背景：普遍报道急性淋巴细胞白血病(ALL)的小儿科生还者的身体成分会发生变化。然而还没有运用对于急性淋巴细胞白血病以及相应治疗对患儿身体成分的影响进行完备检查的标准方法。
目的：我们旨在确定急性淋巴细胞白血病得到缓解的患儿的身体成分和去脂体重(FFM)的成分。同时我们试图对急性淋巴细胞白血病的生还者使用氢化波尼松和地塞米松后对身体成分的影响进行对比。
设计：我们设计一个交叉组合研究项目，对24名急性淋巴细胞白血病得到缓解的患儿和24名相应年龄健康控制受试对象测量身高、体重、身体体积、身体总水量和骨矿物质成分。运用4-成分模型来评价身体成分和去脂体重的成分。
结果：急性淋巴细胞白血病生还儿童的身体质量指数和脂肪质量指数的平均值(皆为：P = 0.05)显著高于24名相应年龄的健康控制受试对象。2个治疗组的去脂体重成分未观察到显著的变化。对去脂体重成分的检查可以确信：急性淋巴细胞白血病得到缓解的患儿和相应年龄的健康控制受试对象相比，去脂体重的水合作用(P = 0.0001)显著增加，而去脂体重的密度(P = 0.0001)显著降低。
结论：急性淋巴细胞白血病得到缓解的患儿可能会形成过多的身体脂肪，为了更为准确的测定急性淋巴细胞白血病患者的身体成分，必须对这些患者去脂体重的高水合作用和低密度加以考虑。
关键词：身体成分 急性淋巴细胞白血病 去脂体重 4-成分模型 地塞米松 氢化波尼松
Body composition in children in remission from acute lymphoblastic leukemia
American Journal of Clinical Nutrition, Vol. 83, No. 1, 70-74, January 2006
Alexia J Murphy, Jonathan CK Wells, Jane E Williams, Mary S Fewtrell, Peter SW Davies and David K Webb
Background: Changes in body composition are commonly reported in pediatric survivors of acute lymphoblastic leukemia (ALL). However, the effect of ALL and of its treatment on body composition in children in remission from ALL has not been fully examined with the use of a reference method.
Objectives: We aimed to determine the body composition and composition of fat-free mass (FFM) in children in remission from ALL. We also aimed to compare the effects that prednisolone and dexamethasone had on the body composition of an ALL survivor population.
Design: This cross-sectional study measured height, weight, body volume, total body water, and bone mineral content in 24 children in remission from ALL and 24 age-matched, healthy control subjects. Body composition and FFM composition were evaluated by using the 4-component model.
Results: The mean body mass index and fat mass index were significantly (P = 0.05 for both) higher in the ALL survivors than in age-matched control subjects. The composition of the FFM in the 2 treatment groups was not observed to differ significantly. Examination of the composition of FFM made it evident that children in remission from ALL had both significantly greater hydration (P = 0.001) and lower density (P = 0.0001) of FFM than did the control children.
Conclusions: Children in remission from ALL may develop excess body fat. To measure body composition accurately in an ALL population, the high hydration and low density of FFM in this population should be taken into consideration.
Key Words: Body composition • acute lymphoblastic leukemia • fat-free mass • 4-component model • dexamethasone • prednisolone
