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
{"title":"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。","authors":"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","doi":"10.1093/ejendo/lvae149","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":" ","pages":""},"PeriodicalIF":5.3000,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prevalence and determinants of dyslipidemia in 2,338 Dutch childhood cancer survivors: a DCCS-LATER 2 Study.\",\"authors\":\"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\",\"doi\":\"10.1093/ejendo/lvae149\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":11884,\"journal\":{\"name\":\"European Journal of Endocrinology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":5.3000,\"publicationDate\":\"2024-11-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Endocrinology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/ejendo/lvae149\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Endocrinology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ejendo/lvae149","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Prevalence and determinants of dyslipidemia in 2,338 Dutch childhood cancer survivors: a DCCS-LATER 2 Study.
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.
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.
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