 6 (IL-6) among overweight or obese postmenopausal women. METHODS: In a randomized controlled trial, 115 postmenopausal, overweight or obese, sedentary women, aged 50-75 yr were randomized to an aerobic exercise intervention of moderate-intensity (60%-75% observed maximal HR), for 〉 or = 45 min x d(-1), 5 d x wk (n = 53), or to a 1-d x wk(-1) stretching control (n = 62), on an intent-to-treat basis. CRP, SAA, and IL-6 were measured at baseline, at 3 months, and at 12 months. RESULTS: From baseline to 12 months, CRP decreased 10% in exercisers and increased 12% in controls (P = 0.01); no effects were observed for SAA and IL-6. Among participants at baseline who were obese (body mass index (BMI) 〉 or = 30 kg x m(-2)) or had abdominal obesity (waist circumference (WC) 〉 or = 88 cm), exercise resulted in a more pronounced reduction in CRP (BMI 〉 or = 30 kg x m(-2), P = 0.002; WC 〉 or = 88 cm, P 〈 0.0001), borderline for SAA (BMI 〉 or = 30 kg x m(-2), P = 0.08; WC 〉 or = 88 cm, P = 0.04); no intervention effects were observed among women who did not have these characteristics. Overall, weight loss was minimal in the exercise intervention ( approximately 1.8 kg). Linear trends were observed between CRP and 12-month changes in aerobic fitness (Ptrend = 0.006), exercise adherence (Ptrend = 0.004), percentage body fat (Ptrend = 0.002), body weight (Ptrend = 0.002), WC (Ptrend = 0.02), and intra-abdominal fat (Ptrend = 0.03). CONCLUSIONS: A moderate-intensity exercise intervention reduced CRP for 12 months among women who were obese at baseline. These findings support the role of exercise in modulating inflammatory processes that are related to increased risk of chronic disease among obese women.
    Type of Publication: Journal article published
    PubMed ID: 19568208
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    Keywords: CANCER ; MODEL ; MODELS ; DIAGNOSIS ; COHORT ; cohort studies ; cohort study ; HISTORY ; PROTEIN ; radiation ; PATIENT ; MARKER ; treatment ; ASSOCIATION ; BREAST ; breast cancer ; BREAST-CANCER ; HEALTH ; HUMANS ; AGE ; WOMEN ; PROSPECTIVE COHORT ; smoking ; chemotherapy ; MARKERS ; CANCER-PATIENTS ; C-REACTIVE PROTEIN ; FAILURE ; CANCER PATIENTS ; inflammation ; physical activity ; SERUM ; ADULT ; REGRESSION ; PROGNOSTIC-FACTOR ; PHYSICAL-ACTIVITY ; SURVIVORS ; heart failure ; methods ; CLINICAL CHARACTERISTICS ; prospective ; female ; multivariate analysis ; BMI ; population-based ; cross-sectional studies ; Aged ; Middle Aged ; WAIST CIRCUMFERENCE ; Aged,80 and over ; VITAMIN ; C-REACTIVE-PROTEIN ; C-Reactive Protein/*analysis ; Breast Neoplasms/*blood/*epidemiology/ethnology ; Life Style ; Serum Amyloid A Protein/*analysis ; Tumor Markers,Biological/*blood
    Abstract: INTRODUCTION: Inflammatory status may be an important prognostic factor for breast cancer. Correlates of markers of inflammation in breast cancer survivors have not been thoroughly evaluated. METHODS: Using data from, the Health, Eating, Activity, and Lifestyle (HEAL) Study (a population-based, multiethnic prospective cohort study of female breast cancer patients) we evaluated the associations between circulating markers of inflammation (C-reactive protein [CRP] and serum amyloid A [SAA], measured approximately 31 months after diagnosis) and several demographic, lifestyle, and clinical characteristics in 741 disease-free breast cancer survivors. Analysis of variance and regression methods were used for statistical analyses of log-transformed values of CRP and SAA. RESULTS: After adjusting for age, BMI, ethnicity, and study site, higher concentrations of CRP were associated with increasing concentration of SAA (P-trend 〈 0.0001), increasing age (P-trend 〈 0.0001), increasing BMI (P-trend 〈 0.0001), increasing waist circumference (P-trend 〈 0.0001), positive history of heart failure (P = 0.0007), decreasing physical activity (P-trend = 0.005), Hispanic ethnicity (P = 0.05 vs. non-Hispanic white), and current smoking (P = 0.03 vs. never smoking). Vitamin E supplementation (P = 0.0005), tamoxifen use (P = 0.008), and radiation treatment (compared to no chemotherapy or radiation; P = 0.04) were associated with reduced CRP. Associations of CRP with clinical characteristics were not significant in the adjusted models. In a multivariate analysis, CRP showed significant associations with waist circumference, BMI, age, history of heart failure, tamoxifen use, and vitamin E supplementation (R (2) = 0.35). Similar, yet fewer, associations were observed for SAA (R (2) = 0.19). CONCLUSIONS: This study highlights important correlates of inflammatory status in breast cancer patients. Our results are consistent with those from similar studies of healthy women.
    Type of Publication: Journal article published
    PubMed ID: 18401703
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  • 4
    Keywords: proliferation ; CELL ; SYSTEM ; POPULATION ; PROTEIN ; MARKER ; ASSOCIATION ; TRIAL ; HEALTH ; HUMANS ; ASSAY ; WOMEN ; MARKERS ; POPULATIONS ; C-REACTIVE PROTEIN ; OUTCOMES ; questionnaires ; inflammation ; CYTOTOXICITY ; exercise ; SERUM ; air pollution ; INTERLEUKIN-6 ; IMMUNE-SYSTEM ; methods ; ASSAYS ; OVERWEIGHT ; USA ; female ; cross-sectional studies ; Middle Aged ; outcome ; immune system ; postmenopause ; CONFIDENCE ; MEDIATOR ; C-REACTIVE-PROTEIN ; Serum Amyloid A Protein/analysis ; Air Pollutants/*toxicity ; C-Reactive Protein/analysis ; Cell Proliferation/drug effects ; Geographic Information Systems ; Immunity,Cellular/*drug effects ; Inflammation/*chemically induced ; Interleukin-6/analysis ; Interviews as Topic ; Killer Cells,Natural/drug effects ; Linear Models ; T-Lymphocytes/drug effects ; Vehicle Emissions/*toxicity ; Washington
    Abstract: BACKGROUND: Traffic-related air pollution has been associated with adverse health outcomes, and the immune system may be a biologic mediator of health effects. OBJECTIVES: We analyzed associations between living near major roads and immune status as measured by five immune assays. We hypothesized that living near a freeway, arterial, or truck route would be associated with increased inflammation and decreased immune function. METHODS: We used a geographic information system (GIS) to determine residential proximity to major roads among 115 postmenopausal, overweight women in the greater Seattle, Washington (USA), area whose immunity was assessed at the baseline visit of an exercise intervention trial. We evaluated three inflammatory markers (C-reactive protein, serum amyloid A, and interleukin-6) and two functional assays of cellular immunity [natural killer (NK) cell cytotoxicity and T-lymphocyte proliferation]. RESULTS: Women living within 150 m of arterial roads had 21% lower NK cytotoxicity compared with women who lived farther from an arterial [mean cytotoxicity, 19.5%; 95% confidence interval (CI), 15.6-23.5%; vs. mean cytotoxicity, 24.8%; 95% CI, 22.0-27.5%], after adjustment for both individual-level and census tract-level demographic characteristics. This association was limited to women who reported exercising near traffic. Fewer women lived near freeways and truck routes. Markers of inflammation and lymphocyte proliferation did not consistently differ according to proximity to major roads. CONCLUSIONS: If the observed association between residential proximity to traffic and decreased NK cytotoxicity is confirmed in other populations, our results may have implications for local land use policy.
    Type of Publication: Journal article published
    PubMed ID: 19337511
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  • 5
    Keywords: CANCER ; SURVIVAL ; tumor ; MODEL ; MODELS ; DIAGNOSIS ; FOLLOW-UP ; COHORT ; cohort studies ; cohort study ; DEATH ; DISEASE ; HISTORY ; LONG-TERM ; PROTEIN ; PATIENT ; MARKER ; INDEX ; BIOMARKERS ; ASSOCIATION ; BREAST ; breast cancer ; BREAST-CANCER ; STAGE ; PROGRESSION ; HEALTH ; HUMANS ; AGE ; WOMEN ; PROSPECTIVE COHORT ; MARKERS ; LONG-TERM SURVIVAL ; DOSE-RESPONSE ; CANCER-PATIENTS ; C-REACTIVE PROTEIN ; RISK ASSESSMENT ; PREDICTORS ; CANCER PATIENTS ; inflammation ; SERUM ; ADULT ; CARDIOVASCULAR-DISEASE ; development ; biomarker ; methods ; PROGNOSTIC MARKER ; EVENTS ; prospective ; female ; Middle Aged ; cancer survival ; Proportional Hazards Models ; LOW-GRADE ; hazard ratio ; treatment outcome ; C-REACTIVE-PROTEIN ; Disease-Free Survival ; *Prognosis ; Biological Markers/*blood ; Breast Neoplasms/blood/diagnosis/*mortality/pathology ; C-Reactive Protein/*metabolism ; Inflammation/blood/etiology/mortality ; Serum Amyloid A Protein/*metabolism ; Young Adult
    Abstract: PURPOSE Chronic inflammation is believed to contribute to the development and progression of breast cancer. Systemic C-reactive protein (CRP) and serum amyloid A (SAA) are measures of low-grade chronic inflammation and potential predictors of cancer survival. PATIENTS AND METHODS We evaluated the relationship between circulating markers of inflammation and breast cancer survival using data from the Health, Eating, Activity, and Lifestyle (HEAL) Study (a multiethnic prospective cohort study of women diagnosed with stage 0 to IIIA breast cancer). Circulating concentrations of CRP and SAA were measured approximately 31 months after diagnosis and tested for associations with disease-free survival (approximately 4.1 years of follow-up) and overall survival (approximately 6.9 years of follow-up) in 734 disease-free breast cancer survivors. Cox proportional hazards models were used with adjustment for potential confounding factors to generate hazard ratios (HRs) and 95% CIs. Results Elevated SAA and CRP were associated with reduced overall survival, regardless of adjustment for age, tumor stage, race, and body mass index (SAA P trend 〈 .0001; CRP P trend = .002). The HRs for SAA and CRP tertiles suggested a threshold effect on survival, rather than a dose-response relationship (highest v lowest tertile: SAA HR = 3.15; 95% CI, 1.73 to 5.65; CRP HR = 2.27; 95% CI, 1.27 to 4.08). Associations were similar and still significant after adjusting for self-reported history of cardiovascular events and censoring cardiovascular disease deaths. Elevated CRP and SAA were also associated with reduced disease-free survival, although these associations were of borderline significance (SAA P trend = .04; CRP P trend = .07). CONCLUSION Circulating SAA and CRP may be important prognostic markers for long-term survival in breast cancer patients, independent of race, tumor stage, and body mass index.
    Type of Publication: Journal article published
    PubMed ID: 19470939
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