title: The prevalence of Vitamin D deficiency is higher in adult survivors of childhood cancer.
abstract: BACKGROUND
  It is unclear whether the rate of vitamin D deficiency in paediatric cancer survivors is higher than in the background population, and whether this is of pathological significance.
  
  
  METHODS
  25OHD was measured in a previously studied group of 208 survivors (n = 108 paediatric 5-17 years, n = 99 adults 18-39 years) and compared with paediatric (5-17 years; n = 132) and adult controls (25-35 years; n = 1393 from the AusDiab cohort) adjusted for age and gender. Relationships with treatment factors (irradiation, bone marrow transplantation and intensity of treatment) along with overweight/obesity (defined by BMI), abdominal adiposity (waist:height ratio >0·5) and hyperinsulinism or abnormal glucose tolerance (HI/aGT) were sought.
  
  
  RESULTS
  25OHD concentrations were similar in paediatric survivors compared with controls (64·3 ± 21·6 nmol/l vs 66·3 ± 22·8 nmol/l), with no effect of age or gender. Adjusted for gender, rates of 25OHD deficiency (<50 nmol/l) were higher in adult survivors compared with AusDiab controls (42·4% vs 20·8%; P < 0·001). Apart from time since diagnosis (P = 0·03), no relationship with treatment factors was detected. In multivariate regression analysis, abdominal adiposity (P = 0·001), but not overweight/obesity by BMI status nor HI/aGT, was associated with significantly lower 25OHD concentrations.
  
  
  CONCLUSIONS
  Adult survivors are at increased risk of abnormalities in vitamin D compared to the background population, probably reflecting longer time since diagnosis. Like others, we have not identified any contributory treatment-related factors. Vitamin D deficiency does not appear to be associated with the development of abnormal glucose tolerance in this population.
authors.affiliation: Department of Endocrinology, Sydney Children's Hospital, Sydney, NSW, Australia; School of Women's & Children's Health, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Kristen A
authors.initials: KA
authors.lastname: Neville
authors.forename: Jan L
authors.initials: JL
authors.lastname: Walker
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Cohn
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Cowell
authors.forename: Christopher P
authors.initials: CP
authors.lastname: White
mesh_terms: D050154:Adiposity; D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006946:Hyperinsulinism / Q000097:blood; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000453:epidemiology; D009765:Obesity / Q000150:complications; D050177:Overweight / Q000473:pathology; D015995:Prevalence; D017741:Survivors; D014808:Vitamin D Deficiency / Q000150:complications* / Q000453:epidemiology; D055815:Young Adult