Melissa Bolier MD, Demi T.C. de Winter MD, Vincent G. Pluimakers MD, PhD, Marta Fiocco PhD, Sjoerd A.A. van den Berg PhD, Dorine Bresters MD, PhD, Eline van Dulmen-den Broeder PhD, Margriet van der Heiden-van der Loo PhD, Imo Höfer MD, Geert O. Janssens MD, PhD, Leontien C.M. Kremer MD, PhD, Jacqueline J. Loonen MD, PhD, Marloes Louwerens MD, Heleen J. van der Pal MD, PhD, Saskia M.F. Pluijm PhD, Wim J.E. Tissing MD, PhD, Hanneke M. van Santen MD, PhD, Andrica C.H. de Vries MD, PhD, Aart-Jan van der Lely MD, PhD, Marry M. van den Heuvel-Eibrink MD, PhD, Sebastian J.C.M.M. Neggers MD, PhD
{"title":"2338名儿童癌症幸存者中代谢综合征的患病率和决定因素：一项荷兰儿童癌症幸存者LATER 2研究","authors":"Melissa Bolier MD, Demi T.C. de Winter MD, Vincent G. Pluimakers MD, PhD, Marta Fiocco PhD, Sjoerd A.A. van den Berg PhD, Dorine Bresters MD, PhD, Eline van Dulmen-den Broeder PhD, Margriet van der Heiden-van der Loo PhD, Imo Höfer MD, Geert O. Janssens MD, PhD, Leontien C.M. Kremer MD, PhD, Jacqueline J. Loonen MD, PhD, Marloes Louwerens MD, Heleen J. van der Pal MD, PhD, Saskia M.F. Pluijm PhD, Wim J.E. Tissing MD, PhD, Hanneke M. van Santen MD, PhD, Andrica C.H. de Vries MD, PhD, Aart-Jan van der Lely MD, PhD, Marry M. van den Heuvel-Eibrink MD, PhD, Sebastian J.C.M.M. Neggers MD, PhD","doi":"10.1002/cncr.35681","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Because the occurrence of metabolic syndrome (MetS) might contribute to childhood cancer survivor’s excess risk of cardiovascular disease, the authors assessed the prevalence and determinants of MetS in the Dutch Childhood Cancer Survivor Study (DCCSS-LATER2) cohort.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>In total, 2338 adult childhood cancer survivors (CCS) were cross-sectionally assessed for the prevalence of MetS, using the Lifelines cohort (<i>N</i> = 132,226 adults without a history of cancer) as references. The prevalence of MetS was clinically assessed using existing classifications, as well as an alternative method using dual-energy x-ray absorptiometry fat% instead of waist circumference to define abdominal adiposity. Logistic regression models, adjusted for age and sex, were used to investigate the association between the presence of MetS and both cohorts. Demographic, lifestyle, and treatment determinants of MetS were identified through multivariable logistic regression.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The survivor cohort (median age, 34.7 years, median follow-up time, 27.1 years) showed increased adjusted odds ratio (aOR) for MetS (modified National Cholesterol Education Program Adult Treatment Panel III criteria), as compared to the reference cohort (aOR, 2.07; 95% confidence interval [CI], 1.85–2.32). Compared to these criteria, the alternative method identified 57 additional survivors with MetS (395 of 2070 [19.1%] vs. 452 of 1960 [23.1%], respectively). Age (odds ratio [OR], 1.07; 95% CI, 1.04–1.10, per year increase), smoking (OR, 1.46; 95% CI, 1.04–2.04), low physical activity (OR, 1.48; 95% CI, 1.05–2.09), abdominal radiotherapy (OR, 2.13; 95% CI, 1.01–4.31; >30 Gy), cranial radiotherapy (OR, 2.89; 95% CI, 1.67–4.96; 1–25 Gy; and OR, 2.44; 95% CI, 1.30–4.47; >25 Gy), total body irradiation (OR, 6.17; 95% CI, 3.20–11.76), and underlying central nervous system tumor (OR, 1.78; 95% CI, 1.21–2.60) were associated with MetS.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>The high risk of MetS in CCS, combined with several potential modifiable factors, underscores the need for timely identification and intervention strategies to mitigate the long-term cardiovascular risks in CCS.</p>\n </section>\n </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 1","pages":""},"PeriodicalIF":6.1000,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695793/pdf/","citationCount":"0","resultStr":"{\"title\":\"Prevalence and determinants of metabolic syndrome in 2338 childhood cancer survivors: A Dutch Childhood Cancer Survivor LATER 2 study\",\"authors\":\"Melissa Bolier MD, Demi T.C. de Winter MD, Vincent G. Pluimakers MD, PhD, Marta Fiocco PhD, Sjoerd A.A. van den Berg PhD, Dorine Bresters MD, PhD, Eline van Dulmen-den Broeder PhD, Margriet van der Heiden-van der Loo PhD, Imo Höfer MD, Geert O. Janssens MD, PhD, Leontien C.M. Kremer MD, PhD, Jacqueline J. Loonen MD, PhD, Marloes Louwerens MD, Heleen J. van der Pal MD, PhD, Saskia M.F. Pluijm PhD, Wim J.E. Tissing MD, PhD, Hanneke M. van Santen MD, PhD, Andrica C.H. de Vries MD, PhD, Aart-Jan van der Lely MD, PhD, Marry M. van den Heuvel-Eibrink MD, PhD, Sebastian J.C.M.M. 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Logistic regression models, adjusted for age and sex, were used to investigate the association between the presence of MetS and both cohorts. Demographic, lifestyle, and treatment determinants of MetS were identified through multivariable logistic regression.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>The survivor cohort (median age, 34.7 years, median follow-up time, 27.1 years) showed increased adjusted odds ratio (aOR) for MetS (modified National Cholesterol Education Program Adult Treatment Panel III criteria), as compared to the reference cohort (aOR, 2.07; 95% confidence interval [CI], 1.85–2.32). Compared to these criteria, the alternative method identified 57 additional survivors with MetS (395 of 2070 [19.1%] vs. 452 of 1960 [23.1%], respectively). Age (odds ratio [OR], 1.07; 95% CI, 1.04–1.10, per year increase), smoking (OR, 1.46; 95% CI, 1.04–2.04), low physical activity (OR, 1.48; 95% CI, 1.05–2.09), abdominal radiotherapy (OR, 2.13; 95% CI, 1.01–4.31; >30 Gy), cranial radiotherapy (OR, 2.89; 95% CI, 1.67–4.96; 1–25 Gy; and OR, 2.44; 95% CI, 1.30–4.47; >25 Gy), total body irradiation (OR, 6.17; 95% CI, 3.20–11.76), and underlying central nervous system tumor (OR, 1.78; 95% CI, 1.21–2.60) were associated with MetS.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>The high risk of MetS in CCS, combined with several potential modifiable factors, underscores the need for timely identification and intervention strategies to mitigate the long-term cardiovascular risks in CCS.</p>\\n </section>\\n </div>\",\"PeriodicalId\":138,\"journal\":{\"name\":\"Cancer\",\"volume\":\"131 1\",\"pages\":\"\"},\"PeriodicalIF\":6.1000,\"publicationDate\":\"2025-01-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695793/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cancer\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/cncr.35681\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/cncr.35681","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
Prevalence and determinants of metabolic syndrome in 2338 childhood cancer survivors: A Dutch Childhood Cancer Survivor LATER 2 study
Background
Because the occurrence of metabolic syndrome (MetS) might contribute to childhood cancer survivor’s excess risk of cardiovascular disease, the authors assessed the prevalence and determinants of MetS in the Dutch Childhood Cancer Survivor Study (DCCSS-LATER2) cohort.
Methods
In total, 2338 adult childhood cancer survivors (CCS) were cross-sectionally assessed for the prevalence of MetS, using the Lifelines cohort (N = 132,226 adults without a history of cancer) as references. The prevalence of MetS was clinically assessed using existing classifications, as well as an alternative method using dual-energy x-ray absorptiometry fat% instead of waist circumference to define abdominal adiposity. Logistic regression models, adjusted for age and sex, were used to investigate the association between the presence of MetS and both cohorts. Demographic, lifestyle, and treatment determinants of MetS were identified through multivariable logistic regression.
Results
The survivor cohort (median age, 34.7 years, median follow-up time, 27.1 years) showed increased adjusted odds ratio (aOR) for MetS (modified National Cholesterol Education Program Adult Treatment Panel III criteria), as compared to the reference cohort (aOR, 2.07; 95% confidence interval [CI], 1.85–2.32). Compared to these criteria, the alternative method identified 57 additional survivors with MetS (395 of 2070 [19.1%] vs. 452 of 1960 [23.1%], respectively). Age (odds ratio [OR], 1.07; 95% CI, 1.04–1.10, per year increase), smoking (OR, 1.46; 95% CI, 1.04–2.04), low physical activity (OR, 1.48; 95% CI, 1.05–2.09), abdominal radiotherapy (OR, 2.13; 95% CI, 1.01–4.31; >30 Gy), cranial radiotherapy (OR, 2.89; 95% CI, 1.67–4.96; 1–25 Gy; and OR, 2.44; 95% CI, 1.30–4.47; >25 Gy), total body irradiation (OR, 6.17; 95% CI, 3.20–11.76), and underlying central nervous system tumor (OR, 1.78; 95% CI, 1.21–2.60) were associated with MetS.
Conclusion
The high risk of MetS in CCS, combined with several potential modifiable factors, underscores the need for timely identification and intervention strategies to mitigate the long-term cardiovascular risks in CCS.
期刊介绍：
The CANCER site is a full-text, electronic implementation of CANCER, an Interdisciplinary International Journal of the American Cancer Society, and CANCER CYTOPATHOLOGY, a Journal of the American Cancer Society.
CANCER publishes interdisciplinary oncologic information according to, but not limited to, the following disease sites and disciplines: blood/bone marrow; breast disease; endocrine disorders; epidemiology; gastrointestinal tract; genitourinary disease; gynecologic oncology; head and neck disease; hepatobiliary tract; integrated medicine; lung disease; medical oncology; neuro-oncology; pathology radiation oncology; translational research
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