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AMPLIFIed muscle mass in older cancer survivors enrolled in a diet-exercise program

参加饮食锻炼计划的老年癌症幸存者的肌肉质量增加

基本信息

批准号：
10531199
负责人：
Peggy Mannen Cawthon
金额：
$ 31.78万
依托单位：
UNIVERSITY OF CALIFORNIA BERKELEY
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-12-09 至 2024-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10531199
关键词：
Acceleration Activities of Daily Living Aerobic Affect Age Aging Area Behavior Therapy Body Composition Body Weight decreased Cancer Survivor Clinical Clinical Trials Cohort Studies Control Groups Creatine Creatinine Data Diet Dietary Intervention Dual-Energy X-Ray Absorptiometry Elderly Enrollment Exercise Fasting Fatty acid glycerol esters Fracture Funding Gait speed Health Home Hour Individual Ingestion Intervention Intervention Trial Longevity MRI Scans Magnetic Resonance Imaging Malignant Neoplasms Measurement Measures Medical Research Methods Minority Muscle Obesity Older Population Outcome Overweight Participant Patients Performance Physical Function Physical Performance Physical activity Physical assessment Populations at Risk Prevalence Program Research Project Grants Quality of life Risk Rural Sampling Schedule Skeletal Muscle Surveys Testing Thinness Time Urine Venous blood sampling Visiting Nurse Woman X-Ray Computed Tomography arm cancer diagnosis cancer survival capsule comparative efficacy design diet and exercise disability disability risk effective intervention exercise intervention exercise program falls health assessment high risk population improved intervention effect lean body mass lifestyle intervention men muscle form novel older men older women preservation programs reduced muscle mass response rural setting sarcopenia tool validation studies wasting weight loss intervention

项目摘要

We propose to add the measurement of muscle mass to an already funded program project grant. Rapid declines in physical functioning often occur after the diagnosis of cancer, especially among older cancer survivors; however, a handful of diet and exercise interventions have been found to ameliorate these losses. The contribution of muscle mass and changes in muscle mass in older men and women, particularly those who have survived cancer is not well characterized, partly due to the inability to directly and accurately quantify skeletal muscle mass and reliance on assessments of lean mass as a surrogate. The Adapting MultiPLe behavior Interventions that eFfectively Improve (AMPLIFI) Cancer Survivor Health (1P01CA22997) is aimed at testing three distinct lifestyle interventions among 652 older, inactive, overweight or obese cancer survivors, a large proportion of whom will be minority and rural. The interventions include: 1) a 6-month dietary intervention aimed at improving diet quality and weight loss, as well as preserving lean body mass; 2) a 6-month intervention that is aimed at promoting aerobic physical activity; and 3) a 12-month diet and exercise intervention that combines both diet and exercise simultaneously (and effects will be evaluated against the combination of interventions 1 and 2 in sequence). Visiting nurses will assess physical function and perform phlebotomy at home health assessments scheduled at baseline and every six months; participants also will complete surveys that assess diet, physical activity and overall quality of life. We propose to measure the effects of these interventions on muscle mass using the novel D3-creatine (D3Cr) dilution method. We have demonstrated that this non- invasive method can be implemented in a large cohort study (MrOS) and that D3Cr muscle mass is strongly associated with functional capacity and risk of disability and that age- associated decreases in muscle mass are associated with slower gait speed and decreased strength. These associations were not observed using DXA derived lean mass. Subjects will ingest a 60 mg capsule of D3Cr and produce a fasting urine sample 48 – 96 hours later for the assessment of D3-Creatinine enrichment to determine creatine pool size and, because 98% of total body creatine is found in muscle, muscle mass. For the first time, the relationship between changes in muscle mass resulting from exercise and weight loss and functional capacity and physical activity will be assessed in this at-risk population of older cancer survivors.

我们建议将肌肉质量的测量添加到已经资助的计划项目中授予。诊断出癌症后，身体机能通常会迅速下降，尤其是老年癌症幸存者；然而，一些饮食和运动干预措施已发现可以改善这些损失。肌肉质量的贡献和变化老年男性和女性，尤其是癌症幸存者的肌肉质量不佳特征部分是由于无法直接准确地量化骨骼肌质量并依赖对瘦体重的评估作为替代。适应多重行为有效改善 (AMPLIFI) 癌症幸存者健康的干预措施 (1P01CA22997) 旨在测试 652 名老年人、不活动、超重或肥胖的癌症幸存者，其中很大一部分是少数民族和农村人。干预措施包括：1) 为期 6 个月的饮食干预，旨在改善饮食质量和减轻体重，如以及保持去脂体重； 2) 为期 6 个月的干预，旨在促进有氧运动； 3) 为期 12 个月的饮食和运动干预，将两者结合起来同时饮食和运动（并且将根据两者的组合来评估效果按顺序干预 1 和 2）。上门护士将评估身体功能并执行在基线和每六个月安排一次家庭放血健康评估；参与者还将完成评估饮食、身体活动和整体质量的调查生活。我们建议使用以下方法来测量这些干预措施对肌肉质量的影响新型 D3-肌酸 (D3Cr) 稀释方法。我们已经证明，这种非侵入性方法可以在大型队列研究（MrOS）中实施，并且 D3Cr 肌肉质量与功能能力和残疾风险密切相关，并且年龄肌肉质量的减少与步态速度减慢有关，并且肌肉质量的减少与步态速度减慢有关力量。使用 DXA 得出的去脂体重未观察到这些关联。受试者将摄入 60 毫克 D3Cr 胶囊，并在 48 – 96 小时后产生空腹尿液样本，用于评估 D3-肌酐富集以确定肌酸池大小，因为全身肌酸的 98% 存在于肌肉、肌肉质量中。首次，运动引起的肌肉质量变化与体重减轻之间的关系将评估这一高危老年人群的功能能力和体力活动癌症幸存者。