Pereira Cristiane Pavan, Amaral Denise Johnsson Campos, Funke Vaneuza Araujo Moreira, Borba Victória Zeghbi Cochenski
Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil.
Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil.
Rev Bras Hematol Hemoter. 2017 Oct-Dec;39(4):343-348. doi: 10.1016/j.bjhh.2017.06.005. Epub 2017 Jul 27.
The aim of this study was to evaluate the prevalence of pre-sarcopenia and bone mineral density after hematopoietic stem cell transplantation.
The study group consisted of over 18-year-old patients who had been submitted to allogeneic transplantation at least one year previously. Patients and healthy controls were matched by sex, ethnic background, age, and body mass index. Body composition and bone mineral density were measured by dual-energy X-ray absorptiometry. A 24-h food recall and food frequency survey were performed. The biochemical evaluation included calcium, parathormone and vitamin D. Eighty-seven patients (52 men; age: 37.2±12.7 years; body mass index: 25±4.5kg/m) were compared to 68 controls [31 men; age 35.4±15.5 years (p=0.467); body mass index 25.05±3.7kg/m (p=0.927)].
There was no significant difference in the dietary intake between patients and controls. The mean levels of vitamin D were 23.5±10.3ng/mL; 29 patients (41.0%) had insufficient and 26 (37.14%) deficient levels. A higher prevalence of reduced bone mineral density was observed in 24 patients (25%) compared to 12 controls (19.1% - p<0.001). Pre-sarcopenia was diagnosed in 14 (14.4%) patients and none of the controls (p=0.05). There was a higher prevalence of pre-sarcopenia (66%) in patients with grades III and IV compared to those with grades 0-II graft-versus-host disease (10.9%) (p=0.004).
patients submitted to transplantation had a higher prevalence of pre-sarcopenia and greater changes in bone mineral density compared to controls; the severity of graft-versus-host disease had an impact on the prevalence of pre-sarcopenia.
本研究旨在评估造血干细胞移植后肌少症前期和骨密度的患病率。
研究组由至少在一年前接受过异基因移植的18岁以上患者组成。患者和健康对照在性别、种族背景、年龄和体重指数方面相匹配。通过双能X线吸收法测量身体成分和骨密度。进行了24小时食物回顾和食物频率调查。生化评估包括钙、甲状旁腺激素和维生素D。将87例患者（52例男性；年龄：37.2±12.7岁；体重指数：25±4.5kg/m）与68例对照[31例男性；年龄35.4±15.5岁（p=0.467）；体重指数25.05±3.7kg/m（p=0.927）]进行比较。
患者与对照之间的饮食摄入量无显著差异。维生素D的平均水平为23.5±10.3ng/mL；29例患者（41.0%）水平不足，26例（37.14%）水平缺乏。与12例对照（19.1% - p<0.001）相比，24例患者（25%）骨密度降低的患病率更高。14例（14.4%）患者被诊断为肌少症前期，对照中无此情况（p=0.05）。与0-II级移植物抗宿主病患者（10.9%）相比，III级和IV级患者肌少症前期的患病率更高（66%）（p=0.004）。
与对照相比，接受移植的患者肌少症前期患病率更高，骨密度变化更大；移植物抗宿主病的严重程度对肌少症前期的患病率有影响。
