title: Characteristics and determinants of adiposity in pediatric cancer survivors.
abstract: BACKGROUND
  Adiposity and the 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, and trunk fat]. For the survivors alone, we determined factors independently associated with BMI and body fat.
  
  
  RESULTS
  Survivors were at 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% versus 20.7%; P = 0.007), as was trunk fat (26.7% versus 21.3%; P = 0.008). Total or trunk fat did not differ among females. Cholesterol, triglycerides, low-density lipoprotein cholesterol, and television viewing hours were higher among male survivors than in controls. Independent factors associated with higher BMI and total and trunk fat included any cranial radiation and television viewing hours, whereas prior treatment with cyclophosphamide was associated with lower BMI and body fat measures.
  
  
  CONCLUSIONS
  Compared with 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.
  
  
  CONCLUSIONS
  Pediatric cancer survivors should be carefully monitored for cardiovascular risk factors and sedentary lifestyles.
authors.affiliation: Batchelor Children's Research Institute, Division of Pediatric Clinical Research, Department of Pediatrics (D820), Miller School of Medicine, University of Miami, Miami, FL 33101, USA. tracie.miller@miami.edu
authors.forename: Tracie L
authors.initials: TL
authors.lastname: Miller
authors.forename: Stuart R
authors.initials: SR
authors.lastname: Lipsitz
authors.forename: Gabriela
authors.initials: G
authors.lastname: Lopez-Mitnik
authors.forename: Andrea S
authors.initials: AS
authors.lastname: Hinkle
authors.forename: Louis S
authors.initials: LS
authors.lastname: Constine
authors.forename: M Jacob
authors.initials: MJ
authors.lastname: Adams
authors.forename: Carol
authors.initials: C
authors.lastname: French
authors.forename: Cynthia
authors.initials: C
authors.lastname: Proukou
authors.forename: Amy
authors.initials: A
authors.lastname: Rovitelli
authors.forename: Steven E
authors.initials: SE
authors.lastname: Lipshultz
mesh_terms: D000273:Adipose Tissue; D050154:Adiposity; D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology*; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications*; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D035781:Siblings; D017741:Survivors / Q000706:statistics & numerical data*; D044465:White People; D055815:Young Adult