Boland Alexandra M, Gibson Todd M, Lu Lu, Kaste Sue C, DeLany James P, Partin Robyn E, Lanctot Jennifer Q, Howell Carrie R, Nelson Heather H, Chemaitilly Wassim, Pui Ching-Hon, Robison Leslie L, Mulrooney Daniel A, Hudson Melissa M, Ness Kirsten K
A.M. Boland, MPH, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
T.M. Gibson, PhD, Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
Phys Ther. 2016 Jul;96(7):1029-38. doi: 10.2522/ptj.20150507. Epub 2016 Feb 18.
Survivors of childhood acute lymphoblastic leukemia (ALL) are at risk for low lean muscle mass and muscle weakness, which may contribute to inactivity and early development of chronic diseases typically seen in older adults. Although increasing protein intake, in combination with resistance training, improves lean muscle mass in other populations, it is not known whether muscular tissue among survivors of ALL, whose impairments are treatment-related, will respond similarly.
The aim of this study was to evaluate associations among dietary protein intake, resistance training, and lean muscle mass in survivors of ALL and age-, sex-, and race-matched controls.
This was a cross-sectional study.
Lean muscle mass was determined with dual-energy x-ray absorptiometry, dietary information with 24-hour recalls, and participation in resistance training with a questionnaire. Participants were 365 survivors of ALL (52% male; 87% white; median age=28.5 years, range=23.6-31.7) and 365 controls with no previous cancer.
Compared with controls, survivors of ALL had lower lean muscle mass (55.0 versus 57.2 kg, respectively) and lower percentage of lean muscle mass (68.6% versus 71.4%, respectively) than controls. Similar proportions of survivors (71.1%) and controls (69.7%) met recommended dietary protein intake (0.8 g/kg/d). Survivors (45.4%) were less likely to report resistance training than controls (53.8%). In adjusted models, 1-g higher protein intake per kilogram of body mass per day was associated with a 7.9% increase and resistance training ≥1×wk, with a 2.8% increase in lean muscle mass.
The cross-sectional study design limits temporal evaluation of the association between protein intake and lean muscle mass.
The findings suggest that survivors of childhood ALL with low lean muscle mass may benefit from optimizing dietary protein intake in combination with resistance training. Research is needed to determine whether resistance training with protein supplementation improves lean muscle mass in survivors of childhood ALL.
儿童急性淋巴细胞白血病（ALL）幸存者存在低瘦肌肉量和肌肉无力的风险，这可能导致身体活动不足，并促使通常在老年人中出现的慢性疾病过早发展。尽管增加蛋白质摄入量并结合抗阻训练可改善其他人群的瘦肌肉量，但尚不清楚ALL幸存者中与治疗相关的肌肉组织是否会有类似反应。
本研究旨在评估ALL幸存者以及年龄、性别和种族匹配的对照组中，膳食蛋白质摄入量、抗阻训练与瘦肌肉量之间的关联。
这是一项横断面研究。
通过双能X线吸收法测定瘦肌肉量，通过24小时膳食回顾获取饮食信息，并通过问卷调查了解抗阻训练参与情况。参与者包括365名ALL幸存者（52%为男性；87%为白人；中位年龄=28.5岁，范围=23.6 - 31.7岁）和365名无癌症病史的对照组。
与对照组相比，ALL幸存者的瘦肌肉量较低（分别为55.0千克和57.2千克），瘦肌肉量百分比也较低（分别为68.6%和71.4%）。幸存者（71.1%）和对照组（69.7%）达到推荐膳食蛋白质摄入量（0.8克/千克/天）的比例相似。与对照组（53.8%）相比，幸存者（45.4%）报告进行抗阻训练的可能性较小。在调整模型中，每天每千克体重蛋白质摄入量增加1克与瘦肌肉量增加7.9%相关，抗阻训练≥每周1次与瘦肌肉量增加2.8%相关。
横断面研究设计限制了对蛋白质摄入量与瘦肌肉量之间关联的时间评估。
研究结果表明，瘦肌肉量低的儿童ALL幸存者可能受益于优化膳食蛋白质摄入量并结合抗阻训练。需要开展研究以确定补充蛋白质的抗阻训练是否能改善儿童ALL幸存者的瘦肌肉量。
