Prevalence and determinants of dyslipidemia in 2338 Dutch childhood cancer survivors: a DCCS-LATER 2 study.

Autor:	Bolier M; Department of Internal Medicine, Section Endocrinology, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands.; Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands., Pluimakers VG; Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands., de Winter DTC; Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands., Fiocco M; Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands.; Department of Biomedical Data Science, Section Medical Statistics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands.; Mathematical Institute Leiden University, 2333 CC Leiden, The Netherlands., van den Berg SAA; Department of Internal Medicine, Section Endocrinology, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands.; Department of Clinical Chemistry, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands., Bresters D; Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands., van Dulmen-den Broeder E; Pediatric Oncology, Cancer Center Amsterdam, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, 1105 AZ Amsterdam, The Netherlands., van der Heiden-van der Loo M; Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands., Höfer I; Central Diagnostic Laboratory, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands., Janssens GO; Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands.; Department of Radiation Oncology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands., Kremer LCM; Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands.; Department of Pediatric Oncology, Emma Children's Hospital/Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands., Loonen JJ; Department of Hematology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands., Louwerens M; Department of Internal Medicine, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands., van der Pal HJ; Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands., Pluijm SMF; Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands., Tissing WJE; Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands.; Department of Pediatric Oncology/Hematology, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands., van Santen HM; Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands.; Department of Pediatric Endocrinology, Wilhelmina Children's Hospital, University Medical Center, 3584 CX Utrecht, Netherlands., de Vries ACH; Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands.; Department of Pediatric Oncology, Sophia Children's Hospital, Erasmus Medical Center, 3015 GD Rotterdam, Netherlands., van der Lely AJ; Department of Internal Medicine, Section Endocrinology, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands., van den Heuvel-Eibrink MM; Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands.; Department of Pediatric Oncology, Wilhelmina Children's Hospital, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands., Neggers SJCMM; Department of Internal Medicine, Section Endocrinology, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands.; Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands.
Jazyk:	angličtina
Zdroj:	European journal of endocrinology [Eur J Endocrinol] 2024 Nov 27; Vol. 191 (6), pp. 588-603.
DOI:	10.1093/ejendo/lvae149
Abstrakt:	Objective: Childhood cancer survivors (CCS) face an increased risk of early cardiovascular disease (CVD). In our nationwide CCS cohort, we assessed the prevalence and determinants of dyslipidemia, a well-established risk factor for accelerated atherosclerosis and CVD. Methods: Prevalence of dyslipidemia was cross-sectionally assessed in 2338 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 34.7 year, median follow-up 27.1 year) 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 = 2007), lipid abnormalities were present in 20.6% (triglycerides > 1.7 mmol/L), 30.3% (HDL-c < 1.0/1.3 mmol/L (male/female)), 29.9% (total cholesterol > 5.2 mmol/L), 7.3% (LDL-c > 4.1 mmol/L), and 7.7% (apolipoprotein-B > 130 mg/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 is 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. Competing Interests: Conflict of interest: None declared (© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Endocrinology.)
Databáze:	MEDLINE
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