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Schündeln MM, Fritzemeier S, Goretzki SC, Hauffa PK, Munteanu M, Kiewert C, Hauffa BP, Fleischhack G, Tippelt S, Grasemann C. Prevalence of osteopathologies in a single center cohort of survivors of childhood primary brain tumor. Front Pediatr 2022; 10:913343. [PMID: 35923779 PMCID: PMC9339690 DOI: 10.3389/fped.2022.913343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Childhood primary brain tumors (CPBT) are the second largest group of childhood malignancies and associated with a high risk for endocrine late effects. OBJECTIVE To assess endocrine late effects and their relevance for the development of osteopathologies in survivors. METHODS This single center cross sectional study investigated data from 102 CPBT survivors with a mean age of 13.0 years and a mean age at diagnosis of 8.7 years. Clinical, biochemical, radiographic, and anamnestic data regarding endocrine and bone health were obtained at study visits. In addition, data regarding tumor stage and therapy was obtained by chart review. An expert opinion was applied to define presence of osteopathologies. RESULTS Impaired bone health, defined by at least one pathological screening parameter, was present in 65% of patients. 27.5% were found to have overt osteopathologies per expert opinion. 37.8% displayed a severe vitamin D deficiency (25-OH vitamin D < 10 ng/ml) and 11% a secondary hyperparathyroidism. Patients with osteopathologies had lower 25-OH vitamin D levels compared to patients without osteopathologies. Multiple endocrine late effects were present: diabetes insipidus in 10.8%, aberrant pubertal development in 13.7%, central hypocortisolism in 14.9%, thyroid dysfunction in 23.8% and growth hormone deficiency in 21.8%. A total of 31.3% of survivors displayed any endocrinopathy. Tumors located near hypothalamic structures and patients who received irradiation had a higher likelihood of endocrine morbidity. CONCLUSION This study indicates that endocrine deficiencies are common in pediatric survivors of CPBTs. Osteopathologies are present in this cohort. A prominent effect of hormonal deficiencies on bone health was not detected, possibly because patients were sufficiently treate for their endocrine conditions or indicating resilience of the childhood bone remodeling process. Vitamin D deficiency is frequent and should be treated as recommended.
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Affiliation(s)
- Michael M Schündeln
- Pediatric Hematology and Oncology, Department of Pediatrics III, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Sebastian Fritzemeier
- Pediatric Hematology and Oncology, Department of Pediatrics III, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Sarah C Goretzki
- Pediatric Hematology and Oncology, Department of Pediatrics III, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Pia K Hauffa
- Pediatric Hematology and Oncology, Department of Pediatrics III, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Martin Munteanu
- Pediatric Endocrinology and Diabetology, Department of Pediatrics II, University Hospital Essen, University Duisburg-Essen, Essen, Germany.,Department of Pediatric Endocrinology and Diabetology, Caritas Hospital, Bad Mergentheim, Germany
| | - Cordula Kiewert
- Pediatric Endocrinology and Diabetology, Department of Pediatrics II, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Berthold P Hauffa
- Pediatric Endocrinology and Diabetology, Department of Pediatrics II, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Gudrun Fleischhack
- Pediatric Hematology and Oncology, Department of Pediatrics III, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Stephan Tippelt
- Pediatric Hematology and Oncology, Department of Pediatrics III, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Corinna Grasemann
- Department of Pediatrics, Division of Rare Diseases, St. Josef-Hospital Bochum, Ruhr-University Bochum, Bochum, Germany
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High molecular weight adiponectin levels are inversely associated with adiposity in pediatric brain tumor survivors. Sci Rep 2020; 10:18606. [PMID: 33122755 PMCID: PMC7596561 DOI: 10.1038/s41598-020-75638-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 10/19/2020] [Indexed: 12/11/2022] Open
Abstract
While children with brain tumors are surviving at record rates, survivors are at risk of cardiovascular disease and type 2 diabetes mellitus; these conditions may be driven by excess body fat. Adiponectin in an adipokine that is inversely associated with the fat mass, and has been linked to cardiometabolic risk stratification in the general population. However, adiponectin’s profile and determinants in SCBT have not been established. We tested the hypothesis that high molecular weight (HMW) adiponectin levels, the more biologically active form of adiponectin, were associated with adiposity in SCBT similarly to non-cancer controls. Seventy-four SCBT (n = 32 female) and 126 controls (n = 59 female) who were 5–17 years old were included. Partial correlations and multivariable regression analyses assessed the relationship between HMW adiponectin and adiposity. HMW adiponectin was inversely associated with total and central adiposity (FM%: β − 0.21, 95% CI − 0.15, − 0.08; p value < 0.0001; WHR: β − 0.14, 95% CI − 0.02, − 0.01; p value < 0.0001 ;WHtR: β − 0.21, 95% CI − 0.05, − 0.03; p value < 0.0001). In conclusion, HMW adiponectin is inversely correlated with adiposity in SCBT. Adiponectin may serve as a biomarker of cardiometabolic risk and response to interventions to prevent and manage obesity and its comorbidities in SCBT.
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3
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Johnson AH, Rodgers Phillips S, Rice M. Abnormal weight gain with fatigue and stress in early survivorship after childhood brain tumor diagnosis. J SPEC PEDIATR NURS 2020; 25:e12288. [PMID: 32065725 DOI: 10.1111/jspn.12288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/21/2020] [Accepted: 01/27/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND Diagnosis and treatment for individuals with brain tumors during childhood involves sequelae, including abnormal weight gain. This symptom is commonly clustered with fatigue and increased risk for cardiovascular disease. Children's Oncology Group recommendations include annual surveillance of body mass index (BMI) and cardiometabolic comorbidities; however, there has been little emphasis on individualized screening early in survivorship. PURPOSE The primary purpose of this paper is to describe the findings of abnormal weight gain and its correlates in a sample of young childhood brain tumor survivors during early survivorship. DESIGN AND METHODS This cross-sectional multi-site study included brain tumor survivors of ages 8-12 years who were less than 6 years posttreatment. Convenience sampling from two pediatric cancer centers in the southern United States was utilized. Data collected included BMI, parent report of sleep, and child report of fatigue and stress. RESULTS The sample (N = 21) consisted of children who had received chemotherapy, radiation treatment, and surgery for childhood brain tumor. BMI in overweight and obese categories exceeded normative samples with 38% at or above the 85th percentile. There were clinically significant relationships with fatigue, stress about weight, tumor location, cranial radiation, chemotherapy, and recurrence PRACTICE IMPLICATIONS: Screening for abnormal weight gain and related factors, such as fatigue should begin early in survivorship after childhood brain tumor treatment completion with the aim of health promotion and disease prevention. Adiposity measurement techniques should be utilized in future clinical and research settings to improve assessment of cardiometabolic risk.
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Affiliation(s)
- Ann H Johnson
- Harris College of Nursing and Health Sciences, Texas Christian University, Fort Worth, Texas
| | | | - Marti Rice
- University of Alabama at Birmingham, School of Nursing, Birmingham, Alabama
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4
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Sims ED, Jennings WJ, Empringham B, Fleming A, Portwine C, Johnston DL, Zelcer SM, Rassekh SR, Burrow S, Thabane L, Samaan MC. Circulating leptin levels are associated with adiposity in survivors of childhood brain tumors. Sci Rep 2020; 10:4711. [PMID: 32170116 PMCID: PMC7070034 DOI: 10.1038/s41598-020-61520-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 02/28/2020] [Indexed: 11/16/2022] Open
Abstract
Survivors of Childhood Brain Tumors (SCBT) are at a higher risk of developing cardiovascular disease and type 2 diabetes compared to the general population. Adiposity is an important risk factor for the development of these outcomes, and identifying biomarkers of adiposity may help the stratification of survivors based on their cardiovascular risk or allow for early screening and interventions to improve cardiometabolic outcomes. Leptin is an adipokine that positively correlates with the adipose mass in the general population and is a predictor of adverse cardiometabolic outcomes, yet its association with adiposity in SCBT has not been studied. The aim of this study was to determine if leptin levels are associated with the adipose mass in SCBT, and to define its predictors. This cross-sectional study included 74 SCBT (n = 32 females) with 126 non-cancer controls (n = 59 females). Total adiposity was measured using Bioelectrical Impendence Analysis (BIA) and central adiposity was measured using waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR). We used multivariable linear regression analysis to determine if leptin predicts adiposity in SCBT and adjusted for age, sex, puberty, and cancer status. Leptin correlated strongly with total (p < 0.001) and central (WHR p = 0.001; WHtR p < 0.001) adiposity in SCBT and non-cancer controls. In conclusion, leptin is a potential biomarker for adiposity in SCBT, and further investigation is needed to clarify if leptin is a predictor of future cardiometabolic risk in SCBT.
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Affiliation(s)
- E Danielle Sims
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - William J Jennings
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Brianna Empringham
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Adam Fleming
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,Division of Pediatric Hematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Carol Portwine
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.,Division of Pediatric Hematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Donna L Johnston
- Division of Pediatric Hematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Shayna M Zelcer
- Pediatric Hematology Oncology, Children's Hospital, London Health Sciences Center, London, Ontario, Canada
| | - Shahrad Rod Rassekh
- Division of Pediatric Hematology/Oncology/BMT, Department of Pediatrics, British Columbia Children's Hospital, Vancouver, BC, Canada
| | - Sarah Burrow
- Division of Orthopedic Surgery, Department of Surgery, McMaster University Medical Centre, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.,Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada.,Centre for Evaluation of Medicines, St. Joseph's Health Care, Hamilton, Ontario, Canada.,Biostatistics Unit, St Joseph's Healthcare-Hamilton, Hamilton, Ontario, Canada
| | - M Constantine Samaan
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada. .,Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada. .,Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
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5
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Sloof N, Hendershot E, Griffin M, Anderson L, Marjerrison S. The Impact of Physical Activity on the Health of Young Adult Survivors of Childhood Cancer: An Exploratory Analysis. J Adolesc Young Adult Oncol 2019; 8:602-609. [PMID: 31120346 DOI: 10.1089/jayao.2019.0001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Physical activity (PA) habits of young adult survivors of childhood cancer (SCC) have not been well-characterized, and it is unclear whether PA has a relationship with the health status of young adult SCC. The objective of this study was to determine PA participation of young adult SCC and examine associations between PA participation and late adverse effects of treatment. Methods: A retrospective chart review, including SCC enrolled in the McMaster AfterCare program, was performed. Patient characteristics, health outcomes, and PA information were abstracted. Multivariable logistic regression models were used to examine associations in this exploratory analysis. Results: We identified 253 young adult SCC, 240 of whom had sufficient information on PA participation to determine a Leisure Score Index (LSI). Of these, 45% reported adequate PA (LSI ≥24) and 26% reported no PA (LSI = 0). Significant associations between PA and bone mineral density (p = 0.03), blood pressure (p = 0.04), triglycerides (p = 0.05), and high-density lipoprotein cholesterol (p < 0.01) were demonstrated. Conclusions: The majority of young adult SCC in this cohort reported inadequate PA, despite ongoing healthy active living counseling. We identified associations between PA and bone mineral density as well as lipid profile in this group, which suggest that PA may mitigate risk of sequelae of cancer treatment. Strategies to improve young adult SCC engagement in PA are required.
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Affiliation(s)
- Natalie Sloof
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada.,Schulich School of Medicine & Dentistry, London, ON, Canada
| | - Eleanor Hendershot
- Pediatric Hematology/Oncology, McMaster Children's Hospital, Hamilton, ON, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Meridith Griffin
- Department of Health, Aging, & Society, McMaster University, Hamilton, ON, Canada
| | - Loretta Anderson
- Pediatric Hematology/Oncology, McMaster Children's Hospital, Hamilton, ON, Canada
| | - Stacey Marjerrison
- Pediatric Hematology/Oncology, McMaster Children's Hospital, Hamilton, ON, Canada.,Division of Hematology/Oncology, Department of Pediatrics, McMaster University, Hamilton, ON, Canada
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6
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Sims ED, Wang KW, Fleming A, Johnston DL, Zelcer SM, Rassekh SR, Burrow S, Thabane L, Samaan MC. Tri-ponderal mass index in survivors of childhood brain tumors: A cross-sectional study. Sci Rep 2018; 8:16336. [PMID: 30397217 PMCID: PMC6218522 DOI: 10.1038/s41598-018-34602-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 10/22/2018] [Indexed: 02/07/2023] Open
Abstract
Survivors of childhood brain tumors (SCBT) face a higher risk of cardiometabolic disorders and premature mortality compared to the general population. Excess adiposity is a known risk factor for these comorbidities. However, while SCBT have higher adiposity compared to healthy controls, measuring adiposity in clinical practice involves access to specialized equipment and may impact busy clinical services. Tri-ponderal Mass Index (TMI; kg/m3) may be a superior measure of adiposity when compared to Body Mass Index (BMI; kg/m2). However, its use in determining adiposity in SCBT has not been assessed. This study aims to validate TMI as a clinical measure of adiposity in SCBT. This was a cross-sectional study including 44 SCBT (n = 20 female) and 137 (n = 64 female) non-cancer control children, 5-17 years of age. BMI and TMI were calculated from height and weight measurements. Fat mass percentage was assessed using bioelectrical impedance analysis and waist to hip and waist to height ratios were used to assess central adiposity. Regression analyses were adjusted for age, sex, puberty and treatment. TMI demonstrated strong correlations to measures of total and central adiposity and predicted adiposity in SCBT and non-cancer controls, with stronger trends in the latter group. TMI may serve as a reliable clinical measure of adiposity in both SCBT and healthy children.
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Affiliation(s)
- E Danielle Sims
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Kuan-Wen Wang
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Adam Fleming
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Hematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Donna L Johnston
- Division of Pediatric Hematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Shayna M Zelcer
- Pediatric Hematology Oncology, Children's Hospital, London Health Sciences Center, London, Ontario, Canada
| | - Shahrad Rod Rassekh
- Division of Pediatric Hematology/Oncology/BMT, Department of Pediatrics, British Columbia's Children's Hospital, Vancouver, BC, Canada
| | - Sarah Burrow
- Division of Orthopedic Surgery, Department of Surgery, McMaster University Medical Centre, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
- Centre for Evaluation of Medicines, St. Joseph's Health Care, Hamilton, Ontario, Canada
- Biostatistics Unit, St Joseph's Healthcare-Hamilton, Hamilton, Ontario, Canada
| | - M Constantine Samaan
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
- Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada.
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
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7
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Wang KW, Fleming A, Johnston DL, Zelcer SM, Rassekh SR, Ladhani S, Socha A, Shinuda J, Jaber S, Burrow S, Singh SK, Banfield L, de Souza RJ, Thabane L, Samaan MC. Overweight, obesity and adiposity in survivors of childhood brain tumours: a systematic review and meta-analysis. Clin Obes 2018; 8:55-67. [PMID: 29024558 DOI: 10.1111/cob.12224] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 08/27/2017] [Indexed: 12/22/2022]
Abstract
Survivors of childhood brain tumours (SCBT) have increased cardiometabolic risks, but the determinants of these risks are unclear. This systematic review aims to compare the prevalence of overweight and obesity as well as adiposity measures between SCBT and non-cancer controls. The PubMed, EMBASE, MEDLINE, CINAHL and the Cochrane Library databases were searched. The primary outcomes were the prevalence of overweight and obesity based on body mass index. The secondary outcomes were adiposity measures including percent fat mass, waist-to-hip and waist-to-height ratios. Forty-one studies were included in the meta-analysis. The prevalence of overweight and obesity combined was similar between overall SCBT, SCBT excluding craniopharyngioma and non-cancer controls (42.6%, 95% CI 30.1-55.1 vs. 31.7%, 95% CI 20.4-43.0 vs. 40.4%, 95% CI 34.0-46.8). We also found that SCBT have higher percent fat mass (mean difference 4.1%, 95% CI 2.0-6.1), waist-to-hip ratio (mean difference 0.07, 95% CI 0.02-0.13) and waist-to-height ratio (mean difference 0.06, 95% CI 0.01-0.10) than non-cancer controls. We conclude that SCBT have similar overweight and obesity distribution but higher adiposity than non-cancer controls. More studies were needed to explore the determinants of adiposity and its contribution to cardiometabolic outcomes in SCBT.
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Affiliation(s)
- K-W Wang
- Department of Pediatrics, McMaster University, Hamilton, Canada
- Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Canada
- Medical Sciences Graduate Program, McMaster University, Hamilton, Canada
| | - A Fleming
- Department of Pediatrics, McMaster University, Hamilton, Canada
- Medical Sciences Graduate Program, McMaster University, Hamilton, Canada
- Division of Pediatric Hematology/Oncology, McMaster Children's Hospital, Hamilton, Canada
| | - D L Johnston
- Division of Pediatric Hematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - S M Zelcer
- Pediatric Hematology Oncology, Children's Hospital, London Health Sciences Center, London, Canada
| | - S R Rassekh
- Division of Pediatric Hematology/Oncology/BMT, Department of Pediatrics, British Columbia's Children's Hospital, Vancouver, Canada
| | - S Ladhani
- Department of Pediatrics, McMaster University, Hamilton, Canada
- Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Canada
| | - A Socha
- Department of Pediatrics, McMaster University, Hamilton, Canada
- Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Canada
| | - J Shinuda
- Department of Pediatrics, McMaster University, Hamilton, Canada
- Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Canada
| | - S Jaber
- Department of Pediatrics, McMaster University, Hamilton, Canada
- Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Canada
| | - S Burrow
- Division of Orthopedic Surgery, Department of Surgery, McMaster University Medical Centre, Hamilton, Canada
| | - S K Singh
- Division of Neurosurgery, Department of Surgery, McMaster Children's Hospital, Hamilton, Canada
- McMaster Stem Cell and Cancer Research Institute, McMaster University, Hamilton, Canada
| | - L Banfield
- Health Sciences Library, McMaster University, Hamilton, Canada
| | - R J de Souza
- Medical Sciences Graduate Program, McMaster University, Hamilton, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | - L Thabane
- Medical Sciences Graduate Program, McMaster University, Hamilton, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
- Department of Anesthesia, McMaster University, Hamilton, Canada
- Centre for Evaluation of Medicines, St. Joseph's Health Care, Hamilton, Canada
- Biostatistics Unit, St Joseph's Healthcare-Hamilton, Hamilton, Canada
| | - M C Samaan
- Department of Pediatrics, McMaster University, Hamilton, Canada
- Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Canada
- Medical Sciences Graduate Program, McMaster University, Hamilton, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
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8
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Wang KW, de Souza RJ, Fleming A, Johnston DL, Zelcer SM, Rassekh SR, Burrow S, Thabane L, Samaan MC. Birth weight and body mass index z-score in childhood brain tumors: A cross-sectional study. Sci Rep 2018; 8:1642. [PMID: 29374278 PMCID: PMC5786044 DOI: 10.1038/s41598-018-19924-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 01/11/2018] [Indexed: 01/31/2023] Open
Abstract
Children with brain tumors (CBT) are at higher risk of cardiovascular disease and type 2 diabetes compared to the general population, in which birth weight is a risk factor for these diseases. However, this is not known in CBT. The primary aim of this study was to explore the association between birth weight and body mass measures in CBT, compared to non-cancer controls. This is a secondary data analysis using cross-sectional data from the CanDECIDE study (n = 78 CBT and n = 133 non-cancer controls). Age, sex, and birth weight (grams) were self-reported, and confirmed through examination of the medical records. Body mass index (BMI) was calculated from height and weight measures and reported as kg/m2. BMI z-scores were obtained for subjects under the age of 20 years. Multivariable linear regression was used to evaluate the relationship between birth weight and BMI and BMI z-score, adjusted for age, sex, puberty, and fat mass percentage. Higher birth weight was associated with higher BMI and BMI z-score among CBT and controls. In conclusion, birth weight is a risk factor for higher body mass during childhood in CBT, and this may help the identification of children at risk of future obesity and cardiometabolic risk.
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Affiliation(s)
- Kuan-Wen Wang
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada
- Medical Sciences Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Russell J de Souza
- Medical Sciences Graduate Program, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Adam Fleming
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Medical Sciences Graduate Program, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Hematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Donna L Johnston
- Division of Pediatric Hematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Shayna M Zelcer
- Pediatric Hematology Oncology, Children's Hospital, London Health Sciences Center, London, Ontario, Canada
| | - Shahrad Rod Rassekh
- Division of Pediatric Hematology/Oncology/BMT, Department of Pediatrics, British Columbia's Children's Hospital, Vancouver, BC, Canada
| | - Sarah Burrow
- Division of Orthopedic Surgery, Department of Surgery, McMaster University Medical Centre, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
- Centre for Evaluation of Medicines, St. Joseph's Health Care, Hamilton, Ontario, Canada
- Biostatistics Unit, St Joseph's Healthcare-Hamilton, Hamilton, Ontario, Canada
| | - M Constantine Samaan
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
- Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada.
- Medical Sciences Graduate Program, McMaster University, Hamilton, Ontario, Canada.
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
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9
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Rudrapatna S, Peterson D, Missiuna P, Aditya I, Drew B, Sahar N, Thabane L, Samaan MC. Understanding muscle-immune interactions in adolescent idiopathic scoliosis: a feasibility study. Pilot Feasibility Stud 2017; 3:50. [PMID: 29225911 PMCID: PMC5715623 DOI: 10.1186/s40814-017-0193-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 10/20/2017] [Indexed: 11/29/2022] Open
Abstract
Background Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis in children, and its cause remains unknown. The Immune-metabolic CONnections to Scoliosis (ICONS) Study was designed to elucidate the potential mechanisms by which immune system-paraspinal muscle crosstalk contributes to the development of AIS. In this report, we document the evaluation of ICONS Study feasibility. Methods This study was conducted at a tertiary pediatric academic center in Hamilton, Ontario, Canada. We included boys and girls, aged 10–17 years with a diagnosis of AIS requiring corrective spinal surgery. Exclusion criteria included patients on high-dose steroids, immunosuppressive therapy, anti-thrombotic medications, those with an active infection for 15 days before participation, autoimmune disease, pregnancy, and patients who were unwilling to consent. Pre-determined feasibility criteria included permission to approach participants and recruitment rates of 80%, consenting of at least 80% of participants to provide biological samples, 90% or higher case report form and questionnaire completion, resources to be sufficient in at least 80% of recruitments, and the ability to successfully collect and process 80% or more of the biological samples needed for this study. Results Between August 2013 and October 2014, we identified 32 potential participants with AIS, but had the resources to approach only 16, of which 12 (75%) agreed to be approached by the research team, and all consented to participate. Of the 12 participants recruited, 11 questionnaire packages and muscle biopsies (91.7% for each objective) were collected, while other biological samples (serum, plasma, whole blood for DNA and RNA processing, urine) were collected from all participants. Conclusions The ICONS study protocols and procedures are feasible. However, recruitment rates were less than predicted. For the full study, we plan on prolonging the recruitment phase and the inclusion of additional centers to achieve recruitment targets.
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Affiliation(s)
- Srikesh Rudrapatna
- Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, Ontario Canada
| | - Devin Peterson
- Department of Pediatric Surgery, Division of Orthopedics, McMaster University, Hamilton, ON Canada
| | - Paul Missiuna
- Department of Pediatric Surgery, Division of Orthopedics, McMaster University, Hamilton, ON Canada
| | - Ishan Aditya
- Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, Ontario Canada
| | - Brian Drew
- Department of Pediatric Surgery, Division of Orthopedics, McMaster University, Hamilton, ON Canada
| | - Nicola Sahar
- Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, Ontario Canada
| | - Lehana Thabane
- Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, Ontario Canada.,Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario Canada.,Department of Anesthesia, McMaster University, Hamilton, ON Canada.,Centre for Evaluation of Medicines, Hamilton, ON Canada.,Biostatistics Unit, St Joseph's Healthcare-Hamilton, Hamilton, ON Canada
| | - M Constantine Samaan
- Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, Ontario Canada.,Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario Canada.,Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, ON Canada
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