Accepted Article

Article Type: 3 Original Article - Australia, Japan, SE Asia

The Prevalence of Vitamin D deficiency is higher in adult survivors of childhood cancer. Short Title: Vitamin D in survivors of childhood cancer Kristen A Neville1,2 MBBS (Hons 1) FRACP PhD, Jan L Walker1,2 MBBS FRACP, Richard J Cohn2,3 MBBCH (RAND) DCH (SA) FCP (SA) FRACP, Christopher T Cowell4,5 MB FRCP (C) FRACP, Christopher P White2,6 MBBS FRACP. 1

Department of Endocrinology, Sydney Children’s Hospital, AUSTRALIA. School of Women’s & Children’s Health, University of New South Wales, AUSTRALIA. 3 Centre for Children’s Cancer and Blood Disorders, Sydney Children’s Hospital, AUSTRALIA 4 Kids Research Institute, The Children’s Hospital Westmead, AUSTRALIA 5 Faculty of Medicine, University of Sydney, AUSTRALIA 6 SEALS Clinical Chemistry & Endocrinology Prince of Wales Hospital, AUSTRALIA 2

Correspondence: Dr Kristen Neville Department of Endocrinology Sydney Children’s Hospital High St, Randwick NSW 2031 AUSTRALIA Ph: +61 2 9382 1456 Fax: +61 2 9382 1787 Email: [email protected] Keywords: Childhood Cancer (Late Effects), Vitamin D, Population, Abdominal Adiposity Acknowledgements: We acknowledge the help support and encouragement of the medical and nursing clinicians in the departments of Oncology and Endocrinology at the Sydney Children’s Hospital in carrying out this study, particularly Ms Karen Johnston, our clinical nurse consultant in late effects. We thank the Australian National Diabetes Survey (AusDiab) for the use of their raw patient data, which was used as

This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/cen.12721 This article is protected by copyright. All rights reserved.

Accepted Article

normative data for our adult subjects. We gratefully acknowledge the financial support from the Sydney Children’s Hospital Foundation to conduct this study.

Abstract: Background: It is unclear whether the rate of Vitamin D deficiency in paediatric cancer survivors is higher than in the background population, and whether this is of pathological significance

Patients and Methods: 25OHD was measured in a previously studied group of 208 survivors (n=108 paediatric 5-17 years, n=99 adults 18-39 years) and compared with paediatric (5-17 years; n=132) and adult controls (25-35 years; n=1393 from the AusDiab cohort) adjusted for age and gender. Relationships with treatment factors (irradiation, bone marrow transplantation and intensity of treatment) along with overweight/obesity (defined by BMI), abdominal adiposity (waist:height ratio >0.5) and hyperinsulinism or abnormal glucose tolerance (HI/aGT) were sought.

Results: 25OHD concentrations were similar in paediatric survivors compared with controls (64.3 ±21.6nmol/L vs. 66.3 ±22.8nmol/L), with no effect of age or gender. Adjusted for gender, rates of 25OHD deficiency (< 50nmol/L) were higher in adult survivors compared with Ausdiab controls (42.4% vs. 20.8%; p0.5) HI/aGT

aGT

1% (1) 0

Characteristics unique to survivors alone Years Since First Oncological Diagnosis Diagnosis, n (%)* ALL AML NHL HD Brain Tumour Neuroblastoma Wilms Soft Tissue Sarcomas Bone Tumours Other Intensity of oncological treatment rating(19)

13.8 [5.8-17.9] p

The prevalence of Vitamin D deficiency is higher in adult survivors of childhood cancer.

It is unclear whether the rate of vitamin D deficiency in paediatric cancer survivors is higher than in the background population, and whether this is...
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