Endocrine Abstracts

Introduction: Obesity, represented by high body mass index (BMI), is a major complication after treatment for childhood cancer. High amount of total and visceral fat and low lean body mass are described as more reliable determinants, predicting the development of cardiovascular disease. In this study longitudinal changes of BMI and body composition in adult childhood cancer survivors were evaluated.

Methods: Data of 417 adult childhood cancer survivors, who had visited the late effects clinic twice, were analyzed retrospectively. Median follow up time was 16 years (interquartile range 11–21) and time between visits was 3.2 years (2.9–3.6). At both time points BMI was measured and body composition was assessed by dual X-ray absorptiometry (Lunar Prodigy). BMI and body composition measures were compared with those of healthy Dutch references and calculated as standard deviation scores (SDS). Pituitary dysfunction and hormonal replacement were evaluated in all survivors. GH deficient subjects treated with GH replacement at time of follow up were excluded from further analyses.

Results: BMI SDS at first assessment was only significantly higher in female cranial radiotherapy (CRT) survivors as compared to healthy Dutch references (SDS=0.40, P=0.02). Increase of BMI over time (expressed as units per year) was only significantly higher in male survivors (0.27 vs 0.02 in controls (P<0.001)). Percentage fat was significantly higher than controls in both men (SDS 1.37, P<0.001) and women (SDS 1.05, P<0.001) in all therapy groups, with the highest SDS after CRT (mean SDS 1.73 in men, 1.48 in women, P<0.001). Only in men, increase in total fat percentage was significantly higher as compared to controls (delta SDS=0.22, P<0.001). Lean body mass did not significantly change over time.

Conclusion: Significantly greater increase of BMI and total fat percentage as compared to healthy references was found, especially in adult male survivors of childhood cancer.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.