Device-measured physical activity and cardiovascular disease risk in adolescent childhood cancer survivors. A physical activity in childhood cancer survivors (PACCS) study

Mari Bratteteig; Sigmund Alfred Anderssen; Corina Silvia Rueegg; Ellen Ruud; Ingrid Kristin Torsvik; Susi Kriemler; May Grydeland

doi:10.3389/fped.2022.977365

Device-measured physical activity and cardiovascular disease risk in adolescent childhood cancer survivors. A physical activity in childhood cancer survivors (PACCS) study

Front Pediatr. 2022 Aug 25:10:977365. doi: 10.3389/fped.2022.977365. eCollection 2022.

Authors

Mari Bratteteig¹, Sigmund Alfred Anderssen¹, Corina Silvia Rueegg², Ellen Ruud^{3

4}, Ingrid Kristin Torsvik⁵, Susi Kriemler⁶, May Grydeland⁷

Affiliations

¹ Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
² Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway.
³ Division for Pediatric and Adolescent Medicine, Department of Paediatric Haematology and Oncology, Oslo University Hospital, Oslo, Norway.
⁴ Faculty of Medicine, Institute for Clinical Medicine, University of Oslo, Oslo, Norway.
⁵ Department of Pediatrics, Haukeland University Hospital, Bergen, Norway.
⁶ Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
⁷ Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway.

Abstract

Objectives: We aimed to compare cardiovascular disease (CVD) risk factors in childhood cancer survivors (CCS) with age- and sex-stratified reference material and examine the association between physical activity (PA) intensities and CVD risk factors in CCS.

Materials and methods: Within the cross-sectional, multicenter Physical Activity in Childhood Cancer Survivors (PACCS) study, we collected data on CVD risk factors [VO_2-peak (mL⋅kg^-1⋅min^-1), body mass index (BMI, kg/m²), systolic blood pressure (SBP, mmHg), and total-cholesterol/HDL-cholesterol (Total/HDL)] among CCS aged 9-18 years. CVD risk factors were compared to references with immediate t-tests. We transformed CVD risk factors into z-scores based on international references and generated an individual CVD risk score: [inverse ZVO_2-peak + Z _BMI + Z _SBP + Z _Total/HDL )/4]. Multivariable mixed linear regression models were used to analyze the associations between device-measured PA intensities and CVD risk factors.

Results: We included 157 CCS aged on average 13.4 years at inclusion and 8.2 years from diagnosis. Male CCS had lower VO_2-peak compared to references (45.4 vs. 49.4 mL⋅kg^-1⋅min^-1, P = 0.001), higher diastolic BP (67 vs. 63 mmHg, P < 0.001), lower HDL (1.35 vs. 1.44 mmol/L, P = 0.012), as well as a tendency to higher CVD risk score (z-score=0.14 vs. 0.00, P = .075). Female CCS' CVD risk factors were comparable to references. Vigorous-intensity PA (VPA) was associated with CVD risk factors. A 10-min increase in VPA was associated with higher VO_2-peak (β = 4.9, 95% CI, 2.1-7.7), lower Total/HDL (β = -0.3, 95% CI, -0.6 to -0.1) and a lower CVD risk score (β = -0.4, 95% CI, -0.6 to -0.2).

Conclusion: Male adolescent CCS had less favorable values of CVD risk factors compared to references. VPA in adolescent CCS is associated with clinically meaningful favorable values of CVD risk factors.

Keywords: accelerometry; cardiometabolic risk; cardiovascular disease risk; childhood cancer survivors; physical activity.