Pediatric Oncology/Hematology, University Children's Hospital Basel, Basel, Switzerland.
Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
Cancer. 2021 May 15;127(10):1690-1698. doi: 10.1002/cncr.33351. Epub 2021 Jan 6.
Childhood cancer survivors are at risk for cardiovascular disease (CVD) because of intensive cancer therapies often accompanied by an unhealthy lifestyle. This study was aimed at 1) describing modifiable CVD risk factors in survivors and 2) investigating the association between different aspects of physical fitness and CVD risk factors.
The authors analyzed cross-sectional data from ≥5-year survivors who were 16 years old or younger at their cancer diagnosis and 16 years old or older at the time of the study. Single CVD risk factors (waist circumference, blood pressure, fasting glucose, inverse high-density lipoprotein, and triglycerides), a composite CVD risk score (combined z scores of all CVD risk factors), and metabolic syndrome were evaluated. Physical fitness measures included cardiopulmonary exercise testing (CPET), a handgrip test, and a 1-minute sit-to-stand test (STS). Multivariable logistic regression was used for the association between fitness measures and CVD risk factors, with adjustments made for demographic factors and cancer therapy.
This study included 163 survivors with a median age at diagnosis of 7 years and a median age at the time of the study of 28 years. Among those survivors, 27% had a high waist circumference, 32% had high blood pressure, 19% had high triglycerides, 20% had an increased composite CVD risk score, and 10% had metabolic syndrome. A better performance during CPET, handgrip testing, and STS was associated with a lower probability of having a high waist circumference, high triglycerides, and metabolic syndrome.
Better aerobic fitness (CPET) and, to a lesser extent, handgrip and STS were associated with fewer CVD risk factors. Further investigations are warranted to investigate which fitness measures should preferably be used to screen survivors to promote physical activity in those with impaired test performance.
This study investigated the relationship between physical fitness of adult childhood cancer survivors and their risk factors for cardiovascular disease. Cardiovascular risk factors such as high blood pressure, a high waist circumference, and high blood lipids were frequently found in childhood cancer survivors. Survivors with better physical fitness (measured by a cycling test or simple strength and endurance tests) had a lower chance of having cardiovascular risk factors. This suggests that childhood cancer survivors could benefit from physical activity and general fitness by increasing their physical fitness and possibly decreasing their risk of cardiovascular disease.
由于强化癌症治疗以及不健康的生活方式，儿童癌症幸存者面临心血管疾病（CVD）的风险。本研究旨在：1）描述幸存者的可改变 CVD 风险因素；2）研究不同身体成分与 CVD 风险因素之间的关联。
作者分析了≥5 年的幸存者的数据，这些幸存者在癌症诊断时年龄为 16 岁或以下，在研究时年龄为 16 岁或以上。评估了单一 CVD 风险因素（腰围、血压、空腹血糖、反向高密度脂蛋白和甘油三酯）、综合 CVD 风险评分（所有 CVD 风险因素的综合 Z 评分）和代谢综合征。身体成分测试包括心肺运动测试（CPET）、握力测试和 1 分钟坐站测试（STS）。使用多变量逻辑回归分析身体成分测试与 CVD 风险因素之间的关联，同时调整人口统计学因素和癌症治疗。
本研究纳入了 163 名幸存者，中位诊断年龄为 7 岁，中位研究年龄为 28 岁。其中，27%的人腰围较大，32%的人血压较高，19%的人甘油三酯较高，20%的人综合 CVD 风险评分增加，10%的人患有代谢综合征。CPET、握力测试和 STS 表现较好与较低的高腰围、高甘油三酯和代谢综合征发生概率相关。
更好的有氧身体成分（CPET），以及在较小程度上的握力和 STS，与更少的 CVD 风险因素相关。进一步的研究需要调查哪种身体成分测试最适合用于筛查幸存者，以促进那些测试表现不佳的患者的身体活动。
本研究调查了成年儿童癌症幸存者的身体成分与心血管疾病风险因素之间的关系。高血压、高腰围和高血脂等心血管疾病风险因素在儿童癌症幸存者中经常出现。身体成分较好（通过自行车测试或简单的力量和耐力测试测量）的幸存者发生心血管疾病风险因素的可能性较低。这表明，通过提高身体成分，儿童癌症幸存者可能会受益于身体活动和整体身体成分，从而降低患心血管疾病的风险。
