title: Association of muscle strength and bone mineral density in adult survivors of childhood acute lymphoblastic leukemia.
abstract: OBJECTIVE
  To investigate the association between bone mineral density (BMD) and muscle strength in survivors of childhood acute lymphoblastic leukemia (ALL), a population at increased risk for both decreased BMD and muscle strength from cancer and its treatment.
  
  
  METHODS
  Cohort data from the St Jude Lifetime Cohort (SJLIFE) study.
  
  
  METHODS
  Department of Cancer Control at St Jude Children's Research Hospital.
  
  
  METHODS
  Subjects were adults enrolled in St Jude Lifetime Cohort study and treated for childhood ALL between 1962 and 1999. As part of a comprehensive evaluation, participants had dual energy x-ray absorptiometry (DEXA) scans and muscle strength testing. The participants consisted of 261 women and 232 men who were 20.4 to 49.8 years old (median, 35.7y), and 12.7 to 46.5 years from diagnosis of childhood ALL (median, 27.2y).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  BMD was determined by DEXA scan. Muscle strength of upper and lower extremities was assessed with physical performance testing.
  
  
  RESULTS
  After adjusting for covariates, we found significant (P<0.005) associations between BMD and muscle strength in lower extremities (R(2) range, 0.33-0.40) and strong, significant associations in upper extremities (left-side R(2)=0.558; right-side R(2)=0.560).
  
  
  CONCLUSIONS
  Muscle strength was associated with BMD in the extremities of long-term survivors of childhood ALL, a finding suggesting that muscle strengthening interventions may improve bone health in them.
authors.affiliation: Department of Radiological Sciences, St Jude Children's Research Hospital, Memphis, TN 38105-2794, USA.
authors.forename: Emily D
authors.initials: ED
authors.lastname: Joyce
authors.forename: Vikki G
authors.initials: VG
authors.lastname: Nolan
authors.forename: Kirsten K
authors.initials: KK
authors.lastname: Ness
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Ferry
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Robison
authors.forename: Ching-Hon
authors.initials: CH
authors.lastname: Pui
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Hudson
authors.forename: Sue C
authors.initials: SC
authors.lastname: Kaste
mesh_terms: D000328:Adult; D015519:Bone Density; D005260:Female; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000503:physiopathology*; D017741:Survivors; D055815:Young Adult