Effects of exercise on insulin, IGF axis, adipocytokines, and inflammatory markers in breast cancer survivors: A systematic review and meta-analysis

Dong Woo Kang, Junga Lee, Sang Hoon Suh, Jennifer Ligibel, Kerry S. Courneya, Justin Y. Jeon

Research output: Contribution to journalArticlepeer-review

80 Citations (Scopus)


Background: Insulin, IGF axis, adiponectin, and inflammatory markers are associated with breast cancer. Given that physical activity improves prognosis of breast cancer survivors, we investigated the effects of exercise on these markers as potential mediators between physical activity and breast cancer. Methods: PubMed, EMBASE, CENTRAL, CINAHL, and SportDiscus were searched up to December 3, 2015, to identify randomized controlled trials (RCT) that investigated the effect of exercise on insulin, IGF axis, and cytokines in breast cancer survivors. Weighted mean difference (WMD) was calculated using either fixed-or random-effects models on the basis of the heterogeneity of the studies. Results: A total of 18 studies involving 681 breast cancer survivors were included, and these numbers were reduced for individual biomarker analyses. We found that exercise significantly reduced fasting insulin levels [WMD, μ3.46 mU/mL; 95% confidence interval (CI),-5.97 to-0.95; P = 0.007]. Furthermore, potentiallymeaningfulbutstatisticallynonsignificantchangeswere observed in insulin resistance (WMD,-0.73; 95% CI,-0.54 to 0.13; P = 0.23),adiponectin(WMD, 1.17 mg/mL;95% CI,-0.87to 3.20; P = 0.26), and C-reactive protein (WMD,-1.10 mg/L; 95% CI,-2.39to0.20; P=0.10).Subgroupanalysesshowedthatfasting insulin levels were significantly more impacted in studies in which intervention participants experienced a weight reduction (WMD,-7.10 mU/mL; 95% CI,-10.31 to-3.90; P < 0.001). Conclusions: Exercise reduces fasting insulin levels in breast cancer survivors. This may be due to exercise-induced reductions in body weight. Impact: Practitioners and clinicians may better help breast cancer prognosis be improved through exercise, anticipating physiological effects on cancer.

Original languageEnglish
Pages (from-to)355-365
Number of pages11
JournalCancer Epidemiology Biomarkers and Prevention
Issue number3
Publication statusPublished - 2017 Mar 1

Bibliographical note

Publisher Copyright:
© 2016 American Association for Cancer Research.

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Oncology


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