Prevalence of cardiovascular risk factors in long-term survivors of childhood cancer: 16 years follow up from a prospective registry

• Published in: European journal of preventive cardiology 2015-06, Vol.22 (6), p.762-770
• Main Authors: Felicetti, Francesco, D’Ascenzo, Fabrizio, Moretti, Claudio, Corrias, Andrea, Omedè, Pierluigi, Marra, Walter Grosso, Arvat, Emanuela, Fagioli, Franca, Brignardello, Enrico, Gaita, Fiorenzo
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Biomarkers - blood; Body Mass Index; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - epidemiology; Chi-Square Distribution; Cholesterol, LDL - blood; Female; Hematopoietic Stem Cell Transplantation - adverse effects; Humans; Hypercholesterolemia - blood; Hypercholesterolemia - diagnosis; Hypercholesterolemia - epidemiology; Hypertriglyceridemia - blood; Hypertriglyceridemia - diagnosis; Hypertriglyceridemia - epidemiology; Incidence; Italy - epidemiology; Male; Multivariate Analysis; Neoplasms - diagnosis; Neoplasms - epidemiology; Neoplasms - therapy; Obesity - diagnosis; Obesity - epidemiology; Prevalence; Proportional Hazards Models; Prospective Studies; Registries; Risk Factors; Survivors; Time Factors; Triglycerides - blood; Whole-Body Irradiation - adverse effects; Young Adult
• ISSN: 2047-4873; 2047-4881
• DOI: 10.1177/2047487314529348

Background Childhood cancer survivors (CCSs) have an increased risk of overweight and dyslipidaemia, but the distribution and the potential relationships between anticancer therapies and cardiovascular risk factors have been heterogeneously and not prospectively described. Methods All consecutive CCSs with primary cancer diagnosed between 1973–2007 and subsequently referred to our outpatient clinic were enrolled. Hypercholesterolaemia (total cholesterol >200 and/or low density lipoprotein (LDL)>160 mg/dl) was the primary end point, hypertriglyceridaemia (triglycerides >200 mg/dl) and body mass index >30 kg/m2 the secondary end points. Cox multivariate adjustments were performed to account for differences in cancer and treatments. Results A total of 340 patients were included (197 male, 143 female; mean age at last follow-up 24.1 ± 3.2). The most common diagnosis were haematological malignancies (n = 227) and brain tumours (n = 51). After a median follow-up of 16.1 years, hypercholesterolaemia was diagnosed in 67 CCSs (20%), hypertriglyceridaemia in 20 CCSs (6%) and obesity in 28 CCSs (8%). Total body irradiation and growth hormone deficiency increased the risk of both hypercholesterolaemia (hazard ratio (HR) = 2.7; confidence interval (CI) 1.2–4.4 and HR = 2.3; CI 1.1–4.9; all p