title: Low bone mineral density and high incidences of fractures and vitamin D deficiency in 52 pediatric cancer survivors.
abstract: OBJECTIVE
  To evaluate bone mineral density (BMD), fractures, and vitamin D deficiency in pediatric patients in complete remission of solid tumor; and to identify risk factors for these three abnormalities.
  
  
  METHODS
  Data were collected prospectively after completion of cancer treatment. Hormonal and vitamin D deficiencies were treated. The patients were evaluated again 1 year later.
  
  
  METHODS
  52 consecutive patients, 30 boys and 22 girls. Among them, 21 completed the second evaluation.
  
  
  METHODS
  A clinical examination, nutritional assessment, and laboratory workup were performed. BMD was measured by absorptiometry.
  
  
  RESULTS
  Calcium intake was inadequate in 75% of patients and vitamin D reserves were low in 61.5%. BMD was low at the spine in 32.7%, and at the femur in 24% of patients. Spinal and femoral BMD Z-scores correlated significantly with each other. Femoral BMD Z-score showed significant positive correlations with changes in body mass index, urinary calcium/creatinine ratio, and time since treatment completion, and a significant negative correlation with treatment duration. Fractures were noted in 10 patients but were not correlated with BMD. In the 21 re-evaluated patients, no significant improvements were found in calcium intake, vitamin D status, or BMD Z-score.
  
  
  CONCLUSIONS
  Survivors of childhood solid cancer have high rates of insufficient calcium intake, vitamin D deficiency, low bone mass and fractures.
authors.affiliation: Endocrinologie Pédiatrique, Hôpital Necker Enfants Malades, AP-HP, Université Paris Descartes, Paris, France.
authors.forename: Kalliopi
authors.initials: K
authors.lastname: Bilariki
authors.forename: Elli
authors.initials: E
authors.lastname: Anagnostou
authors.forename: Virginie
authors.initials: V
authors.lastname: Masse
authors.forename: Caroline
authors.initials: C
authors.lastname: Elie
authors.forename: Jacques
authors.initials: J
authors.lastname: Grill
authors.forename: Dominique
authors.initials: D
authors.lastname: Valteau-Couanet
authors.forename: Chantal
authors.initials: C
authors.lastname: Kalifa
authors.forename: François
authors.initials: F
authors.lastname: Doz
authors.forename: Christian
authors.initials: C
authors.lastname: Sainte-Rose
authors.forename: Michel
authors.initials: M
authors.lastname: Zerah
authors.forename: Eric
authors.initials: E
authors.lastname: Mascard
authors.forename: Françoise
authors.initials: F
authors.lastname: Mosser
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Ruiz
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Souberbielle
authors.forename: Dominique
authors.initials: D
authors.lastname: Eladari
authors.forename: Laurence
authors.initials: L
authors.lastname: Brugières
authors.forename: Michel
authors.initials: M
authors.lastname: Polak
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D015519:Bone Density / Q000502:physiology*; D001846:Bone Development / Q000502:physiology; D002118:Calcium / Q000172:deficiency; D002136:Calcium, Dietary / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D004032:Diet; D019587:Dietary Supplements; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000453:epidemiology*; D006728:Hormones / Q000097:blood; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000150:complications*; D009752:Nutritional Status; D012307:Risk Factors; D012727:Sex Characteristics; D017741:Survivors; D014807:Vitamin D / Q000378:metabolism; D014808:Vitamin D Deficiency / Q000453:epidemiology*
chemical_list: D002136:Calcium, Dietary; D006728:Hormones; D014807:Vitamin D; D002118:Calcium