Cardiometabolic Health After Pediatric Cancer Treatment: Adolescents Are More Affected than Children

Abstract

This cross-sectional study aimed at comparing the cardiometabolic (CM) health of children and adolescents and identifying factors associated with CM complications shortly after cancer treatment. Cancer-related characteristics, blood pressure (BP), anthropometry, and biochemical parameters were collected in 80 patients (56.3% female, mean age: 11.8 years; range: 4.5 − 21.0) a mean of 1.4 years following therapy completion. Compared to children, adolescents had higher mean z-score of insulin (–0.47 vs. 0.20; P = 0.01), HOMA-IR (–0.40 vs. 0.25; P = 0.02), waist-to-height ratio (0.36 vs. 0.84; P = 0.01), subscapular skinfold thickness (–0.19 vs. 0.47; P = 0.02), total body fat (–1.43 vs. 0.26; P < 0.01), and lower mean z-score of HDL-C (0.07 vs. –0.53; P < 0.01). Adolescents were more likely to have high BP (42% vs. 15%; P < 0.01), dyslipidemia (64% vs. 15%; P < 0.001), and cumulating ≥ 2 CM complications (42% vs. 2%; P < 0.001) than children. Adiposity indices (z-scores) were associated with high BP [odds ratio (OR) ranging from 2.11 to 4.09] and dyslipidemia (OR ranging from 2.06 to 4.34). These results suggest that adolescents have a worse CM profile than children shortly after therapy and that adiposity parameters are associated with CM complications, highliting the importance to develop intervention strategies targeting this population.

Acknowledgment

We thank all the families and the clinical team of the Division of Hematology-Oncology at Sainte-Justine University Health Center.

Disclosure Statement

The authors have no relevant financial or non-financial interests to disclose.

Author Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Veronique Belanger. The first draft of the manuscript was written by Veronique Belanger and Valerie Marcil, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Data Availability Statement

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Ethics Approval

This study was conducted in accordance with the Declaration of Helsinki and the protocol was approved by the Ethics Review Board of CHU Sainte-Justine (CHUSJ) (Montreal, Canada).

Consent to Participate

Written informed consent was obtained from all patients and parents/legal guardians.

Additional information

Funding

This research was funded by the Fondation Charles-Bruneau, the Fonds de Recherche du Québec en Santé, and the CHU Sainte-Justine Foundation.