title: Risk factors for osteoporosis in long-term survivors of intracranial germ cell tumors.
abstract: CONCLUSIONS
  We measured bone mineral densities in 28 intracranial germ cell tumor long-term survivors. There was the high prevalence of osteoporosis and osteopenia, 25.0% and 42.9%, respectively, and three additional risk factors, male sex, a low lean mass, and adult growth hormone replacement, were identified.
  
  
  BACKGROUND
  Intracranial germ cell tumor long-term survivors (iGCTLS) have many risk factors for osteoporosis, including irradiation from cancer therapy and multiple hormone deficiencies. However, no study of bone mineral density (BMD) has been conducted in iGCTLS because these tumors are rare. The aims of this study were to evaluate the prevalence of osteoporosis and to identify risk factors associated with reduced bone mass in iGCTLS.
  
  
  METHODS
  We evaluated BMD and body composition of 28 iGCTLS (10.9 ± 5.2 years after cancer treatment; 13 males) using dual-energy X-ray absorptiometry. To determine risk factors, we analyzed the medical history, including the nature of the tumor, treatment modality, endocrine status, hormone replacement therapy, lifestyle, and biochemical parameters.
  
  
  RESULTS
  Twenty-five percent of iGCTLS were diagnosed with osteoporosis and 42.9% with osteopenia. Most males (92.3%) had low BMD. Lean mass (LM) was positively correlated with BMD in all regions of interest, and the starting age of adult growth hormone (GH) replacement was negatively correlated with the BMD Z-score at the femur neck. In logistic regression analysis, male sex and low LM were related to low BMD.
  
  
  CONCLUSIONS
  The iGCTLS had a high prevalence of low BMD. We found that male sex, low LM, and delayed start of adult GH replacement were risk factors for osteoporosis. Therefore, the BMD of all iGCTLS should be evaluated, and if it is low, proper management should be started early.
authors: Department of Pediatrics, Seoul National University College of Medicine, Seoul, 110-744, South Korea.
authors: M J
authors: MJ
authors: Kang
authors: S M
authors: SM
authors: Kim
authors: Y A
authors: YA
authors: Lee
authors: C H
authors: CH
authors: Shin
authors: S W
authors: SW
authors: Yang
authors: J S
authors: JS
authors: Lim
mesh_terms: D000293:Adolescent; D000328:Adult; D001823:Body Composition / Q000502:physiology; D015992:Body Mass Index; D015519:Bone Density / Q000502:physiology; D001851:Bone Diseases, Metabolic / Q000209:etiology / Q000503:physiopathology; D001932:Brain Neoplasms / Q000628:therapy*; D002648:Child; D004334:Drug Administration Schedule; D005260:Female; D005272:Femur Neck / Q000503:physiopathology; D019382:Human Growth Hormone / Q000008:administration & dosage; D006801:Humans; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000628:therapy*; D010024:Osteoporosis / Q000209:etiology* / Q000503:physiopathology; D058866:Osteoporotic Fractures / Q000209:etiology / Q000503:physiopathology; D012307:Risk Factors; D012737:Sex Factors; D017741:Survivors; D013851:Thinness / Q000150:complications; D055815:Young Adult
chemical_list: D019382:Human Growth Hormone