Background
Adiposity and diseases associated with it, including cardiovascular disease, are emerging long-term complications of pediatric cancer survivors. Direct evaluations of adiposity and comparisons to contemporary controls that can differentiate recent trends in obesity from cancer-related treatments and sequelae are limited.
Methods
We evaluated demographic, treatment, lifestyle, and endocrine factors at the time of dual energy x-ray absorptiometry testing in 170 non-Hispanic white survivors and 71 sibling controls and compared three measures of adiposity (body mass index [BMI], total body fat, trunk fat). For the survivors alone, we determined factors independently associated with BMI and body fat.
Results
Survivors were 12 years since diagnosis; 58% had leukemia or lymphoma. BMI did not differ between groups. Among males, body fat was greater in survivors than in controls, (25.8% vs. 20.7%; P=0.007), as was trunk fat (26.7% vs 21.3%; P=0.008). Total or trunk fat did not differ among females. Cholesterol, triglycerides, LDL-cholesterol, and television-viewing hours were higher among male survivors than in controls. Independent factors associated with higher BMI, total and trunk fat included any cranial radiation and television-viewing hours, while prior treatment with cyclophosphamide was associated with lower BMI and body fat measures.
Conclusions
Compared to siblings, male survivors have greater body fat and metabolic risks. Cranial irradiation and television hours are important risk factors for adiposity in pediatric cancer survivors.
Impact
Pediatric cancer survivors should be carefully monitored for cardiovascular risk factors and sedentary lifestyles.