肌肉减少症和低面积骨矿物质密度 (aBMD) 是儿科癌症治疗后常见的肌肉骨骼并发症。然而，尚未在年轻儿科癌症幸存者中研究它们的关系。本研究旨在根据肌肉减少症状态评估 aBMD 差异，以及确诊/可能患有肌肉减少症的年轻儿科癌症幸存者中 aBMD Z 评分低的风险。这项横断面研究包括 116 名儿科癌症幸存者（12.1 ± 3.3 岁；42.2%）女性）。握力用于评估肌肉力量。双能 X 射线吸收法估计 aBMD (g/cm2) 和四肢去脂质量指数 (ALMI, kg/m2)。当肌肉强度 > 十分位数 2 时，定义为“无肌肉减少症”。当肌肉强度 ≤ 十分位数 2 且 ALMI Z 评分 > -1.5 标准差 (SD) 时，定义为“可能患有肌肉减少症”。当肌肉力量 ≤ 十分位数 2 且 ALMI Z 评分 ≤ -1.5 SD 时，定义为“确认肌少症”。协方差和逻辑回归分析，根据治疗完成时间、放射治疗暴露、钙摄入量和体力活动进行调整，用于评估 aBMD 并估计低 aBMD（aBMD Z 得分 < -1.0）的比值比 (OR)。确诊患有肌肉减少症的幸存者的全身 aBMD 显着低于无肌肉减少症患者（-1.2 [95% CI：-1.5 至 -0.8] 对比 0.2 [-0.2 至 0.6]，P < 0.001），腰椎 (-0.7 [ -1.1 至 -0.3] 对比 0.4 [0.0 至 0.8]，P < 0.001），总髋关节（-0.5 [-0.9 至 -0.2] 对比 0.4 [0.1 至 0.8]，P < 0.001）和股骨颈（ -1.0 [-1.4 至 -0.6] 与 0.1 [-0.3 至 0.4]，P = 0.001）。与可能患有肌肉减少症的幸存者相比，确诊患有肌肉减少症的幸存者的全身 aBMD Z 评分显着较低（-1.2 [-1.5 至 -0.8] 对比 -0.2 [-0.7 至 0.4]，P = 0.009）、全髋关节（ -0.5 [-0.9 至 -0.2] 对比 0.5 [-0.1 至 1.0]，P = 0.010) 和股骨颈（-1.0 [-1.4 至 -0.6] 对比 0.1 [-0.5 至 0.7]，P = 0.014 ）。确诊患有肌肉减少症的幸存者全身（OR：6.91，95％CI：2.31-24.15）、全髋（OR：2.98，1.02-9.54）和股骨颈（OR： 4.72, 1.72-14.19)，比没有肌肉减少症的患者要高。与没有肌肉减少症的幸存者相比，可能患有肌肉减少症的幸存者全身低 aBMD Z 评分的风险更高（OR：4.13、1.04-17.60）。患有肌肉减少症的年轻儿科癌症幸存者存在更高的低 aBMD 风险。应在早期阶段实施旨在减轻该人群骨肌减少症的基于阻力训练的干预措施。© 2024 作者。 《恶病质、肌肉减少症和肌肉杂志》由 Wiley periodicals LLC 出版。

Sarcopenia and low areal bone mineral density (aBMD) are prevalent musculoskeletal complications after paediatric cancer treatment. However, their relationship has not been examined in young paediatric cancers survivors. This study aimed to evaluate aBMD differences according to sarcopenia status and the risk of low aBMD Z-score in young paediatric cancer survivors with sarcopenia confirmed/probable.This cross-sectional study included 116 paediatric cancer survivors (12.1 ± 3.3 years old; 42.2% female). Handgrip strength was used to assessed muscle strength. Dual-energy X-ray absorptiometry estimated aBMD (g/cm2) and appendicular lean mass index (ALMI, kg/m2). 'No sarcopenia' was defined when muscle strength was >decile 2. 'Sarcopenia probable' was defined when muscle strength was ≤ decile 2 and ALMI Z-score was > -1.5 standard deviation (SD). 'Sarcopenia confirmed' was defined when muscle strength was ≤ decile 2 and ALMI Z-score ≤ -1.5 SD. Analysis of covariance and logistic regression, adjusted for time from treatment completion, radiotherapy exposure, calcium intake, and physical activity, was used to evaluate aBMD and estimate the odds ratios (ORs) of low aBMD (aBMD Z-score < -1.0).Survivors with sarcopenia confirmed had significantly lower aBMD than those without sarcopenia at total body (-1.2 [95% CI: -1.5 to -0.8] vs. 0.2 [-0.2 to 0.6], P < 0.001), lumbar spine (-0.7 [-1.1 to -0.3] vs. 0.4 [0.0 to 0.8], P < 0.001), total hip (-0.5 [-0.9 to -0.2] vs. 0.4 [0.1 to 0.8], P < 0.001), and femoral neck (-1.0 [-1.4 to -0.6] vs. 0.1 [-0.3 to 0.4], P = 0.001). Compared with survivors with sarcopenia probable, survivors with sarcopenia confirmed had significantly lower aBMD Z-score at total body (-1.2 [-1.5 to -0.8] vs. -0.2 [-0.7 to 0.4], P = 0.009), total hip (-0.5 [-0.9 to -0.2] vs. 0.5 [-0.1 to 1.0], P = 0.010), and femoral neck (-1.0 [-1.4 to -0.6] vs. 0.1 [-0.5 to 0.7], P = 0.014). Survivors with sarcopenia confirmed were at higher risk of low aBMD Z-score at the total body (OR: 6.91, 95% CI: 2.31-24.15), total hip (OR: 2.98, 1.02-9.54), and femoral neck (OR: 4.72, 1.72-14.19), than those without sarcopenia. Survivors with sarcopenia probable were at higher risk of low aBMD Z-score at the total body (OR: 4.13, 1.04-17.60) than those without sarcopenia.Young paediatric cancer survivors with sarcopenia present higher risk of low aBMD. Resistance training-based interventions designed to mitigate osteosarcopenia in this population should be implemented at early stages.© 2024 The Author(s). Journal of Cachexia, Sarcopenia and Muscle published by Wiley Periodicals LLC.