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儿童癌症治疗后的心脏代谢健康:青少年受影响大于儿童。

Cardiometabolic Health After Pediatric Cancer Treatment: Adolescents Are More Affected than Children.

机构信息

Research Centre, CHU Sainte-Justine University Health Centre, Montreal, Quebec, Canada.

Department of Nutrition, Université de Montréal, Montreal, Quebec, Canada.

出版信息

Nutr Cancer. 2022;74(9):3236-3252. doi: 10.1080/01635581.2022.2072908. Epub 2022 May 9.

DOI:10.1080/01635581.2022.2072908
PMID:35533005
Abstract

This cross-sectional study aimed at comparing the cardiometabolic (CM) health of children and adolescents and identifying factors associated with CM complications shortly after cancer treatment. Cancer-related characteristics, blood pressure (BP), anthropometry, and biochemical parameters were collected in 80 patients (56.3% female, mean age: 11.8 years; range: 4.5 - 21.0) a mean of 1.4 years following therapy completion. Compared to children, adolescents had higher mean -score of insulin (-0.47 vs. 0.20;  = 0.01), HOMA-IR (-0.40 vs. 0.25;  = 0.02), waist-to-height ratio (0.36 vs. 0.84;  = 0.01), subscapular skinfold thickness (-0.19 vs. 0.47;  = 0.02), total body fat (-1.43 vs. 0.26;  < 0.01), and lower mean -score of HDL-C (0.07 vs. -0.53;  < 0.01). Adolescents were more likely to have high BP (42% vs. 15%;  < 0.01), dyslipidemia (64% vs. 15%;  < 0.001), and cumulating ≥ 2 CM complications (42% vs. 2%;  < 0.001) than children. Adiposity indices (-scores) were associated with high BP [odds ratio (OR) ranging from 2.11 to 4.09] and dyslipidemia (OR ranging from 2.06 to 4.34). These results suggest that adolescents have a worse CM profile than children shortly after therapy and that adiposity parameters are associated with CM complications, highliting the importance to develop intervention strategies targeting this population.

摘要

这项横断面研究旨在比较儿童和青少年的心脏代谢(CM)健康,并确定癌症治疗后不久与 CM 并发症相关的因素。在治疗完成后平均 1.4 年,收集了 80 名患者(56.3%为女性,平均年龄:11.8 岁;范围:4.5-21.0)的癌症相关特征、血压(BP)、人体测量和生化参数。与儿童相比,青少年的胰岛素平均评分更高(-0.47 与 0.20;=0.01)、HOMA-IR 更高(-0.40 与 0.25;=0.02)、腰高比更高(0.36 与 0.84;=0.01)、肩胛下皮褶厚度更低(-0.19 与 0.47;=0.02)、全身脂肪更少(-1.43 与 0.26;<0.01)、HDL-C 评分更低(0.07 与-0.53;<0.01)。与儿童相比,青少年更有可能出现高血压(42%与 15%;<0.01)、血脂异常(64%与 15%;<0.001)和累积≥2 个 CM 并发症(42%与 2%;<0.001)。肥胖指数(-评分)与高血压(比值比范围为 2.11 至 4.09)和血脂异常(比值比范围为 2.06 至 4.34)相关。这些结果表明,青少年在治疗后不久的 CM 状况比儿童更差,并且肥胖参数与 CM 并发症相关,强调了针对该人群制定干预策略的重要性。

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