Department of Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
Department of Pediatric Hematology and Oncology, University Children's Hospital Basel (UKBB) and the University of Basel, Basel, Switzerland.
Int J Cancer. 2020 Oct 1;147(7):1845-1854. doi: 10.1002/ijc.32963. Epub 2020 Mar 25.
Childhood cancer survivors (CCS) are at risk of reduced bone health and premature osteoporosis. As physical activity with high impact loading (IL-PA) is known to promote bone health, we compared bone densitometry and microstructure between groups of CCS who performed different amounts of physical activities in their daily life. We used baseline data of a single-center PA trial including 161 CCS from the Swiss Childhood Cancer Registry, aged <16 at diagnosis, ≥16 at study and ≥5 years since diagnosis. Lower body bone health was assessed with peripheral quantitative computed tomography (pQCT) and dual-energy X-ray absorptiometry (DXA). Daily IL-PA (duration in activities >2 g acceleration and numbers of vertical impacts/hr >2 g) was captured using hip-worn accelerometers (1-3 weeks). For both IL-PA approaches, we formed low, middle and high activity groups based on tertiles. Bone health of the high and middle active groups was compared to the low active group. 63% of CCS had indication of at least one bone mineral density z-score ≤ -1 measured by pQCT or DXA. The high IL-PA group performing 2.8 min/day or 19.1 impact peaks/hr > 2 g (median) showed about 3-13% better microstructural and densitometric bone health as compared to the low IL-PA group with 0.38 min/day or 0.85 peaks/hr > 2 g. Just a few minutes and repetitions of high IL-PA as easily modifiable lifestyle factor may be sufficient to improve bone health in adult CCS. Future longitudinal research is needed to better understand pattern and dosage of minimal impact loading needed to strengthen bone in growing and adult CCS.
儿童癌症幸存者（CCS）存在骨健康受损和骨质疏松症提前发生的风险。已知高强度冲击性体力活动（IL-PA）可促进骨健康，因此，我们比较了在日常生活中进行不同体力活动量的 CCS 组的骨密度和微观结构。我们使用了瑞士儿童癌症登记处的单中心体力活动试验的基线数据，该试验纳入了 161 名诊断时年龄<16 岁、研究时年龄≥16 岁且诊断后≥5 年的 CCS。使用外周定量计算机断层扫描（pQCT）和双能 X 射线吸收法（DXA）评估下肢骨健康。使用佩戴在髋部的加速度计（1-3 周）记录每日 IL-PA（活动中加速度>2g 的持续时间和每小时垂直冲击次数>2g 的次数）。对于这两种 IL-PA 方法，我们根据三分位数将活动量分为低、中、高活动组。将高和中活动组的骨健康与低活动组进行比较。63%的 CCS 至少有一个骨矿物质密度 z 评分≤-1，通过 pQCT 或 DXA 测量。与低 IL-PA 组（每天 0.38 分钟或每小时>2g 的冲击峰值 0.85 个）相比，高 IL-PA 组（每天 2.8 分钟或每小时>2g 的冲击峰值 19.1 个）的微观结构和骨密度健康状况要好 3-13%。作为易于调整的生活方式因素，只需几分钟和几次高强度 IL-PA 就足以改善成年 CCS 的骨健康。需要进行未来的纵向研究，以更好地了解对生长和成年 CCS 骨骼进行强化所需的最小冲击负荷的模式和剂量。
