Prevalence and determinants of dyslipidemia in 2,338 Dutch childhood cancer survivors: a DCCS-LATER 2 Study.

IF 5.3 1区医学 Q1 ENDOCRINOLOGY & METABOLISM

European Journal of Endocrinology Pub Date : 2024-11-20 DOI:10.1093/ejendo/lvae149

M Bolier, V G Pluimakers, D T C de Winter, M Fiocco, S A A van den Berg, D Bresters, E van Dulmen-den Broeder, M van der Heiden-van der Loo, I Höfer, G O Janssens, L C M Kremer, J J Loonen, M Louwerens, H J van der Pal, S M F Pluijm, W J E Tissing, H M van Santen, A C H de Vries, A J van der Lely, M M van den Heuvel-Eibrink, S J C M M Neggers

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引用次数: 0

Abstract

Objective: Childhood cancer survivors (CCS) face an increased risk of early cardiovascular disease. In our nationwide CCS cohort, we assessed the prevalence and determinants of dyslipidemia, a well-established risk factor for accelerated atherosclerosis and cardiovascular disease.

Methods: Prevalence of dyslipidemia was cross-sectionally assessed in 2,338 adult CCS and compared to adults with no cancer history (Lifelines, n=132,226). Dyslipidemia was defined by multiple classifications as well as lipid abnormalities to investigate the impact on prevalence and determinants. Logistic regression models, adjusted for age, sex, and BMI, were used to assess the cohort effect on presence of dyslipidemia. Determinants of dyslipidemia were identified through multivariable logistic regression.

Results: CCS (median age 34.7y, median follow-up 27.1y) had significantly increased odds of dyslipidemia compared to the reference cohort according to all classifications (NCEP-ATP-III, WHO, EGIR, CTCAEv.4.03). In survivors without lipid-lowering agents (n=2,007), lipid abnormalities were present in 20.6% (triglycerides>1.7mmol/L), 30.3% (HDL-c<1.0/1.3mmol/L (male/female)), 29.9% (total cholesterol>5.2mmol/L), 7.3% (LDL-c>4.1mmol/L), and 7.7% (apolipoprotein-B>130mg/dl). Compared to references without lipid-lowering agents (n=126,631), survivors had increased odds of high triglycerides (aOR=1.89, 95%CI=1.68-2.13), low HDL-c (aOR=2.73, 95%CI=2.46-3.03), and high apolipoprotein-B (aOR=1.84, 95%CI=1.53-2.20). Sex, age, BMI, physical activity, abdominal/pelvic, cranial, and total body irradiation, alkylating agents, smoking, growth hormone deficiency, and diabetes mellitus were associated with (≥1 definition of) dyslipidemia in CCS.

Conclusions: CCS are at increased risk of dyslipidemia, with various modifiable and non-modifiable determinants identified, underscoring the importance of survivor-specific risk assessment tools to control cardiovascular morbidity and mortality in this high-risk population.

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2,338 名荷兰儿童癌症幸存者血脂异常的患病率和决定因素：DCCS-LATER 2 研究。

目的：儿童癌症幸存者（CCS）罹患早期心血管疾病的风险增加。我们在全国范围内的儿童癌症幸存者队列中评估了血脂异常的患病率和决定因素，血脂异常是导致动脉粥样硬化和心血管疾病加速的公认风险因素：方法：对 2,338 名成年 CCS 的血脂异常患病率进行横截面评估，并与无癌症病史的成年人（生命线，n=132,226）进行比较。血脂异常通过多种分类和血脂异常来定义，以研究其对患病率和决定因素的影响。采用逻辑回归模型，并对年龄、性别和体重指数进行调整，以评估存在血脂异常的队列效应。通过多变量逻辑回归确定了血脂异常的决定因素：根据所有分类（NCEP-ATP-III、WHO、EGIR、CTCAEv.4.03），与参照队列相比，CCS（中位年龄 34.7 岁，中位随访 27.1 年）出现血脂异常的几率明显增加。在未服用降脂药的幸存者中（n=2,007），20.6%（甘油三酯>1.7mmol/L）、30.3%（高密度脂蛋白-c5.2mmol/L）、7.3%（低密度脂蛋白-c>4.1mmol/L）和7.7%（载脂蛋白-B>130mg/dl）存在血脂异常。与未使用降脂药的参照者（n=126,631）相比，幸存者甘油三酯偏高（aOR=1.89，95%CI=1.68-2.13）、高密度脂蛋白胆固醇偏低（aOR=2.73，95%CI=2.46-3.03）和载脂蛋白-B偏高（aOR=1.84，95%CI=1.53-2.20）的几率增加。性别、年龄、体重指数、体力活动、腹部/骨盆、头颅和全身照射、烷化剂、吸烟、生长激素缺乏和糖尿病与 CCS 的血脂异常（≥1 个定义）相关：结论：慢性病患者发生血脂异常的风险增加，其中存在各种可改变和不可改变的决定因素，这突出了幸存者特定风险评估工具对控制这一高风险人群心血管疾病发病率和死亡率的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Endocrinology 医学-内分泌学与代谢

CiteScore

9.80

自引率

3.40%

发文量

354

审稿时长

1 months

期刊介绍： European Journal of Endocrinology is the official journal of the European Society of Endocrinology. Its predecessor journal is Acta Endocrinologica. The journal publishes high-quality original clinical and translational research papers and reviews in paediatric and adult endocrinology, as well as clinical practice guidelines, position statements and debates. Case reports will only be considered if they represent exceptional insights or advances in clinical endocrinology. Topics covered include, but are not limited to, Adrenal and Steroid, Bone and Mineral Metabolism, Hormones and Cancer, Pituitary and Hypothalamus, Thyroid and Reproduction. In the field of Diabetes, Obesity and Metabolism we welcome manuscripts addressing endocrine mechanisms of disease and its complications, management of obesity/diabetes in the context of other endocrine conditions, or aspects of complex disease management. Reports may encompass natural history studies, mechanistic studies, or clinical trials. Equal consideration is given to all manuscripts in English from any country.