Modifiable risk factors associated with bone deficits in childhood cancer survivors
1 Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
2 Department of Pediatrics, University of California San Diego and Rady Children's Hospital, San Diego, CA, USA
3 Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
4 School of Public Health, University of Minnesota, Minneapolis, MN, USA
5 Children's Hospitals & Clinics of Minnesota, Minneapolis, MN, USA
6 School of Kinesiology, University of Minnesota, Minneapolis, MN, USA
7 Pediatric Endocrinology, University of Minnesota, East Building Room MB671 2450 Riverside Ave., Minneapolis, MN 55454, USA
BMC Pediatrics 2012, 12:40 doi:10.1186/1471-2431-12-40Published: 28 March 2012
To determine the prevalence and severity of bone deficits in a cohort of childhood cancer survivors (CCS) compared to a healthy sibling control group, and the modifiable factors associated with bone deficits in CCS.
Cross-sectional study of bone health in 319 CCS and 208 healthy sibling controls. Bone mineral density (BMD) was measured by dual-energy x-ray absorptiometry (DXA). Generalized estimating equations were used to compare measures between CCS and controls. Among CCS, multivariable logistic regression was used to evaluate odds ratios for BMD Z-score ≤ -1.
All subjects were younger than 18 years of age. Average time since treatment was 10.1 years (range 4.3 - 17.8 years). CCS were 3.3 times more likely to have whole body BMD Z-score ≤ -1 than controls (95% CI: 1.4-7.8; p = 0.007) and 1.7 times more likely to have lumbar spine BMD Z-score ≤ -1 than controls (95% CI: 1.0-2.7; p = 0.03). Among CCS, hypogonadism, lower lean body mass, higher daily television/computer screen time, lower physical activity, and higher inflammatory marker IL-6, increased the odds of having a BMD Z-score ≤ -1.
CCS, less than 18 years of age, have bone deficits compared to a healthy control group. Sedentary lifestyle and inflammation may play a role in bone deficits in CCS. Counseling CCS and their caretakers on decreasing television/computer screen time and increasing activity may improve bone health.