SwePub
Sök i LIBRIS databas

  Utökad sökning

onr:"swepub:oai:gup.ub.gu.se/324146"
 

Sökning: onr:"swepub:oai:gup.ub.gu.se/324146" > Risk and determinan...

LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00006464naa a2200637 4500
001oai:gup.ub.gu.se/324146
003SwePub
008260529s2023 | |||||||||||000 ||eng|
0247 a https://gup.ub.gu.se/publication/3241462 URI
0247 a https://doi.org/10.1016/s2213-8587(22)00286-82 DOI
040 a (SwePub)gu
041 a eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a van Atteveld, J. E.4 aut
2451 0a Risk and determinants of low and very low bone mineral density and fractures in a national cohort of Dutch adult childhood cancer survivors (DCCSS-LATER): a cross-sectional study
264 1b Elsevier BV,c 2023
520 a Background Childhood cancer survivors are at risk of developing skeletal comorbidities later in life. We aimed to assess risk factors for low and very low bone mineral density (BMD), and the risk of and risk factors for any fractures and vertebral fractures in a national cohort of Dutch adult childhood cancer survivors. Methods In this cross-sectional study, we used data from the DCCSS LATER cohort, which comprised individuals who were alive for at least 5 years after diagnosis of childhood cancer (ie, histologically confirmed malignancies or Langerhans cell histiocytosis), were diagnosed before the age of 19 years, and who had been treated at one of seven Dutch paediatric oncology centres between 1963 and 2002 (hereafter referred to as survivors). For this study, we invited survivors aged 18-45 years, who were alive as of Oct 10, 2016, living in the Netherlands, and who were deemed eligible by their treating physician to participate. We assessed BMD using dual-energy x-ray absorptiometry (DXA). Self-reported fractures that occurred at least 5 years after cancer diagnosis were assessed using available medical history and compared with population-level data from the Swedish national registry. We assessed vertebral fractures in a subset of participants using a vertebral fracture assessment. We assessed associations between the occurrence of low (Z-score of <=-1) or very low (Z-score of <=-2) BMD, fractures, and vertebral fractures and demographic, treatment -related, endocrine, and lifestyle-related factors using logistic regression analysis. Findings Between April 29, 2016, and Jan 22, 2020, 3996 (64 center dot 8%) of 6165 individuals from the DCCSS LATER cohort were invited to participate, of whom 2003 (50 center dot 1%) were enrolled (mean age at participation was 33 center dot 1 years [SD 7 center dot 2], 966 [48 center dot 2%] were female, and 1037 [51 center dot 8%] were male [data on ethnicity and race were not available due to national policies]). 1548 (77 center dot 3%) had evaluable DXA scans for assessment of BMD, 1892 (94 center dot 5%) provided medical history of fractures, and 249 (12 center dot 4%) were assessed for vertebral fractures. 559 (36 center dot 1%) of 1548 had low BMD at any site, and 149 (9 center dot 6%) had very low BMD at any site. The standardised incidence ratio of any first fracture was 3 center dot 53 (95% CI 3 center dot 06-4 center dot 06) for male participants and 5 center dot 35 (4 center dot 46-6 center dot 52) for female participants. 33 (13 center dot 3%) of 249 participants had vertebral fractures. Male sex, underweight, high carboplatin dose, any dose of cranial radiotherapy, hypogonadism, hyperthyroidism, low physical activity, and severe vitamin D deficiency were associated with low BMD at any site and male sex, underweight, cranial radiotherapy, growth hormone deficiency, and severe vitamin D deficiency were associated with very low BMD at any site. Additionally, male sex, former and current smoking, and very low lumbar spine BMD were associated with any fractures, whereas older age at follow-up, previous treatment with platinum compounds, growth hormone deficiency, and low physical activity were specifically associated with vertebral fractures. Interpretation Survivors of childhood cancer are at increased risk of any first fracture. Very low lumbar spine BMD was associated with fractures, highlighting the importance of active BMD surveillance in high-risk survivors (ie, those treated with cranial, craniospinal, or total body irradiation). Moreover, our results indicate that intensive surveillance and timely interventions for endocrine disorders and vitamin deficiencies might improve bone health in childhood cancer survivors, but this needs to be assessed in future studies.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Endokrinologi och diabetes0 (SwePub)302052 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Endocrinology and Diabetes0 (SwePub)302052 hsv//eng
653 a long-term survivors
653 a hip fracture
653 a recommendations
653 a adolescent
653 a europe
653 a health
653 a Endocrinology & Metabolism
7001 a de Winter, D. T. C.4 aut
7001 a Pluimakers, V. G.4 aut
7001 a Fiocco, M.4 aut
7001 a Nievelstein, R. A. J.4 aut
7001 a Hobbelink, M. G. G.4 aut
7001 a de Vries, A. C. H.4 aut
7001 a Loonen, J. J.4 aut
7001 a van Dulmen-den Broeder, E.4 aut
7001 a van der Pal, H. J.4 aut
7001 a Pluijm, S. M. F.4 aut
7001 a Kremer, L. C. M.4 aut
7001 a Ronckers, C. M.4 aut
7001 a van der Heiden-van der Loo, M.4 aut
7001 a Versluijs, A. B.4 aut
7001 a Louwerens, M.4 aut
7001 a Bresters, D.4 aut
7001 a van Santen, H. M.4 aut
7001 a Olsson, Daniel S,d 1983u Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition4 aut0 (Swepub:gu)xolssd
7001 a Hoefer, I.4 aut
7001 a van den Berg, S. A. A.4 aut
7001 a den Hartogh, J.4 aut
7001 a Tissing, W. J. E.4 aut
7001 a Neggers, Sjcmm4 aut
7001 a van den Heuvel-Eibrink, M. M.4 aut
7102 a Göteborgs universitetb Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition4 org
7730 t Lancet Diabetes & Endocrinologyd : Elsevier BVg 11:1, s. 21-32q 11:1<21-32x 2213-8587
8564 8u https://gup.ub.gu.se/publication/324146
8564 8u https://doi.org/10.1016/s2213-8587(22)00286-8

Hitta via bibliotek

Till lärosätets databas

Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst. Hantera kakor

 
pil uppåt Stäng

Kopiera och spara länken för att återkomma till aktuell vy