title: Cardiovascular risk factors in adult survivors of pediatric cancer--a report from the childhood cancer survivor study.
abstract: BACKGROUND
  Childhood cancer survivors are at higher risk of morbidity and mortality from cardiovascular disease compared with the general population.
  
  
  METHODS
  Eight thousand five hundred ninety-nine survivors (52% male) and 2,936 siblings (46% male) from the Childhood Cancer Survivor Study, a retrospectively ascertained, prospectively followed study of persons who survived 5 years after childhood cancer diagnosed from 1970 to 1986, were evaluated for body mass index of > or =30 kg/m(2) based on self-reported heights and weights and self-reported use of medications for hypertension, dyslipidemia, and impaired glucose metabolism. The presence of three or more of the above constituted Cardiovascular Risk Factor Cluster (CVRFC), a surrogate for Metabolic Syndrome.
  
  
  RESULTS
  Survivors were more likely than siblings to take medications for hypertension [odds ratio (OR), 1.9; 95% confidence interval (95% CI), 1.6-2.2], dyslipidemia (OR, 1.6; 95% CI, 1.3-2.0) or diabetes (OR, 1.7; 95% CI, 1.2-2.3). Among these young adults (mean age of 32 years for survivors and 33 years for siblings), survivors were not more likely than siblings to be obese or have CVRFC. In a multivariable logistic regression analysis, factors associated with having CVRFC included older age at interview [> or =40 versus <30 years of age (OR, 8.2; 95% CI, 3.5-19.9)], exposure to total body irradiation (OR, 5.5; 95% CI, 1.5-15.8) or radiation to the chest and abdomen (OR, 2.3; 95% CI, 1.2-2.4), and physical inactivity (OR, 1.7; 95% CI, 1.1-2.6).
  
  
  CONCLUSIONS
  Among adult survivors of pediatric cancer, older attained age, exposure to total body irradiation or abdominal plus chest radiation, and a sedentary life-style are associated with CVRFC.
authors.affiliation: Aflac Cancer Center, Emory University, Hematology/Oncology and Endocrinology, 2015 Uppergate Drive Northeast, Atlanta, GA 30322, USA. Lmeacha@emory.edu
authors.forename: Lillian R
authors.initials: LR
authors.lastname: Meacham
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Chow
authors.forename: Kirsten K
authors.initials: KK
authors.lastname: Ness
authors.forename: Kala Y
authors.initials: KY
authors.lastname: Kamdar
authors.forename: Yan
authors.initials: Y
authors.lastname: Chen
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yasui
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Oeffinger
authors.forename: Charles A
authors.initials: CA
authors.lastname: Sklar
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Robison
authors.forename: Ann C
authors.initials: AC
authors.lastname: Mertens
mesh_terms: D000328:Adult; D018943:Anthracyclines / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000009:adverse effects; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology*; D002648:Child; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000628:therapy; D016017:Odds Ratio; D011878:Radiotherapy / Q000009:adverse effects; D012307:Risk Factors; D017741:Survivors
chemical_list: D018943:Anthracyclines; D000970:Antineoplastic Agents