BACKGROUND: Cranial irradiation for children with brain tumors frequently leads to neuroendocrine deficiencies. In this controlled study, the authors investigated risk factors for cardiovascular disease (CVD) for long term survivors of childhood brain cancer. They also tested whether the presence of these risk factors was related to endocrine status. METHODS: In 26 survivors of childhood brain cancer (mean age, 25.8 years; mean posttreatment interval, 16 years) and 29 healthy controls (mean age, 27.7 years), the blood pressure, smoking habits, body mass index (BMI), and waist/hip (W/H) ratio were determined. Lipids and lipoproteins were measured and endocrine function was assessed. Carotid intima-media thickness (IMT) measurements were performed by high resolution ultrasonography. RESULTS: In the survivors of childhood brain cancer, systolic blood pressure and W/H ratio were elevated compared with controls. The cholesterol/high density lipoprotein ratio (4.7 +/- 1.7 vs. 3.4 +/- 0.8 mmol/L, P = 0.0005), low density lipoprotein cholesterol level (3.3 +/- 0.9 vs. 2.8 +/- 0.6 mmol/L, P = 0.027), and apolipoprotein B level (P = 0.001) were higher in survivors of childhood brain cancer, whereas HDL cholesterol was lower (P = 0.005). The IMT was increased in the survivor group, but only in the carotid bulb (0.63 mm +/- 1.6 vs. 0.53 mm +/- 1.1, P = 0.02), not in the internal or common carotid artery. In the absolute growth hormone deficient (GHD) population (n = 9), LDL cholesterol and apolipoprotein B levels were elevated and the W/H ratio was particularly increased compared with the other survivors of childhood brain cancer. CONCLUSIONS: For long term survivors of brain cancer, the risk for CVD is strongly increased due to dyslipidemia, central obesity, and elevated systolic blood pressure, particularly for those with GHD. The first effects of this increased risk for CVD were observed in the carotic bulb, as assessed by IMT measurements. Efforts should be directed at CVD prevention by risk factor control.
BACKGROUND: Cranial irradiation for children with brain tumors frequently leads to neuroendocrine deficiencies. In this controlled study, the authors investigated risk factors for cardiovascular disease (CVD) for long term survivors of childhood brain cancer. They also tested whether the presence of these risk factors was related to endocrine status. METHODS: In 26 survivors of childhood brain cancer (mean age, 25.8 years; mean posttreatment interval, 16 years) and 29 healthy controls (mean age, 27.7 years), the blood pressure, smoking habits, body mass index (BMI), and waist/hip (W/H) ratio were determined. Lipids and lipoproteins were measured and endocrine function was assessed. Carotid intima-media thickness (IMT) measurements were performed by high resolution ultrasonography. RESULTS: In the survivors of childhood brain cancer, systolic blood pressure and W/H ratio were elevated compared with controls. The cholesterol/high density lipoprotein ratio (4.7 +/- 1.7 vs. 3.4 +/- 0.8 mmol/L, P = 0.0005), low density lipoprotein cholesterol level (3.3 +/- 0.9 vs. 2.8 +/- 0.6 mmol/L, P = 0.027), and apolipoprotein B level (P = 0.001) were higher in survivors of childhood brain cancer, whereas HDL cholesterol was lower (P = 0.005). The IMT was increased in the survivor group, but only in the carotid bulb (0.63 mm +/- 1.6 vs. 0.53 mm +/- 1.1, P = 0.02), not in the internal or common carotid artery. In the absolute growth hormone deficient (GHD) population (n = 9), LDL cholesterol and apolipoprotein B levels were elevated and the W/H ratio was particularly increased compared with the other survivors of childhood brain cancer. CONCLUSIONS: For long term survivors of brain cancer, the risk for CVD is strongly increased due to dyslipidemia, central obesity, and elevated systolic blood pressure, particularly for those with GHD. The first effects of this increased risk for CVD were observed in the carotic bulb, as assessed by IMT measurements. Efforts should be directed at CVD prevention by risk factor control.
Authors: Kim Edelstein; Brenda J Spiegler; Sharon Fung; Tony Panzarella; Donald J Mabbott; Natalie Jewitt; Norma Mammone D'Agostino; Warren P Mason; Eric Bouffet; Uri Tabori; Normand Laperriere; David C Hodgson Journal: Neuro Oncol Date: 2011-03-02 Impact factor: 12.300
Authors: E Sieswerda; R L Mulder; I W E M van Dijk; E C van Dalen; S L Knijnenburg; H J H van der Pal; M S Mud; R C Heinen; H N Caron; L C M Kremer Journal: J Cancer Surviv Date: 2013-04-30 Impact factor: 4.442
Authors: Kirsten K Ness; E Brannon Morris; Vikki G Nolan; Carrie R Howell; Laura S Gilchrist; Marilyn Stovall; Cheryl L Cox; James L Klosky; Amar Gajjar; Joseph P Neglia Journal: Cancer Date: 2010-06-15 Impact factor: 6.860
Authors: Morgan Lamberg; Andrea Rossman; Alexandra Bennett; Sabrina Painter; Rachel Goodman; James MacLeod; Ragasnehith Maddula; David Rayan; Krishna Doshi; Alexander Bick; Simone Bailey; Sherry-Ann Brown Journal: Curr Atheroscler Rep Date: 2022-04-19 Impact factor: 5.113
Authors: Lillian R Meacham; Eric J Chow; Kirsten K Ness; Kala Y Kamdar; Yan Chen; Yutaka Yasui; Kevin C Oeffinger; Charles A Sklar; Leslie L Robison; Ann C Mertens Journal: Cancer Epidemiol Biomarkers Prev Date: 2010-01 Impact factor: 4.254
Authors: Chu-Ling Yu; Margaret A Tucker; David H Abramson; Kyoji Furukawa; Johanna M Seddon; Marilyn Stovall; Joseph F Fraumeni; Ruth A Kleinerman Journal: J Natl Cancer Inst Date: 2009-04-07 Impact factor: 13.506