Prevalence and Predictors of Overweight and Obesity Among a Multiethnic Population of Pediatric Acute Lymphoblastic Leukemia Survivors: A Cross-Sectional Assessment
Prevalence and Predictors of Overweight and Obesity Among a Multiethnic Population of Pediatric Acute Lymphoblastic Leukemia Survivors: A Cross-Sectional Assessment
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DOI：
10.1097/mph.0000000000000555
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发表时间：
2016-08-01
影响因子：
1.2
通讯作者：
Kamdar, Kala Y.
中科院分区：
文献类型：
--
作者：
Brown, Austin L.;Lupo, Philip J.;Kamdar, Kala Y.
由于先前关于儿童急性淋巴细胞白血病（ALL）幸存者肥胖的研究主要是在非西班牙裔白色幸存者或接受旧方案治疗的儿童中进行的，我们的目的是描述不同种族儿童ALL幸存者人群中超重状态的患病率和相关性，这些儿童主要接受更现代的治疗。我们评估了2004年至2014年期间在德克萨斯州儿童癌症中心随访的儿童ALL幸存者（n=406）的超重/肥胖状态。根据最近随访时的体重指数，将幸存者分为体重不足、体重正常、超重或肥胖。我们的研究结果显示，西班牙裔（39%的受试者）与随访时超重（调整后比值比=1.88; 95%置信区间，1.13-3.14）或肥胖（调整后比值比=2.84; 95%置信区间，1.59-5.06）相关，即使在调整了颅放射治疗（CRT）暴露后。诊断时的体重指数z评分也与随访时的超重/肥胖相关。此外，在诊断时年龄较小和CRT之间存在统计学显著的相互作用，表明在接受CRT的患者中，诊断时年龄较小与肥胖相关。这些发现可能有助于识别治疗后超重或肥胖风险增加的儿童ALL患者。
As previous studies of obesity in survivors of pediatric acute lymphoblastic leukemia (ALL) have primarily been conducted among non-Hispanic white survivors or children treated on older protocols, our objective was to describe the prevalence and correlates of overweight status among an ethnically diverse population of pediatric ALL survivors, largely treated with more contemporary therapies. We evaluated the overweight/obesity status of pediatric ALL survivors (n=406) followed in the Texas Children's Cancer Center between 2004 and 2014. Survivors were classified as underweight, normal weight, overweight, or obese on the basis of their body mass index at their most current follow-up visit. Our results showed that Hispanic ethnicity (39% of the subjects) was associated with being overweight (adjusted odds ratio=1.88; 95% confidence interval, 1.13-3.14) or obese (adjusted odds ratio=2.84; 95% confidence interval, 1.59-5.06) at follow-up, even after adjusting for cranial radiotherapy (CRT) exposure. Body mass index z-score at diagnosis was also associated with overweight/obesity at follow-up. In addition, there was a statistically significant interaction between younger age at diagnosis and CRT, indicating that younger age at diagnosis was associated with obesity among patients who received CRT. These findings may help identify pediatric ALL patients that are at increased risk of being overweight or obese after treatment.