Division of Pediatric Hematology-Oncology, Indiana University School of Medicine, Indianapolis, Indiana.
University of Alberta School of Public Health, Edmonton, Alberta, Canada.
J Clin Endocrinol Metab. 2019 Nov 1;104(11):5183-5194. doi: 10.1210/jc.2019-00627.
Childhood cancer survivors experience chronic health conditions that impact health-related quality of life (HRQOL) and participation in optimal physical activity.
The study aimed to determine independent effects of endocrine and metabolic disorders on HRQOL and physical activity.
DESIGN, SETTING, AND PATIENTS: Retrospective cohort with longitudinal follow-up of survivors of childhood cancer enrolled in the North American Childhood Cancer Survivor Study.
Medical Outcomes Short Form-36 estimated HRQOL, and participation in physical activity was dichotomized as meeting or not meeting recommendations from the Centers for Disease Control and Prevention. Log binomial regression evaluated the association of each endocrine/metabolic disorder with HRQOL scales and physical activity.
Of 7287 survivors, with a median age of 32 years (range, 18 to 54 years) at their last follow-up survey, 4884 (67%) reported one or more endocrine/metabolic disorders. Survivors with either disorder were significantly more likely to be male, older, have received radiation treatment, and have experienced other chronic health conditions. After controlling for covariates, survivors with any endocrine/metabolic disorder were more likely to report poor physical function risk ratio (RR, 1.25; 95% CI, 1.05 to 1.48), increased bodily pain (RR, 1.27; 95% CI, 1.12 to 1.44), poor general health (RR, 1.49; 95% CI, 1.32 to 1.68), and lower vitality (RR, 1.21; 95% CI, 1.09 to 1.34) compared with survivors without. The likelihood of meeting recommended physical activity was lower among survivors with growth disorders (RR, 0.90; 95% CI, 0.83 to 0.97), osteoporosis (RR, 0.87; 95% CI, 0.76 to 0.99), and overweight/obesity (RR, 0.92; 95% CI, 0.88 to 0.96).
Endocrine and metabolic disorders are independently associated with poor HRQOL and suboptimal physical activity among childhood cancer survivors.
儿童癌症幸存者会出现影响健康相关生活质量（HRQOL）和参与最佳身体活动的慢性健康状况。
本研究旨在确定内分泌和代谢紊乱对 HRQOL 和身体活动的独立影响。
设计、地点和患者：对参加北美儿童癌症幸存者研究的儿童癌症幸存者进行回顾性队列研究和纵向随访。
采用医疗结果简表-36 评估 HRQOL，身体活动采用二分法，即是否符合疾病控制与预防中心的建议。采用对数二项式回归评估每种内分泌/代谢障碍与 HRQOL 量表和身体活动的关系。
在最后一次随访调查时，中位年龄为 32 岁（范围为 18 岁至 54 岁）的 7287 名幸存者中，4884 名（67%）报告有 1 种或多种内分泌/代谢障碍。有任何一种疾病的幸存者更有可能是男性、年龄较大、接受过放射治疗，并且患有其他慢性健康状况。在控制了混杂因素后，患有任何内分泌/代谢障碍的幸存者报告身体功能风险比（RR，1.25；95%CI，1.05 至 1.48）、增加的身体疼痛（RR，1.27；95%CI，1.12 至 1.44）、较差的一般健康（RR，1.49；95%CI，1.32 至 1.68）和较低的活力（RR，1.21；95%CI，1.09 至 1.34）的可能性更高。与没有疾病的幸存者相比，生长障碍（RR，0.90；95%CI，0.83 至 0.97）、骨质疏松症（RR，0.87；95%CI，0.76 至 0.99）和超重/肥胖症（RR，0.92；95%CI，0.88 至 0.96）幸存者达到推荐身体活动的可能性较低。
内分泌和代谢紊乱与儿童癌症幸存者 HRQOL 差和身体活动不充分独立相关。
