C-Reactive Protein Is Associated with Physical Fitness in Breast Cancer Survivors

Background: Physical fitness (PF) is an expression of the physiological functioning of multiple body components. PF is an important prognostic factor in terms of cardiovascular mortality, cancer mortality, and all-cause mortality. PF has been related to some biomarkers in the general population but not in breast cancer survivors (BCS). Purpose: To evaluate the effects of PF on biomarkers potentially related to physical activity (PA) in a sample of BCS. Methods: Cross-sectional study. A total of 84 BCS (mean age 54) who had finished their treatment were recruited. Different components of PF were evaluated, namely body composition (anthropometry), cardiorespiratory fitness (one-mile walk test), muscular (handgrip and sit-to-stand timed test), and motor (gait speed) components. Sexual hormones, inflammation, and insulin resistance biomarkers were measured. Results: C-Reactive Protein (CRP) was associated with every component of physical fitness: cardiorespiratory fitness (p-value = 0.002), muscular (sit-to-stand timed test, p-value = 0.002) and motor (gait speed, p-value = 0.004) components, and body composition (body mass index, p-value = 0.003; waist, p-value < 0.000; and waist-to-hip index, p-value = 0.012). CRP also was associated with “poor physical condition,” a constructed variable that encompasses all components of physical fitness (p-value < 0.001). Insulin was associated with cardiorespiratory fitness and gait speed (p-values = 0.002 and 0.024, respectively). Insulin-like Growth Factor-1 was negatively associated with waist perimeter and waist-to-hip ratio. Conclusions: CRP can also be considered an indicator of poor PF in BCS. Implications for cancer survivors: in case of elevation of CRP indicating cardiovascular risk, health professionals should recommend lifestyle changes to improve BCS physical condition.

[1]  S. Qiu,et al.  Changes in objectively-measured physical capability over 4-year, risk of diabetes, and glycemic control in older adults: the China Health and Retirement Longitudinal Study. , 2021, Diabetes research and clinical practice.

[2]  D. Hu,et al.  Association between serum level of C-reactive protein and risk of cardiovascular events based on cohort studies , 2021, Journal of Human Hypertension.

[3]  T. Costa,et al.  Phase angle cutoff value as a marker of the health status and functional capacity in breast cancer survivors , 2021, Physiology & Behavior.

[4]  A. Maier,et al.  Markers of inflammation and their association with muscle strength and mass: A systematic review and meta-analysis , 2020, Ageing Research Reviews.

[5]  E. Maor,et al.  Cardiorespiratory fitness and survival following cancer diagnosis. , 2020, European journal of preventive cardiology.

[6]  C. Meskers,et al.  Pathophysiological mechanisms explaining poor clinical outcome of older cancer patients with low skeletal muscle mass , 2020, Acta physiologica.

[7]  P. Douglas,et al.  Effects of Exercise Therapy Dosing Schedule on Impaired Cardiorespiratory Fitness in Patients With Primary Breast Cancer , 2020, Circulation.

[8]  T. Keil,et al.  Correlates and Determinants of Cardiorespiratory Fitness in Adults: a Systematic Review , 2019, Sports Medicine - Open.

[9]  B. Strasser,et al.  Association Between Muscular Strength and Mortality in Clinical Populations: A Systematic Review and Meta-Analysis. , 2019, Journal of the American Medical Directors Association.

[10]  L. Stewart,et al.  Cardiorespiratory fitness, visceral fat, and body fat, but not dietary inflammatory index, are related to C-reactive protein in cancer survivors , 2019, Nutrition and health.

[11]  J. Pell,et al.  Walking Pace Is Associated with Lower Risk of All-Cause and Cause-Specific Mortality , 2019, Medicine and science in sports and exercise.

[12]  Katherine L. Hsieh,et al.  Gait and Balance Impairments in Breast Cancer Survivors: A Systematic Review and Meta-analysis of Observational Studies , 2019, Archives of rehabilitation research and clinical translation.

[13]  Duck-chul Lee,et al.  Muscular Strength as a Predictor of All-Cause Mortality in an Apparently Healthy Population: A Systematic Review and Meta-Analysis of Data From Approximately 2 Million Men and Women. , 2018, Archives of physical medicine and rehabilitation.

[14]  A. Avan,et al.  Serum C‐reactive protein in the prediction of cardiovascular diseases: Overview of the latest clinical studies and public health practice , 2018, Journal of cellular physiology.

[15]  J. Pell,et al.  Associations of grip strength with cardiovascular, respiratory, and cancer outcomes and all cause mortality: prospective cohort study of half a million UK Biobank participants , 2018, British Medical Journal.

[16]  M. Kivimäki,et al.  Association of 10-Year C-Reactive Protein Trajectories With Markers of Healthy Aging: Findings From the English Longitudinal Study of Aging , 2018, The journals of gerontology. Series A, Biological sciences and medical sciences.

[17]  C. Cavaglieri,et al.  Phase angle is related with inflammatory and oxidative stress biomarkers in older women , 2018, Experimental Gerontology.

[18]  Leonard A Kaminsky,et al.  Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign A Scientific Statement From the American Heart Association , 2016, Circulation.

[19]  V. Choksi,et al.  Objective measures of the frailty syndrome (hand grip strength and gait speed) and cardiovascular mortality: A systematic review. , 2016, International journal of cardiology.

[20]  B. Schoenfeld,et al.  Effect of resistance training on C-reactive protein, blood glucose and lipid profile in older women with differing levels of RT experience , 2015, AGE.

[21]  M. Leitzmann,et al.  Cardiorespiratory fitness as predictor of cancer mortality: a systematic review and meta-analysis. , 2015, Annals of oncology : official journal of the European Society for Medical Oncology.

[22]  Martin Englund,et al.  Muscle strength in adolescent men and risk of cardiovascular disease events and mortality in middle age: a prospective cohort study , 2014, BMC Medicine.

[23]  Sameer M. Siddiqi,et al.  Physical activity, biomarkers, and disease outcomes in cancer survivors: a systematic review. , 2012, Journal of the National Cancer Institute.

[24]  T. Byers,et al.  Cardiovascular disease competes with breast cancer as the leading cause of death for older females diagnosed with breast cancer: a retrospective cohort study , 2011, Breast Cancer Research.

[25]  M. Hamer,et al.  Association of C-reactive protein and muscle strength in the English Longitudinal Study of Ageing , 2009, AGE.

[26]  H. S. Schoeman,et al.  President's Council , 2008 .

[27]  Yau-Hua Yu,et al.  Association of cardiorespiratory fitness and levels of C-reactive protein: data from the National Health and Nutrition Examination Survey 1999-2002. , 2007, International journal of cardiology.

[28]  Suzanne G. Leveille,et al.  Linking C-reactive protein to late-life disability in the National Health and Nutrition Examination Survey (NHANES) 1999-2002. , 2006, The journals of gerontology. Series A, Biological sciences and medical sciences.

[29]  Thierry Troosters,et al.  How to assess physical activity? How to assess physical fitness? , 2005, European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology.

[30]  D. McGee,et al.  Body mass index and mortality: a meta-analysis based on person-level data from twenty-six observational studies. , 2005, Annals of epidemiology.

[31]  Doron Aronson,et al.  The association between cardiorespiratory fitness and C-reactive protein in subjects with the metabolic syndrome. , 2004, Journal of the American College of Cardiology.

[32]  J. Kampert,et al.  Associations Between Cardiorespiratory Fitness and C-Reactive Protein in Men , 2002, Arteriosclerosis, thrombosis, and vascular biology.

[33]  P S Freedson,et al.  Estimation of VO2max from a one-mile track walk, gender, age, and body weight. , 1987, Medicine and science in sports and exercise.

[34]  C. Caspersen,et al.  Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. , 1985, Public health reports.

[35]  T. Manini,et al.  Impact of chemotherapy on medium-term physical function and activity of older breast cancer survivors, and associated biomarkers. , 2017, Journal of geriatric oncology.