Summary

We investigated if bone mineral density was related to testosterone deficiency and/or previous cancer treatment in men who were childhood cancer survivors. Men with untreated testosterone deficiency or previous treatment with cranial irradiation were at increased risk of impaired bone health. Prevention of osteoporosis should be considered in their follow-up.

Introduction

Childhood cancer survivors (CCS) are at increased risk of hypogonadism. Reduced bone mineral density (BMD) has been reported in CCS but it is unclear whether this is due to hypogonadism or a direct effect of cancer therapy. This study investigated BMD in CCS, and association with hypogonadism, previous treatment and cancer type.

Methods

Investigation of 125 CCS (median age 33.7 at inclusion; 9.6 at diagnosis) and 125 age-matched population controls. Serum testosterone and luteinizing hormone were assayed and BMD at total hip and lumbar spine L1–L4 measured. The mean difference in BMD (g/cm²; 95% CI) between CCS and controls was analysed. Odds ratios (OR; 95% CI) for low BMD were also calculated.

Results

Overall, BMD in the CCS cohort did not significantly differ from controls. However, compared with eugonadal CCS, the CCS with untreated hypogonadism had lower BMD at the hip (mean difference − 0.139 (− 0.210; − 0.067); p < 0.001) and spine (− 0.102 (− 0.174; − 0.030); p = 0.006). They also had a higher risk of low hip BMD (OR 4.1 (1.3; 14); p = 0.018). CCS treated with cranial irradiation also had lower BMD (hip − 0.076 (− 0.133; − 0.019); p = 0.009; spine − 0.071 (− 0.124; − 0.018); p = 0.009) compared with controls. The latter associations remained statistically significant after adjustment for hypogonadism.

Conclusions

CCS with hypogonadism or previously treated with cranial irradiation are at increased risk of impaired bone health. Prevention of osteoporosis should be considered as an important part in future follow-up of these men.

中文翻译：

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男性儿童癌症幸存者的骨密度低与性腺功能低下和颅骨放射有关

概要

我们调查了儿童癌症幸存者中男性的骨矿物质密度是否与睾丸激素缺乏和/或先前的癌症治疗有关。患有未经治疗的睾丸激素缺乏症或先前接受过颅骨放射治疗的男性患骨骼健康的风险增加。在随访中应考虑预防骨质疏松症。

介绍

儿童癌症幸存者（CCS）患性腺机能减退的风险增加。据报道，CCS中的骨矿物质密度（BMD）降低，但是目前尚不清楚这是由于性腺功能减退还是癌症治疗的直接作用。这项研究调查了CCS中的BMD，并与性腺功能减退，既往治疗和癌症类型相关。

方法

调查了125个CCS（中位年龄为33.7岁；诊断时为9.6岁）和125个年龄匹配的人群对照。测定血清睾丸激素和黄体生成激素，并测量全髋和腰椎L1-L4的BMD。分析了CCS和对照之间BMD的平均差异（g / cm ²； 95％CI）。还计算了低BMD的几率（OR; 95％CI）。

结果

总体而言，CCS队列中的BMD与对照组无显着差异。然而，随着eugonadal CCS相比，与未处理的性腺机能减退的CCS具有在臀部下部BMD（平均差- 0.139（ - 0.210; - 0.067）; p  <0.001）和脊柱（ - 0.102（ - 0.174; - 0.030）; p  = 0.006）。他们还有较低的髋部BMD风险（OR 4.1（1.3; 14）; p  = 0.018）。与对照相比，经颅照射治疗的CCS的BMD也较低（髋关节-0.076（-0.133;-0.019）; p  = 0.009;脊柱-0.071（-0.124;-0.018）; p  = 0.009）。调整性腺功能减退后，后者的相关性在统计学上仍然很重要。

结论

性腺机能减退或先前接受颅脑放射治疗的CCS患骨健康受损的风险增加。预防骨质疏松应被视为这些人未来随访的重要组成部分。