Obesity Is Underestimated Using Body Mass Index and Waist-Hip Ratio in Long-Term Adult Survivors of Childhood Cancer 英文参考文献.docVIP

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Obesity Is Underestimated Using Body Mass Index and Waist-Hip Ratio in Long-Term Adult Survivors of Childhood Cancer 英文参考文献.doc

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Obesity Is Underestimated Using Body Mass Index and Waist-Hip Ratio in Long-Term Adult Survivors of Childhood Cancer 英文参考文献

ObesityIsUnderestimatedUsingBodyMassIndexand Waist-HipRatioinLong-TermAdultSurvivorsof ChildhoodCancer KarinBlijdorp1,2*,MarryM.vandenHeuvel-Eibrink1,RobPieters1,AnnemiekeM.Boot3, PatricJ.D.Delhanty4,Aart-JanvanderLely2,SebastianJ.C.M.M.Neggers1,2 1Department of Pediatric Oncology/Hematology, Erasmus MC-Sophia Children’s Hospital, Rotterdam, The Netherlands, 2Department of Medicine – Section Endocrinology,ErasmusUniversityMedicalCenter,Rotterdam,TheNetherlands,3DepartmentofPediatricEndocrinology,UniversityMedicalCenterGroningen(UMCG), Groningen,TheNetherlands,4DepartmentofInternalMedicine,ErasmusMC,Rotterdam,TheNetherlands Abstract Objective: Obesity, represented by high body mass index (BMI), is a major complication after treatment for childhood cancer.However,ithasbeenshownthathightotalfatpercentageandlowleanbodymassaremorereliablepredictorsof cardiovascularmorbidity.InthisstudylongitudinalchangesofBMIandbodycomposition,aswellasthevalueofBMIand waist-hipratiorepresentingobesity,wereevaluatedinadultchildhoodcancersurvivors. Methods:Datafrom410survivorswhohadvisitedthelateeffectsclinictwicewereanalyzed.Medianfollow-uptimewas 16years (interquartile range 11–21) and time between visits was 3.2years (2.9–3.6). BMI was measured and body compositionwasassessedbydualX-rayabsorptiometry(DXA,LunarProdigy;availabletwicein182survivors).Datawere comparedwithhealthyDutchreferencesandcalculatedasstandarddeviationscores(SDS).BMI,waist-hipratioandtotalfat percentagewereevaluatedcross-sectionallyin422survivors,inwhoatleastoneDXAscanwasassessed. Results:BMIwassignificantlyhigherinwomen,withoutsignificantchangeovertime.InmenBMIchangedsignificantlywith time(DSDS=0.19,P,0.001).Percentagefatwassignificantlyhigherthanreferencesinallsurvivors,withthehighestSDS after cranial radiotherapy (CRT) (mean SDS 1.73 in men, 1.48 in women, P,0.001). Only in men, increase in total fat percentagewassignificantlyhigherthanreferences(DSDS=0.22,P,0.001).Usingtotalfatpercentageasthegoldstandard, 65%of