{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T13:04:36Z","timestamp":1785762276043,"version":"3.56.0"},"reference-count":62,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,10,9]],"date-time":"2023-10-09T00:00:00Z","timestamp":1696809600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Sarcopenia, a loss of systemic skeletal muscle mass (SMM), is prevalent in childhood cancer survivors and often accompanied by increased fat mass (sarcopenic obesity [SO]). We examined whether calf muscle cross\u2010sectional area (CSA), measured by peripheral quantitative computed tomography (pQCT), can identify sarcopenia and SO in long\u2010term survivors of pediatric acute lymphoblastic leukemia (ALL), and explored its relationship with adjacent bone geometry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedures<\/jats:title><jats:p>Calf muscle CSA and CSA <jats:italic>Z<\/jats:italic> scores at the 38% tibia in 70 subjects (median survival 15\u00a0years) were compared between sexes and ALL risk group, and their association with sarcopenia and SO evaluated. Relationships between bone strength and muscle mass were assessed further using linear regression and methods described by Schoenau et\u00a0al. for evaluation of a functional muscle\u2013bone unit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A calf muscle CSA <jats:italic>Z<\/jats:italic> score of less than or equal to zero is 73.81% sensitive and 84.62% specific for detecting sarcopenia defined by height\u2010adjusted appendicular lean mass measured by dual\u2010energy x\u2010ray absorptiometry. No significant difference in CSA <jats:italic>Z<\/jats:italic> scores was noted between sexes or ALL risk groups; however, <jats:italic>Z<\/jats:italic> scores were markedly higher in those without SO (adjusted odds ratio 0.529, 95% confidence interval [CI]: 0.340\u20130.824). Ratios of calf muscle mass to height and total bone mineral content at the 38% tibia are \u201csufficient\u201d and consistent with estimated reference ranges for a healthy population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>CSA <jats:italic>Z<\/jats:italic> scores may represent a useful clinical measure of SMM and are predictive of SO in this population. Our results are supportive of a functional muscle\u2013bone unit in long\u2010term survivors of pediatric ALL.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.30705","type":"journal-article","created":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T01:01:25Z","timestamp":1697072485000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Sarcopenia in long\u2010term survivors of cancer in childhood and adolescence: A cross\u2010sectional study of calf muscle mass by peripheral quantitative computed tomography with an examination of the muscle\u2013bone unit"],"prefix":"10.1002","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2199-6869","authenticated-orcid":false,"given":"Louise","family":"Guolla","sequence":"first","affiliation":[{"name":"Department of Pediatrics McMaster University  Hamilton Ontario Canada"},{"name":"Department of Health Research Methods, Evidence &amp; Impact McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5711-7440","authenticated-orcid":false,"given":"Ronald","family":"Barr","sequence":"additional","affiliation":[{"name":"Department of Pediatrics McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maciej","family":"Jaworski","sequence":"additional","affiliation":[{"name":"Department of Biochemistry RadioImmunology and Experimental Medicine The Children's Memorial Health Institute  Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Troy","family":"Farncombe","sequence":"additional","affiliation":[{"name":"Departments of Nuclear Medicine and Radiology McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Gordon","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine Hamilton Health Sciences Corporation  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afq034"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2016.09.004"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2011.01.003"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)62167-9"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2019.04.012"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.2000.tb06498.x"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jpen.1681"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-019-04562-7"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/aac2.12027"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/cells11081278"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCO.0b013e328312c37d"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.2000.tb06515.x"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1159\/000521241"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.31191"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1159\/000503666"},{"issue":"11","key":"e_1_2_9_17_1","first-page":"849","article-title":"Obesity and metabolic disease after childhood cancer","volume":"29","author":"Barnea D","year":"2015","journal-title":"Oncology (Williston Park)"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2019.153949"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(08)70153-0"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.3961\/jpmph.15.055"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/23809000.2017.1300507"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0000000000002470"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-7568(23)00020-X"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms24054534"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/36.4.680"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnesp.2021.07.019"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0000000000001988"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/jim\u20102018\u2010000722"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13539-011-0042-6"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41430-021-01016-y"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12514"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1089\/jayao.2021.0107"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13052-016-0297-9"},{"issue":"2","key":"e_1_2_9_34_1","first-page":"215","article-title":"Peripheral quantitative computed tomography of the lower leg in children and adolescents: bone densities, cross\u2010sectional sizes and muscle distribution reference data","volume":"21","author":"Jaworski M","year":"2021","journal-title":"J Musculoskelet Neuronal Interact"},{"issue":"2","key":"e_1_2_9_35_1","first-page":"237","article-title":"Peripheral quantitative computed tomography of the distal and proximal forearm in children and adolescents: bone densities, cross\u2010sectional sizes and soft tissues reference data","volume":"18","author":"Jaworski M","year":"2018","journal-title":"J Musculoskelet Neuronal Interact"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1089\/jayao.2016.0091"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.29218"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0000000000000667"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0000000000001863"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0000000000002566"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/ar.1092190104"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-004-1744-1"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.2002.17.6.1095"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-006191"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2009.253"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/52.6.953"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/S8756-3282(02)00802-5"},{"key":"e_1_2_9_48_1","first-page":"217","article-title":"Peripheral quantitative computed tomography of the proximal radius in young subjects\u2014new reference data and interpretation of results","volume":"8","author":"Rauch F","year":"2008","journal-title":"J Musculoskelet Neuronal Interact"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocd.2010.06.007"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.597987"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.86.2.7186"},{"issue":"3","key":"e_1_2_9_52_1","first-page":"232","article-title":"From mechanostat theory to development of the \u201cFunctional Muscle\u2013Bone\u2010Unit.\u201d","volume":"5","author":"Schoenau E","year":"2005","journal-title":"J Musculoskelet Neuronal Interact"},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2010.12.032"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.3138\/ptc.2010-40BH"},{"key":"e_1_2_9_55_1","first-page":"1","volume-title":"Encyclpedia of Research Design","author":"Abdi H","year":"2010"},{"key":"e_1_2_9_56_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0b013e318279eea2"},{"key":"e_1_2_9_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2006.06.039"},{"key":"e_1_2_9_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2013.07.013"},{"key":"e_1_2_9_59_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-1476"},{"key":"e_1_2_9_60_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2011.06.041"},{"key":"e_1_2_9_61_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(16)30215-7"},{"key":"e_1_2_9_62_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.52.2268"},{"key":"e_1_2_9_63_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.024735"}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.30705","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T13:32:16Z","timestamp":1702042336000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pbc.30705"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,9]]},"references-count":62,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1002\/pbc.30705"],"URL":"https:\/\/doi.org\/10.1002\/pbc.30705","archive":["Portico"],"relation":{},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"value":"1545-5009","type":"print"},{"value":"1545-5017","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,9]]},"assertion":[{"value":"2023-05-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-16","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e30705"}}