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Logo of bmcpediBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Pediatrics
 
BMC Pediatr. 2012; 12: 40.
Published online 2012 March 28. doi:  10.1186/1471-2431-12-40
PMCID: PMC3352180
Copyright ©2012 Polgreen et al; licensee BioMed Central Ltd.
Modifiable risk factors associated with bone deficits in childhood cancer survivors
Lynda E Polgreen,corresponding author1,7 Anna Petryk,corresponding author1,7 Andrew C Dietz,2 Alan R Sinaiko,1 Wendy Leisenring,3 Pam Goodman,3 Lyn M Steffen,4 Joanna L Perkins,5 Donald R Dengel,6 K Scott Baker,3 and Julia Steinberger1
1Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
2Department of Pediatrics, University of California San Diego and Rady Children's Hospital, San Diego, CA, USA
3Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
4School of Public Health, University of Minnesota, Minneapolis, MN, USA
5Children's Hospitals & Clinics of Minnesota, Minneapolis, MN, USA
6School of Kinesiology, University of Minnesota, Minneapolis, MN, USA
7Pediatric Endocrinology, University of Minnesota, East Building Room MB671 2450 Riverside Ave., Minneapolis, MN 55454, USA
corresponding authorCorresponding author.
Lynda E Polgreen: polgr001/at/umn.edu; Anna Petryk: petry005/at/umn.edu; Andrew C Dietz: adietz/at/rchsd.org; Alan R Sinaiko: sinai001/at/umn.edu; Wendy Leisenring: wleisenr/at/fhcrc.org; Pam Goodman: pamgoodman/at/fhcrc.org; Lyn M Steffen: steff025/at/umn.edu; Joanna L Perkins: Joanna.Perkins/at/childrensmn.org; Donald R Dengel: denge001/at/umn.edu; K Scott Baker: ksbaker/at/fhcrc.org; Julia Steinberger: stein055/at/umn.edu
Received September 26, 2011; Accepted March 28, 2012.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background
To determine the prevalence and severity of bone deficits in a cohort of childhood cancer survivors (CCS) compared to a healthy sibling control group, and the modifiable factors associated with bone deficits in CCS.
Methods
Cross-sectional study of bone health in 319 CCS and 208 healthy sibling controls. Bone mineral density (BMD) was measured by dual-energy x-ray absorptiometry (DXA). Generalized estimating equations were used to compare measures between CCS and controls. Among CCS, multivariable logistic regression was used to evaluate odds ratios for BMD Z-score ≤ -1.
Results
All subjects were younger than 18 years of age. Average time since treatment was 10.1 years (range 4.3 - 17.8 years). CCS were 3.3 times more likely to have whole body BMD Z-score ≤ -1 than controls (95% CI: 1.4-7.8; p = 0.007) and 1.7 times more likely to have lumbar spine BMD Z-score ≤ -1 than controls (95% CI: 1.0-2.7; p = 0.03). Among CCS, hypogonadism, lower lean body mass, higher daily television/computer screen time, lower physical activity, and higher inflammatory marker IL-6, increased the odds of having a BMD Z-score ≤ -1.
Conclusions
CCS, less than 18 years of age, have bone deficits compared to a healthy control group. Sedentary lifestyle and inflammation may play a role in bone deficits in CCS. Counseling CCS and their caretakers on decreasing television/computer screen time and increasing activity may improve bone health.
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