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

Bélanger, Véronique; Napartuk, Mélanie; Bouchard, Isabelle; Meloche, Caroline; Curnier, Daniel; Sultan, Serge; Laverdière, Caroline; Sinnett, Daniel; Marcil, Valérie

doi:10.1080/01635581.2022.2072908

Cited by 3 publications

(4 citation statements)

References 83 publications

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“… 6 Independent of treatment exposure, obesity has been linked to diastolic dysfunction, 26 cardiac autonomic dysfunction, 27 and late venous thromboembolism in survivors. 28 It also serves as a central driver of morbidity by doubling the risk of hypertension and dyslipidemia 29 and increasing the risk of diabetes by 5- to 7-fold. 30 , 31 …”

Section: Obesitymentioning

confidence: 99%

“… 70 This leaves approximately 60% of the risk unaccounted for, with obesity and other lifestyle factors being the primary nongenetic contributors to hypertension risk in noncancer populations. 29 , 70 , 71 …”

Section: Hypertensionmentioning

confidence: 99%

“…As for management, failure to demonstrate improvement in blood pressure among childhood cancer survivors participating in 2 lifestyle interventions adapted from the general population emphasizes the need for tailored treatments for this group. 77 , 78 Because obesity is an important contributor to hypertension in survivors, 29 evidence regarding the impact of adapted lifestyle changes on hypertension primarily comes from trials targeting weight loss. Yet, survivors following a 1-year personalized physical activity program did not observe improvement in their blood pressure despite a decrease in total body fat proportion.…”

Section: Hypertensionmentioning

confidence: 99%

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Modifiable Cardiometabolic Risk Factors in Survivors of Childhood Cancer

Hammoud,

Mulrooney,

Rhea

et al. 2024

JACC: CardioOncology

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Section: Obesitymentioning

confidence: 99%

Section: Hypertensionmentioning

confidence: 99%

Section: Hypertensionmentioning

confidence: 99%

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Modifiable Cardiometabolic Risk Factors in Survivors of Childhood Cancer

Hammoud,

Mulrooney,

Rhea

et al. 2024

JACC: CardioOncology

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“…Antineoplastic treatments can also lead to cardiometabolic disturbances including weight gain, insulin resistance, dyslipidemia, and high blood pressure [ 17 , 18 , 19 , 20 , 21 ]. Compared to children, adolescents’ cardiometabolic health is particularly affected by treatments, and these complications can persist after treatment in the short- and the long-term [ 17 , 19 , 20 , 22 , 23 , 24 ]. Accordingly, survivors of childhood and adolescent cancer are at higher risk of early mortality, mainly due to a second neoplasm or to a cardiovascular event, compared to the general population without a cancer history [ 23 , 25 , 26 , 27 , 28 ] or to siblings [ 29 , 30 ].…”

Section: Introductionmentioning

confidence: 99%

Needs, Barriers and Facilitators of Adolescents Participating in a Lifestyle Promotion Program in Oncology: Stakeholders, Adolescents and Parents’ Perspective

et al. 2022

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Treatments for adolescent cancer can cause debilitating side effects in the short- and long-term such as nausea and malnutrition but also cardiometabolic disturbances. Although the risk for cardiometabolic complications is greater for adolescents with cancer than younger ones, adolescents typically respond poorly to family-oriented health promotion programs. This study aims to assess the needs, barriers and facilitators to healthy lifestyle promotion interventions for adolescents with cancer and how to best adapt these interventions for them. Interviews were held with adolescents treated for cancer (n = 9) and parents (n = 6), focus groups were conducted with stakeholders working in oncology (n = 12) and self-report questionnaires were sent to stakeholders involved in a health promotion intervention (n = 6). At the time of interview, mean age of adolescent participants (40% female) was 17.0 ± 1.9 years (mean age at diagnosis: 14.6 ± 1.6 years). Verbatim and responses to questionnaires were coded and analyzed using qualitative methods. Stakeholder stated that adolescents with cancer need to access activities adapted to their age, to communicate with peers going through a similar experience, and to preserve their schooling and friendships. Barriers to intervention reported by adolescents, parents and stakeholders include lack of motivation, schedule conflicts, fatigue and treatment side effects. Some of the barriers mentioned by adolescents and parents include pain, post-surgery problems, school, physical deconditioning, and lack of time. Facilitators mentioned by adolescents and parents comprise trust in stakeholders’ expertise, personalized approaches, scheduling flexibility. Stakeholders recommended to build trust in the relationship, favoring non-moralizing teachings, adapt interventions to adolescents’ limited attention span and avoiding the use of long-term health benefits as a motivator.

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Abnormal HDL lipid and protein composition following pediatric cancer treatment: an associative study

et al. 2023

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Background Long-term childhood cancer survivors (CCS) are at high risk of having dyslipidemia including low high density lipoprotein cholesterol (HDL-C). However, little is known about the prevalence of low HDL-C and the impact of therapy exposure on HDL composition early after treatment is terminated. Methods This associative study included 50 children and adolescents who had completed their cancer treatments (< 4 years). Clinical characteristics (demographic, diagnosis, treatment, anthropometric parameters), fasting plasma lipids, apoliporoteins (Apo) A-I and composition of HDL fractions (HDL2 and HDL3) were assessed. Data were stratified according to the presence of dyslipidemia and median doses of therapeutic agents and compared using Fisher exact or Mann–Whitney tests. Univariate binary logistic regression analyses were carried out to evaluate the associations between the clinical and biochemical characteristics and having low HDL-C. Composition of HDL2 and HDL3 particles was assessed in a sub-group of 15 patients and compared to 15 age- and sex-matched healthy controls using Wilcoxon paired test. Results Of the 50 pediatric cancer patients included in this study (mean age: 11.30 ± 0.72 y; mean time since end of treatment: 1.47 ± 0.12 y; male: 38%), 8 had low HDL-C (16%), all of which were adolescent at diagnosis. Higher doses of doxorubicin were associated with lower HDL-C and Apo A-I levels. In hypertriglyceridemic patients and compared to normolipidemics, triglycerides (TG) content was greater in HDL2 and HDL3 fractions whereas esterified cholesterol (EC) content was lower in HDL2. Enrich TG content of HDL3 and lower EC of HDL2 was found in patients exposed to ≥ 90 mg/m2 doxorubicin. Factors positively associated with the risk of having low HDL-C were age, being overweight or obese and exposure to doxorubicin ≥ 90 mg/m2. Compared to healthy controls, a sub-group of 15 patients showed higher TG and free cholesterol (FC) content of HDL2 and HDL3 and lower EC content in HDL3. Conclusions Overall, we found abnormalities in HDL-C and Apo A-I levels and in HDL composition early after pediatric cancer treatment that are influenced by age, overweight or obesity status and exposure to doxorubicin.

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

Cited by 3 publications

References 83 publications

Modifiable Cardiometabolic Risk Factors in Survivors of Childhood Cancer

Modifiable Cardiometabolic Risk Factors in Survivors of Childhood Cancer

Needs, Barriers and Facilitators of Adolescents Participating in a Lifestyle Promotion Program in Oncology: Stakeholders, Adolescents and Parents’ Perspective

Abnormal HDL lipid and protein composition following pediatric cancer treatment: an associative study

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