Department of Sports Medicine, The Norwegian School of Sport Sciences, Oslo, Norway.
Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway.
J Adolesc Young Adult Oncol. 2024 Apr;13(2):338-346. doi: 10.1089/jayao.2023.0063. Epub 2023 Sep 13.
Childhood cancer survivors have increased risk of cardiac late effects that can be potentially mitigated by physical activity and fitness. We aimed to (1) compare cardiovascular disease (CVD) risk between survivors and controls, and (2) examine whether the associations of moderate-to-vigorous physical activity (MVPA), cardiorespiratory fitness (CRF), and musculoskeletal fitness (MSF) with CVD risk factors differed between survivors and controls. Within the Physical Activity in Childhood Cancer Survivors (PACCS) study, we assessed CVD risk factors (android fat mass, systolic blood pressure [SBP], total cholesterol/high-density lipoprotein [HDL]-cholesterol, and glycosylated hemoglobin) in 157 childhood cancer survivors and 113 age- and sex-matched controls aged 9-18 years. We used multivariable mixed linear regression models to compare CVD risk factors between survivors and controls, and assess associations of MVPA, CRF, and MSF with CVD risk factors. Compared with controls, survivors had more android fat mass (861 vs. 648 g, = 0.001) and lower SBP (114 vs. 118 mmHg, = 0.002). MVPA, CRF, and MSF were associated with lower levels of android fat mass and total cholesterol/HDL-cholesterol, and higher SBP in survivors. Associations of MVPA, CRF, and MSF with CVD risk factors were similar in survivors and controls (P > 0.05), except the associations of CRF and MSF with android fat mass, which were stronger in survivors than in controls (P ≤ 0.001). Owing to higher levels of android fat mass and its stronger association with physical fitness in childhood cancer survivors compared with controls, survivors should get targeted interventions to increase fitness to reduce future risk of CVD.
儿童癌症幸存者患心脏晚期疾病的风险增加，而身体活动和健康水平可以降低这种风险。我们旨在：（1）比较幸存者和对照组之间的心血管疾病（CVD）风险；（2）检查中等到剧烈身体活动（MVPA）、心肺健康（CRF）和肌肉骨骼健康（MSF）与 CVD 危险因素之间的关联在幸存者和对照组之间是否不同。在儿童癌症幸存者体力活动研究（PACCS）中，我们评估了 157 名儿童癌症幸存者和 113 名年龄和性别匹配的对照组（9-18 岁）的 CVD 危险因素（腹部脂肪量、收缩压 [SBP]、总胆固醇/高密度脂蛋白 [HDL]-胆固醇和糖化血红蛋白）。我们使用多变量混合线性回归模型比较幸存者和对照组之间的 CVD 危险因素，并评估 MVPA、CRF 和 MSF 与 CVD 危险因素的关联。与对照组相比，幸存者的腹部脂肪量更多（861 比 648 克， = 0.001），SBP 更低（114 比 118 毫米汞柱， = 0.002）。MVPA、CRF 和 MSF 与幸存者腹部脂肪量和总胆固醇/HDL-胆固醇降低以及 SBP 升高有关。在幸存者和对照组中，MVPA、CRF 和 MSF 与 CVD 危险因素的关联相似（P > 0.05），但 CRF 和 MSF 与腹部脂肪量的关联除外，在幸存者中比在对照组中更强（P ≤ 0.001）。由于儿童癌症幸存者的腹部脂肪量水平较高，且与身体活动的关联强于对照组，因此，应针对幸存者开展有针对性的干预措施，以提高健康水平，降低未来 CVD 的风险。
