title: Physical Activity, Fitness, and Cardiometabolic Risk Factors in Adult Survivors of Childhood Cancer with a History of Hematopoietic Cell Transplantation.
abstract: Along with other childhood cancer survivors (CCS), hematopoietic cell transplantation (HCT) survivors are at high risk of treatment-related late effects, including cardiovascular disease and diabetes. Cardiometabolic risk factor abnormalities may be exacerbated by inadequate physical activity (PA). Relationships between PA and cardiometabolic risk factors have not been well described in CCS with HCT. PA (self reported), mobility (timed up and go test), endurance (6-minute walk test), handgrip strength, and cardiometabolic risk factors were measured in 119 HCT survivors and 66 sibling controls ages ≥18 years. Adjusted comparisons between HCT survivors and controls and between categories of low and high PA, mobility, endurance, and strength were performed with linear regression. Among HCT survivors, the high PA group had lower waist circumference (WC) (81.9 ± 2.5 versus 88.6 ± 3.1 cm ± standard error (SE), P = .009) than the low PA group, whereas the high endurance group had lower WC (77.8 ± 2.6 versus 87.8 ± 2.5 cm ± SE, P = .0001) and percent fat mass (33.6 ± 1.8 versus 39.4 ± 1.7% ± SE, P = .0008) and greater insulin sensitivity (IS) (10.9 ± 1.0 versus 7.42 ± 1.14 mg/kg/min ± SE via euglycemic insulin clamp, P = .001) than the low endurance group. Differences were greater in HCT survivors than in controls for WC between low and high PA groups, triglycerides between low and high mobility groups, and WC, systolic blood pressure, and IS between low and high endurance groups (all Pinteraction <.05). Higher endurance was associated with a more favorable cardiometabolic profile in HCT survivors, suggesting that interventions directed to increase endurance in survivors may reduce the risk of future cardiovascular disease.
authors: Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota. Electronic address: mslater@csrincorporated.com.
authors: Megan E
authors: ME
authors: Slater
authors: Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota.
authors: Julia
authors: J
authors: Steinberger
authors: Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota.
authors: Julie A
authors: JA
authors: Ross
authors: Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota.
authors: Aaron S
authors: AS
authors: Kelly
authors: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Center for Clinical and Translational Research, Seattle Children's Hospital, Seattle, Washington.
authors: Eric J
authors: EJ
authors: Chow
authors: Center for Clinical and Translational Research, Seattle Children's Hospital, Seattle, Washington.
authors: Ildiko H
authors: IH
authors: Koves
authors: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors: Paul
authors: P
authors: Hoffmeister
authors: Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota.
authors: Alan R
authors: AR
authors: Sinaiko
authors: Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota.
authors: Anna
authors: A
authors: Petryk
authors: Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota.
authors: Antoinette
authors: A
authors: Moran
authors: Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota.
authors: Jill
authors: J
authors: Lee
authors: Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota.
authors: Lisa S
authors: LS
authors: Chow
authors: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Center for Clinical and Translational Research, Seattle Children's Hospital, Seattle, Washington.
authors: K Scott
authors: KS
authors: Baker
mesh_terms: D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D018737:Hand Strength / Q000502:physiology; D019337:Hematologic Neoplasms / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D009043:Motor Activity; D010807:Physical Endurance; D011446:Prospective Studies; D012307:Risk Factors; D035781:Siblings; D017741:Survivors; D014184:Transplantation, Homologous; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides
keywords: Cardiometabolic risk; Childhood cancer survivors; Endurance; Hematopoietic cell transplantation; Physical activity