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结直肠癌幸存者治疗后 2 年内的久坐行为和体力活动与身体成分的纵向关联。

Longitudinal associations of sedentary behavior and physical activity with body composition in colorectal cancer survivors up to 2 years post treatment.

机构信息

Department of Epidemiology, GROW School for Oncology and Reproduction, Maastricht University, P.O. BOX 616, 6200 MD, Maastricht, The Netherlands.

Department of Epidemiology, GROW School for Oncology and Reproduction, Maastricht University as Part of an Internship, Maastricht University, Maastricht, The Netherlands.

出版信息

J Cancer Res Clin Oncol. 2023 Jul;149(7):4063-4075. doi: 10.1007/s00432-022-04267-9. Epub 2022 Aug 30.

Abstract

PURPOSE

We investigated longitudinal associations of sedentary behavior, light-intensity physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) with body composition in colorectal cancer (CRC) survivors, between 6 weeks and 24 months post treatment. In addition, we explored whether body composition mediated associations of sedentary behavior and MVPA with fatigue.

METHODS

A prospective cohort study was conducted in 459 stage I-III CRC patients recruited at diagnosis. Measurements were performed of accelerometer-assessed sedentary time (hours/day), self-reported LPA and MVPA (hours/week), anthropometric assessment of body mass index (BMI), waist circumference and fat percentage (measures of adiposity), and muscle circumference and handgrip strength (measures of muscle mass/function) repeated at 6 weeks, and 6, 12 and 24 months post treatment. Longitudinal associations of sedentary time and physical activity with body composition were analyzed using confounder-adjusted linear mixed models. Mediation analyses were performed to explore the role of body mass index (BMI) and handgrip strength as mediators in associations of sedentary time and MVPA with fatigue.

RESULTS

Less sedentary time and LPA were, independent of MVPA, longitudinally associated with increased handgrip strength, but not with measures of adiposity. More MVPA was associated with increased adiposity and increased handgrip strength. Higher BMI partly mediated associations between higher sedentary time and more fatigue.

CONCLUSION

Within the first two years after CRC treatment, changes in sedentary behavior, physical activity and body composition are interrelated and associated with fatigue. Intervention studies are warranted to investigate causality.

TRIAL REGISTRATION

The EnCoRe study is registered at trialregister.nl as NL6904 (former ID: NTR7099).

摘要

目的

我们研究了结直肠癌(CRC)幸存者在治疗后 6 周至 24 个月期间久坐行为、低强度身体活动(LPA)和中高强度身体活动(MVPA)与身体成分之间的纵向关联。此外,我们还探讨了身体成分是否介导了久坐行为和 MVPA 与疲劳之间的关联。

方法

在诊断时招募了 459 名 I-III 期 CRC 患者,进行了一项前瞻性队列研究。使用加速度计评估的久坐时间(小时/天)、自我报告的 LPA 和 MVPA(小时/周)、身体质量指数(BMI)、腰围和体脂百分比(肥胖指标)的人体测量评估,以及肌肉周长和握力(肌肉质量/功能指标)在治疗后 6 周、6、12 和 24 个月时重复测量。使用混杂因素调整的线性混合模型分析久坐时间和身体活动与身体成分的纵向关联。进行中介分析以探讨 BMI(体重指数)和握力作为久坐时间和 MVPA 与疲劳关联中介的作用。

结果

在独立于 MVPA 的情况下,较少的久坐时间和 LPA 与握力的增加呈纵向相关,但与肥胖指标无关。更多的 MVPA 与肥胖和握力增加相关。较高的 BMI 部分介导了较高的久坐时间与更多疲劳之间的关联。

结论

在 CRC 治疗后的头两年内,久坐行为、身体活动和身体成分的变化相互关联,并与疲劳有关。需要进行干预研究来探讨因果关系。

试验注册

EnCoRe 研究在 trialregister.nl 上注册为 NL6904(前 ID:NTR7099)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/179a/11796891/fc7fa3a1fd3e/432_2022_4267_Fig1_HTML.jpg

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