Limitations of body mass index to assess body composition due to sarcopenic obesity during leukemia therapy.
Limitations of body mass index to assess body composition due to sarcopenic obesity during leukemia therapy.
复制标题
DOI：
10.3109/10428194.2015.1136741
复制
发表时间：
2018-01
影响因子：
2.6
通讯作者：
Mittelman SD
中科院分区：
文献类型：
--
作者：
Orgel E;Mueske NM;Sposto R;Gilsanz V;Freyer DR;Mittelman SD
由体重指数百分位数(BMI%)定义的肥胖与ALL儿童的复发和较差的存活率密切相关。BMI%是否准确地反映了这一人群中的体脂百分比(BF%)尚不清楚。我们进行了一项前瞻性研究，评估一线ALL治疗期间的身体成分。双能X线骨密度仪在诊断时、诱导结束时和延迟强化结束时测量BF%和瘦肉量(LMM)。在所有治疗期间，肌源性肥胖(BF%增加而1 MM减少)出人意料地普遍，导致BMI%(以Z分数表示)和BF%总体(r=−0.05)和患者内部(r=−0.09)之间的变化之间的相关性很差。在50%的间期评估中，BMI、Z-Score和BF%的变化方向相反。虽然确诊时的BMI%是流行病学研究中适合预测肥胖/BF%的指标，但BMI%的变化(以Z分数表示)并不能反映身体成分。评估白血病患者肥胖的研究应该考虑使用直接测量身体成分的方法。
Obesity as defined by body mass index percentile (BMI%) is strongly associated with relapse and poorer survival in childhood ALL. Whether BMI% accurately reflects body fat percentage (BF%) in this population is unknown. We conducted a prospective study assessing body composition during frontline ALL therapy. Dual-energy X-ray absorptiometry measured BF% and lean muscle mass (LMM) at diagnosis, end of Induction, and end of Delayed Intensification. Sarcopenic obesity (gain in BF% with loss of LMM) was surprisingly common during ALL treatment, resulting in poor correlation between changes in BMI% (expressed as Z-score) and BF% overall (r=−0.05) and within patients (r=−0.09). BMI Z-score and BF% changed in opposite directions in >50% of interval assessments. While BMI% at diagnosis is a suitable predictor of obesity/BF% for epidemiological studies, change in BMI% (as expressed as Z-score) does not reflect body composition. Studies evaluating obesity in leukemia should consider using direct measures of body composition.