Body Composition Analysis Using DEXA-Scan and its Correlation with Arm-Anthropometry in Childhood Acute Lymphoblastic Leukemia Survivors.

IF 1.5 4区医学 Q2 PEDIATRICS Indian pediatrics Pub Date : 2025-02-15 DOI:10.1007/s13312-025-3378-2

Sanjeev Khera, Naresh Bansal, Amit Kumar, Rajan Kapoor

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Abstract

Objective: To determine the body composition in childhood acute lymphoblastic leukemia survivors (cALLS) using dual-energy x-ray absorptiometry (DEXA) and correlate the same with mid-upper-arm circumference (MUAC) and triceps-skin-fold thickness (TSFT).

Methods: A cross-sectional study was undertaken to assess body composition in cALLS aged >7 years. Patients who were lost to follow-up after completion of therapy, had relapsed acute lymphoblastic leukemia (ALL), undergone hematopoietic stem cell transplantation and those with neurological disabilities/syndromic diagnosis were excluded. Prevalence of high-adiposity (body fat % > 85th centile), sarcopenia (lean body mass < 5th centile) and sarcopenic obesity (positive fat mass index z-score with negative fat-free mass index z-score); and demographic, therapy-related and endocrine factors were noted.

Results: Fifty-nine cALLS survivors with a median (IQR) age of 66 (38, 91) months at diagnosis were analyzed. At a median (IQR) duration of 14 (3, 43) months following completion of therapy, 36 children (61%) had deranged body composition; high adiposity (n = 28; 47%), sarcopenia (n = 20; 34%), sarcopenic obesity (n = 9; 15%). Metabolic syndrome was seen in 7 (12%). Survivors with lower mean-age at diagnosis and at enrolment had high-adiposity levels and sarcopenia. Sarcopenia was seen more commonly in females, pre-pubertal children and survivors with a lower mean-interval from therapy completion. Obesity, sarcopenia and sarcopenic obesity were not significantly associated with the type of ALL, steroid dose and cranial-irradiation. High leptin levels were seen in survivors with obesity and sarcopenic obesity. MUAC and TSFT correlated well with DEXA-generated markers.

Conclusion: The prevalence of deranged body composition in cALLs from a single centre in Northern India was high, indicating need for early and frequent screening. MUAC and TSFT are reliable surrogate measures for body composition.

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儿童急性淋巴细胞白血病幸存者dexa扫描体成分分析及其与臂部人体测量的相关性。

目的：利用双能x线吸收仪（DEXA）测定儿童急性淋巴细胞白血病（cALLS）幸存者的身体组成，并将其与上臂中围（MUAC）和肱三头肌-皮肤褶厚（TSFT）进行相关性分析。方法：采用横断面研究对年龄在bb0 ~ 7岁的人群进行身体成分评估。排除治疗结束后失访、急性淋巴细胞白血病（ALL）复发、接受造血干细胞移植、神经功能障碍/综合征诊断的患者。高脂肪（体脂% > 85百分位）、肌肉减少症（瘦体重< 5百分位）和肌肉减少型肥胖（脂肪质量指数z-score为正，无脂肪质量指数z-score为负）的患病率；并注意到人口统计学、治疗相关和内分泌因素。结果：分析了59例诊断时中位（IQR）年龄为66（38,91）个月的呼叫幸存者。治疗结束后的中位（IQR）持续时间为14（3,43）个月，36名儿童（61%）出现身体组成紊乱；高肥胖(n = 28；47%)，肌肉减少症(n = 20；34%)、肌肉减少性肥胖(n = 9；15%)。7例（12%）出现代谢综合征。诊断时和入组时平均年龄较低的幸存者有高脂肪水平和肌肉减少症。骨骼肌减少症在女性、青春期前儿童和从治疗完成的平均间隔较短的幸存者中更为常见。肥胖、肌少症和肌少性肥胖与ALL类型、类固醇剂量和颅脑照射均无显著相关性。高瘦素水平见于肥胖和肌肉减少性肥胖的幸存者。MUAC和TSFT与dexa生成的标记物相关性良好。结论：来自印度北部单一中心的呼叫中身体组成紊乱的患病率很高，表明需要早期和频繁的筛查。MUAC和TSFT是测定身体成分的可靠替代指标。

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来源期刊

Indian pediatrics 医学-小儿科

CiteScore

3.30

自引率

8.70%

发文量

344

审稿时长

3-8 weeks

期刊介绍： The general objective of Indian Pediatrics is "To promote the science and practice of Pediatrics." An important guiding principle has been the simultaneous need to inform, educate and entertain the target audience. The specific key objectives are: -To publish original, relevant, well researched peer reviewed articles on issues related to child health. -To provide continuing education to support informed clinical decisions and research. -To foster responsible and balanced debate on controversial issues that affect child health, including non-clinical areas such as medical education, ethics, law, environment and economics. -To achieve the highest level of ethical medical journalism and to produce a publication that is timely, credible and enjoyable to read.