La práctica de ejercicio físico ha sido asociada a un menor riesgo de desarrollo y recurrencia del cáncer. Asimismo, estudios previos sugieren que el ejercicio es eficaz para reducir el riesgo de desarrollar alteraciones metabólicas. Por lo tanto, esta investigación pretende evaluar los efectos de un programa de ejercicio combinado de 12 semanas sobre la reducción de los niveles de hemoglobina glicada (HbA1c) en pacientes con cáncer. Para ello, 22 pacientes no diabéticos fueron asignados aleatoriamente a una intervención de ejercicio combinado de 12 semanas o al grupo control. Se realizaron evaluaciones iniciales y a los 3 meses para valorar los cambios en los niveles de HbA1c, la grasa y la masa musculoesquelética de los 22 participantes que completaron el estudio. Analizando la muestra hubo mejoras significativas en los niveles de HbA1c (p=0,033). Además, cuando se excluyeron los mayores de 65 años, las diferencias fueron mayores (p=0,017). Aunque no se encontraron diferencias significativas entre las reducciones de los sujetos con diferentes niveles basales de HbA1c, los que tenían niveles más altos redujeron los valores en un 6,8% y los que tenían niveles normales en un 3,6%. Además, no se encontró ninguna correlación entre las reducciones de la HbA1c y los cambios en la composición corporal. Esta intervención de ejercicio combinado de 12 semanas dio lugar a una reducción de los niveles de HbA1c, pero este cambio no se asoció con los cambios en la composición corporal. Palabras clave: Oncología, Ejercicio, Composición Corporal, Entrenamiento Concurrente, Glucosa, Hemoglobina Glicada. Abstract. Exercise has been associated with lower risk of cancer development and recurrence. Studies suggest that exercise is effective in reducing the risk of developing metabolic alterations. Due to the inconclusive results of previous studies, this research aims to evaluate the effects of a 12-week concurrent exercise programme on the reduction of glycated hemoglobin (HbA1c) levels in cancer patients. 22 non-diabetic patients were randomly assigned to a 12-week combined exercise intervention or to the control group. Baseline and 3-month assessments were performed to evaluate changes in HbA1c, fat and musculoskeletal mass for the 22 participants who completed the study. Analyzing the sample there were significant improvements in HbA1c (p=0.033), when excluding those over 65 years of age, the differences were greater (p=0.017). Although no significant differences were found between the reductions of subjects with different baseline HbA1c levels, those with higher levels reduced values by 6.8% and those with normal levels by 3.6%. Furthermore, no correlation was found between reductions in HbA1c and changes in body composition. This 12-week combined exercise intervention resulted in a reduction in HbA1c levels, but this change was not associated with changes in body composition. Key Words: Oncology, Exercise, Body Composition, Concurrent Training, Glucose, Glycated Hemoglobin.

Background Frailty derived from muscle quality loss can potentially be delayed through early detection and physical exercise interventions. There is a need for affordable tools for the objective evaluation of muscle quality, in both cross-sectional and longitudinal assessment. Literature suggests that quantitative analysis of ultrasound data captures morphometric, compositional and microstructural muscle properties, while biological essays derived from blood samples are associated with functional information. The aim of this study is to evaluate multi-parametric combinations of ultrasound and blood-based biomarkers to provide a cross-sectional evaluation of the patient frailty phenotype and to monitor muscle quality changes associated with supervised exercise programs. Methods This is a prospective observational multi-center study including patients older than 70 years with ability to give informed consent. We will recruit 100 patients from hospital environments and 100 from primary care facilities. At least two exams per patient (baseline and follow-up), with a total of (400 > 300) exams. In the hospital environments, 50 patients will be measured pre/post a 16-week individualized and supervised exercise programme, and 50 patients will be followed-up after the same period without intervention. The primary care patients will undergo a one-year follow-up evaluation. The primary goal is to compare cross-sectional evaluations of physical performance, functional capacity, body composition and derived scales of sarcopenia and frailty with biomarker combinations obtained from muscle ultrasound and blood-based essays. We will analyze ultrasound raw data obtained with a point-of-care device, and a set of biomarkers previously associated with frailty by quantitative Real time PCR (qRT-PCR) and enzyme-linked immunosorbent assay (ELISA). Secondly, we will analyze the sensitivity of these biomarkers to detect short-term muscle quality changes as well as functional improvement after a supervised exercise intervention with respect to usual care. Discussion The presented study protocol will combine portable technologies based on quantitative muscle ultrasound and blood biomarkers for objective cross-sectional assessment of muscle quality in both hospital and primary care settings. It aims to provide data to investigate associations between biomarker combinations with cross-sectional clinical assessment of frailty and sarcopenia, as well as musculoskeletal changes after multicomponent physical exercise programs. Trial Registration ClinicalTrials.gov Identifier: NCT05294757. Date recorded: 24/03/2022. 'retrospectively registered’