Effects of high-intensity interval training on cardiometabolic biomarkers in prostate cancer patients undergoing active surveillance: A randomized controlled trial

Abstract

Purpose: To report the effects of a 12-week high-intensity interval training (HIIT) program on cardiometabolic biomarkers in prostate cancer (PCa) patients on active surveillance (AS) from the Exercise During Active Surveillance for Prostate Cancer (ERASE) Trial. Methods: Fifty-two men with PCa on AS were randomized to either an exercise (HIIT; n=26) or usual care (UC; n=26) group. The HIIT intervention consisted of progressive, supervised, aerobic HIIT at an intensity of 85 to 95% VO_2peak for 28 to 40 minutes per session performed three times/week for 12 weeks. Blood samples were collected at baseline and post-intervention to analyze cardiometabolic biomarkers. Analysis of covariance was used to examine between-group mean differences. Results: Blood data were obtained from 49/52 (94%) participants at postintervention. Participants were aged 63.4±7.1 years and 40% were obese. The HIIT group attended 96% of the planned exercise sessions. No significant between-group changes in weight were observed after the intervention. Compared to UC, HIIT significantly improved total cholesterol (-0.40 mmol/L; 95% confidence interval[CI], -0.70 to -0.10; p=0.011), non-high-density lipoprotein-c (-0.35 mmol/L; 95% CI, -0.60 to -0.11; p=0.006), insulin (-13.6 pmol/L; 95% CI, -25.3 to -1.8; p=0.025), insulin-like growth factor (IGF)-1 (-15.0 ng/mL; 95% CI, -29.9 to -0.1; p=0.048), and IGF binding protein (IGFBP)-3 (152.3 ng/mL; 95% CI, 12.6 to 292.1; p=0.033). No significant differences were observed for fasting glucose, HbA1c, other lipid markers, IGFBP-1, adiponectin, and leptin. Conclusions: The ERASE Trial showed that a 12-week aerobic HIIT program improved several cardiometabolic biomarkers in PCa patients on AS that may contribute to cardiovascular health benefits and potentially influence the signaling pathways in the progression of prostate cancer. Further research is needed to explore the effects of exercise on cardiometabolic markers in men with PCa on AS and determine if these effects are associated with improved long-term clinical outcomes.