title: Health conditions associated with metabolic syndrome after cancer at a young age: A nationwide register-based study.
abstract: OBJECTIVE
  Childhood cancer survivors are at risk for developing metabolic syndrome (MetS), which subsequently leads to cardiovascular morbidity and excess mortality. Our aim was to investigate the purchases of medications associated with MetS among 7551 early onset cancer patients compared to siblings.
  
  
  METHODS
  Our nationwide Finnish population-based registry study analyzed the drug purchase of medication among early onset cancer patients diagnosed with cancer below the age of 35 years between 1994 and 2004 compared to siblings by linkage to the drug purchase registry, allowing for a maximal follow-up of 18 years.
  
  
  RESULTS
  The hazard ratios (HRs) for purchasing antihypertensives and diabetes drugs were higher after both childhood (HR 4.6, 95%CI 3.1-7.0; HR 3.0, 95%1.5-6.1) and young adulthood (YA) cancer (HR 1.5, 95%CI 1.3-1.8; HR 1.6, 95%CI 1.1-2.2) compared to siblings. The HRs for purchasing lipid-lowering drugs were elevated both after childhood (HR 4.3,95%CI 0.9-19.5) and YA cancer (HR 1.6, 95%CI 1.04-2.5), but only reached significance in YA cancer patients. Among specific cancer diagnosis groups, highest HR values for antihypertensives were found in childhood acute lymphoblastic leukemia (ALL) (HR 6.1, 95%CI 3.7-10.3) and bone tumor (HR 4.3, 95%CI 1.9-9.4), and YA ALL (HR 4.8, 95%CI 3.1-7.0) and acute myeloid leukemia (AML) (HR 3.4, 95%CI 2.5-5.1) patients. Moreover, childhood ALL (HR 6.3, 95%CI 2.7-14.8), AML (HR 7.6, 95%CI 1.9-24.5) and central nervous system (CNS)-tumor (HR 3.5, 95%CI 1.3-9.2) and YA ALL (HR 3.7, 95%CI 1.2-9.5) patients showed the strongest likelihood of purchasing diabetes drugs compared to siblings.
  
  
  CONCLUSIONS
  The purchase of medications associated with MetS was increased after early onset cancer and highly dependent on the age at cancer diagnosis and the cancer diagnosis. Prevention strategies are imperative for reducing potentially life-threatening cardiovascular complications after early onset cancer.
authors.affiliation: Department of Pediatric and Adolescent Medicine, Turku University Hospital, Turku, Finland. Electronic address: aneuke@utu.fi.
authors.forename: A E
authors.initials: AE
authors.lastname: Kero
authors.affiliation: Department of Pediatrics, University of Helsinki and Helsinki University Hospital, Finland; Finnish Cancer Registry, Helsinki, Finland.
authors.forename: L M
authors.initials: LM
authors.lastname: Madanat-Harjuoja
authors.affiliation: Department of Pediatric and Adolescent Medicine, Turku University Hospital, Turku, Finland.
authors.forename: L S
authors.initials: LS
authors.lastname: Järvelä
authors.affiliation: Finnish Cancer Registry, Helsinki, Finland; School of Health Sciences, University of Tampere, Tampere, Finland.
authors.forename: N
authors.initials: N
authors.lastname: Malila
authors.affiliation: Turku Clinical Research Center, Turku University Hospital, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Matomäki
authors.affiliation: Department of Pediatric and Adolescent Medicine, Turku University Hospital, Turku, Finland.
authors.forename: P M
authors.initials: PM
authors.lastname: Lähteenmäki
mesh_terms: D000293:Adolescent; D000328:Adult; D000959:Antihypertensive Agents / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012042:Registries; D035781:Siblings; D017741:Survivors; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents
keywords: Cardiovascular morbidity; Childhood cancer; Drug purchase registry; Early onset cancer survivors; Late cardiovascular effects; Metabolic syndrome; Population-based study; Young adult cancer