Wang K-W, Fleming A, Johnston D L, Zelcer S M, Rassekh S R, Ladhani S, Socha A, Shinuda J, Jaber S, Burrow S, Singh S K, Banfield L, de Souza R J, Thabane L, Samaan M C
Department of Pediatrics, McMaster University, Hamilton, Canada.
Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Canada.
Clin Obes. 2018 Feb;8(1):55-67. doi: 10.1111/cob.12224. Epub 2017 Oct 11.
Survivors of childhood brain tumours (SCBT) have increased cardiometabolic risks, but the determinants of these risks are unclear. This systematic review aims to compare the prevalence of overweight and obesity as well as adiposity measures between SCBT and non-cancer controls. The PubMed, EMBASE, MEDLINE, CINAHL and the Cochrane Library databases were searched. The primary outcomes were the prevalence of overweight and obesity based on body mass index. The secondary outcomes were adiposity measures including percent fat mass, waist-to-hip and waist-to-height ratios. Forty-one studies were included in the meta-analysis. The prevalence of overweight and obesity combined was similar between overall SCBT, SCBT excluding craniopharyngioma and non-cancer controls (42.6%, 95% CI 30.1-55.1 vs. 31.7%, 95% CI 20.4-43.0 vs. 40.4%, 95% CI 34.0-46.8). We also found that SCBT have higher percent fat mass (mean difference 4.1%, 95% CI 2.0-6.1), waist-to-hip ratio (mean difference 0.07, 95% CI 0.02-0.13) and waist-to-height ratio (mean difference 0.06, 95% CI 0.01-0.10) than non-cancer controls. We conclude that SCBT have similar overweight and obesity distribution but higher adiposity than non-cancer controls. More studies were needed to explore the determinants of adiposity and its contribution to cardiometabolic outcomes in SCBT.
儿童脑肿瘤幸存者（SCBT）存在更高的心脏代谢风险，但其风险的决定因素尚不清楚。本系统评价旨在比较SCBT与非癌症对照者之间超重和肥胖的患病率以及肥胖指标。检索了PubMed、EMBASE、MEDLINE、CINAHL和Cochrane图书馆数据库。主要结局是基于体重指数的超重和肥胖患病率。次要结局是肥胖指标，包括体脂百分比、腰臀比和腰高比。41项研究纳入了荟萃分析。总体SCBT、排除颅咽管瘤的SCBT与非癌症对照者之间超重和肥胖合并患病率相似（42.6%，95%CI 30.1-55.1 vs. 31.7%，95%CI 20.4-43.0 vs. 40.4%，95%CI 34.0-46.8）。我们还发现，与非癌症对照者相比，SCBT的体脂百分比更高（平均差异4.1%，95%CI 2.0-6.1）、腰臀比更高（平均差异0.07，95%CI 0.02-0.13）和腰高比更高（平均差异0.06，95%CI 0.01-0.10）。我们得出结论，SCBT的超重和肥胖分布相似，但肥胖程度高于非癌症对照者。需要更多研究来探索SCBT肥胖的决定因素及其对心脏代谢结局的影响。
