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战斗部署对美国陆军特种作战部队士兵人体测量学和生理状态的影响。

Effects of Combat Deployment on Anthropometrics and Physiological Status of U.S. Army Special Operations Forces Soldiers.

作者信息

Farina Emily K, Taylor Jonathan C, Means Gary E, Williams Kelly W, Murphy Nancy E, Margolis Lee M, Pasiakos Stefan M, Lieberman Harris R, McClung James P

机构信息

U.S. Army Research Institute of Environmental Medicine, General Greene Avenue, Building 42, Natick, MA 01760.

Office of the Surgeon General, 7700 Arlington Boulevard, Falls Church, VA 22042.

出版信息

Mil Med. 2017 Mar;182(3):e1659-e1668. doi: 10.7205/MILMED-D-16-00022.

Abstract

INTRODUCTION

U.S. Army Special Operations Forces (SOF) soldiers deploy frequently and conduct military operations through special warfare and surgical strike capabilities. Tasks required to execute these capabilities may induce physical and mental stress and have the potential to degrade soldier physiological status. No investigations have longitudinally characterized whether combat deployment alters anthropometrics or biochemical markers of physiological status in a SOF population of frequent deployers.

MATERIALS AND METHODS

Effects of modern combat deployment on longitudinal changes in anthropometrics and physiological status of elite U.S. Army SOF soldiers (n = 50) were assessed. Changes in measures of body composition, grip strength, physiological status, and health behaviors from baseline to postdeployment were determined with paired t test and McNemar's statistic. Baseline measures were obtained between 4 and 8 weeks before deployment. Deployment length was a uniform duration of time between 3 and 6 months (all soldiers completed the same length of deployment). Post hoc analyses determined change in body mass within quartiles of baseline body mass with paired t test and associations between change in sex hormone-binding globulin (SHBG) and change in body mass with correlation coefficient. The study was approved by the Human Use Review Committee at the U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts.

RESULTS

In response to deployment, increases in lean mass (77.1 ± 7.6 to 77.8 ± 7.5 kg), maximum grip strength (57.9 ± 7.2 to 61.6 ± 8.8 kg), and conduct of aerobic (156 ± 106 to 250 ± 182 minutes/week) and strength training (190 ± 101 to 336 ± 251 minutes/week) exercise were observed (p < 0.05). Increases in serum SHBG (35.42 ± 10.68 to 38.77 ± 12.26 nmol/L) and decreases in serum cortisol (443.2 ± 79.3 to 381.9 ± 111.6 nmol/L) were also observed (p < 0.05). Body mass changes were dependent on baseline body mass. Soldiers in the lowest quartile of baseline body mass increased body mass (75.6 ± 2.6 vs. 76.6 ± 2.8 kg, p = 0.03), as did those in the second quartile (81.6 ± 2.0 vs. 83.7 ± 3.5 kg, p = 0.02). Those in the third quartile also tended to increase body mass (89.2 ± 2.6 vs. 90.9 ± 3.3 kg, p = 0.05), while those in the upper quartile tended to decrease body mass (98.5 ± 3.6 vs. 96.7 kg, p = 0.06). Change in SHBG was inversely correlated with change in body mass (r = -0.33, p = 0.02). There were no changes in fat mass, body fat percentage, waist circumference, neck circumference, total testosterone, calculated bioavailable or free testosterone, high-sensitivity C-reactive protein, tumor necrosis factor-α, interleukin-1β, or interleukin-6. Inflammatory markers were skewed toward lower values.

CONCLUSIONS

Overall, physiological status of elite SOF soldiers characterized by multiple prior deployments was minimally impacted by combat deployment, in the absence of major unit casualties. The majority experienced some adaptive changes, including increased lean mass, grip strength, time spent engaged in exercise, and decreased levels of the stress hormone cortisol. Mechanisms contributing to inverse correlations between change in SHBG and change in body mass may be further clarified. Future investigations may also more fully characterize the degradation and optimization of health and physiological status of SOF training and deployment cycles with in-theater data collection and repeated measures.

摘要

引言

美国陆军特种作战部队(SOF)士兵频繁部署,并通过特种作战和外科打击能力开展军事行动。执行这些任务所需的工作可能会引起身心压力,并有可能降低士兵的生理状态。目前尚无研究纵向描述作战部署是否会改变频繁部署的特种作战部队人员的人体测量学指标或生理状态的生化标志物。

材料与方法

评估了现代作战部署对美国陆军精锐特种作战部队士兵(n = 50)人体测量学指标和生理状态纵向变化的影响。采用配对t检验和麦克尼马尔统计量,确定从基线到部署后身体成分、握力、生理状态和健康行为指标的变化。基线测量在部署前4至8周进行。部署时长为3至6个月的统一时间段(所有士兵完成相同时长的部署)。事后分析采用配对t检验确定基线体重四分位数范围内的体重变化,并采用相关系数确定性激素结合球蛋白(SHBG)变化与体重变化之间的关联。该研究得到了位于马萨诸塞州纳蒂克的美国陆军环境医学研究所人类使用审查委员会的批准。

结果

在部署期间,观察到瘦体重增加(从77.1±7.6千克增至77.8±7.5千克)、最大握力增加(从57.9±7.2千克增至61.6±8.8千克),以及有氧运动(从每周156±106分钟增至250±182分钟)和力量训练(从每周190±101分钟增至336±251分钟)的运动量增加(p < 0.05)。还观察到血清SHBG增加(从35.42±10.68纳摩尔/升增至38.77±12.26纳摩尔/升),血清皮质醇降低(从443.2±79.3纳摩尔/升降至381.9±111.6纳摩尔/升)(p < 0.05)。体重变化取决于基线体重。基线体重处于最低四分位数的士兵体重增加(从75.6±2.6千克增至76.6±2.8千克,p = 0.03),第二四分位数的士兵也是如此(从81.6±2.0千克增至83.7±3.5千克,p = 0.02)。第三四分位数的士兵也倾向于体重增加(从89.2±2.6千克增至90.9±3.3千克,p = 0.05),而最高四分位数的士兵则倾向于体重降低(从98.5±3.6千克降至96.7千克,p = 0.06)。SHBG的变化与体重变化呈负相关(r = -0.33,p = 0.02)。脂肪量、体脂百分比、腰围、颈围、总睾酮、计算得出的生物可利用睾酮或游离睾酮、高敏C反应蛋白、肿瘤坏死因子-α、白细胞介素-1β或白细胞介素-6均无变化。炎症标志物倾向于较低值。

结论

总体而言,在没有重大单位伤亡情况时,以多次先前部署为特征的精锐特种作战部队士兵的生理状态受作战部署的影响最小。大多数人经历了一些适应性变化,包括瘦体重增加、握力增加、锻炼时间增加以及应激激素皮质醇水平降低。SHBG变化与体重变化之间负相关的机制可能需要进一步阐明。未来的研究也可能通过战区数据收集和重复测量,更全面地描述特种作战部队训练和部署周期中健康和生理状态的退化与优化情况。

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