Modifiable risk factors associated with bone deficits in childhood cancer survivors

Lynda E. Polgreen, Anna Petryk, Andrew C. Dietz, Alan R Sinaiko, Wendy Leisenring, Pam Goodman, Lyn M Steffen, Joanna L. Perkins, Donald R Dengel, K. Scott Baker, Julia Steinberger

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44 Scopus citations


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.

Original languageEnglish (US)
Article number40
JournalBMC Pediatrics
StatePublished - Mar 28 2012

Bibliographical note

Funding Information:
The project described was supported by RO1CA113930-01A1 from the National Cancer Institute, M01-RR00400 from the National Center for Research Resources, and the Children’s Cancer Research Fund (JS).


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