Cardiovascular risk factors in adult survivors of pediatric cancer--a report from the childhood cancer survivor study.
Cardiovascular risk factors in adult survivors of pediatric cancer--a report from the childhood cancer survivor study.
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DOI：
10.1158/1055-9965.epi-09-0555
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发表时间：
2010-01
期刊：
影响因子：
--
通讯作者：
Mertens AC
中科院分区：
文献类型：
--
作者：
Meacham LR;Chow EJ;Ness KK;Kamdar KY;Chen Y;Yasui Y;Oeffinger KC;Sklar CA;Robison LL;Mertens AC
与一般人群相比，儿童癌症幸存者的心血管（CV）疾病发病率和死亡率风险更高。8，599名幸存者（52%为男性）和2，936名兄弟姐妹（46%男性）。来自儿童癌症幸存者研究（CCSS），一项回顾性确定-前瞻性随访研究，基于自我报告的身高和体重以及自我报告的高血压药物使用情况，对1970-1986年诊断为儿童癌症后存活5年的患者进行BMI ≥30 kg/m2的评价，血脂异常和葡萄糖代谢受损。以上构成的心血管危险因素簇（CVRFC）中存在≥3个的代谢综合征幸存者比兄弟姐妹更可能服用高血压（OR 1.9 95% CI 1.6-2.2）、血脂异常（OR 1.6 95% CI 1.3-2.0）或糖尿病（OR 1.7 95% CI 1.2-2.3）药物。在这些年轻的成年人中（幸存者平均年龄32岁，兄弟姐妹平均年龄33岁），幸存者并不比兄弟姐妹更容易肥胖或患有CVRFC。在多变量逻辑回归分析中，与CVRFC相关的因素包括：面试时年龄较大（≥ 40岁vs.< 30岁[OR 8.2 95% CI 3.5-19.9]），暴露于全身照射（OR 5.5 95% CI 1.5-15.8）或胸部和腹部放射（OR 2.3 95% CI 1.2-2.4）和缺乏体力活动（OR 1.7 95% CI 1.1-2.6）。在儿童癌症的成年幸存者中，年龄较大，暴露于TBI或腹部加胸部辐射，以及久坐的生活方式与CVRFC相关。
Childhood cancer survivors are at higher risk of morbidity and mortality from cardiovascular (CV) disease compared with the general population. 8,599 survivors (52% male) and 2,936 siblings (46% male).from the Childhood Cancer Survivor Study (CCSS), a retrospectively ascertained – prospectively followed study of persons who survived 5 years after childhood cancer diagnosed from 1970–1986 were evaluated for BMI ≥30 kg/m2 based on self reported heights and weights and self-reported use of medications for hypertension, dyslipidemia, and impaired glucose metabolism. The presence of ≥3 of the above constituted Cardiovascular Risk Factor Cluster (CVRFC) a surrogate for Metabolic Syndrome Survivors were more likely than siblings to take medications for hypertension (OR 1.9 95% CI 1.6–2.2), dyslipidemia (OR 1.6 95% CI 1.3–2.0) or diabetes (OR 1.7 95% CI 1.2–2.3). Among these young adults (mean age 32 years for survivors and 33 years for siblings) survivors were not more likely than siblings to be obese or have CVRFC. In a multivariable logistic regression analysis, factors associated with having CVRFC included: older age at interview (≥ 40 vs. < 30 years of age [OR 8.2 95% CI 3.5–19.9]), exposure to total body irradiation (OR 5.5 95% CI 1.5–15.8) or radiation to the chest and abdomen (OR 2.3 95% CI 1.2–2.4), and physical inactivity (OR 1.7 95% CI 1.1–2.6). Among adult survivors of pediatric cancer, older attained age, exposure to TBI or abdominal plus chest radiation, and a sedentary lifestyle are associated with CVRFC.