Longitudinal changes in obesity and body mass index among adult survivors of childhood acute lymphoblastic leukemia: A report from the Childhood Cancer Survivor Study
Longitudinal changes in obesity and body mass index among adult survivors of childhood acute lymphoblastic leukemia: A report from the Childhood Cancer Survivor Study
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DOI：
10.1200/jco.2008.16.3527
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发表时间：
2008-10-01
影响因子：
45.3
通讯作者：
Oeffinger, Kevin C.
中科院分区：
文献类型：
--
作者：
Garmey, Edward G.;Liu, Qi;Oeffinger, Kevin C.
研究目的：探讨体重指数（BMI）的增长率（体重指数;在急性淋巴细胞白血病（ALL）幸存者和非癌症对照组中，在最终身高达到后，是一项回顾性确定的队列研究，前瞻性跟踪1970年至1986年期间被诊断患有儿童癌症的成年人的健康状况，兄妹从基线入组至完成随访时BMI的变化（平均间隔，7.8年）计算了1，451名ALL幸存者（平均年龄，随访时32.3岁）和2，167名儿童癌症幸存者的兄弟姐妹结果CCSS同胞对照组的平均BMI随着年龄的增长而增加（女性，0.25单位/年，95% CI，0.22 - 0.28单位;男性，0.23单位/年，95% CI，0.20 - 0.25单位）。与CCSS同胞相比，接受头颅放射治疗（CRT）的ALL幸存者的BMI显著增加（女性，0.41单位/年，95% CI，0.37至0.45单位;男性，0.29单位/年; 95% CI，0.26至0.32单位）。单独接受化疗的ALL幸存者的BMI增加率没有显著增加。年龄较小的CRT暴露显着修改risk.ConclusionCRT用于治疗儿童ALL是与一个更大的速度增加BMI，特别是在女性CRT治疗在第一个十年的生活。卫生保健专业人员应该意识到这种风险，并且在这种高风险人群中，减少或管理体重增加的干预措施至关重要。
PurposeWe examined the rate of increase in the body mass index (BMI; kg/m(2)) after final height attainment in survivors of acute lymphoblastic leukemia (ALL) and a noncancer comparison group.MethodsChildhood Cancer Survivor Study (CCSS) is a retrospectively ascertained cohort study that prospectively tracks the health status of adults who were diagnosed with childhood cancer between 1970 and 1986 and a comparison group of siblings. Changes in BMI from baseline enrollment to time of completion of follow-up (mean interval, 7.8 years) were calculated for 1,451 ALL survivors (mean age, 32.3 years at follow-up) and 2,167 siblings of childhood cancer survivors (mean age, 35.9 years).ResultsThe mean BMI of the CCSS sibling comparison group increased with age (women, 0.25 units/yr, 95% CI, 0.22 to 0.28 units; men, 0.23 units/yr, 95% CI, 0.20 to 0.25 units). Compared with CCSS siblings, ALL survivors who were treated with cranial radiation therapy (CRT) had a significantly greater increase in BMI (women, 0.41 units/yr, 95% CI, 0.37 to 0.45 units; men, 0.29 units/yr; 95% CI, 0.26 to 0.32 units). The rate of BMI increase was not significantly increased for ALL survivors who were treated with chemotherapy alone. Younger age at CRT exposure significantly modified risk.ConclusionCRT used in the treatment of childhood ALL is associated with a greater rate of increasing BMI, particularly among women treated with CRT during the first decade of life. Health care professionals should be aware of this risk and interventions to reduce or manage weight gain are essential in this high-risk population.