Prevalence and determinants of dyslipidemia in 2338 Dutch childhood cancer survivors: a DCCSS-LATER 2 study

Bolier M; Pluimakers VG; DTC de Winter; Fiocco M; Berg SAA van den; Bresters D; Broeder E van Dulmen-den; Heiden-van  Loo M van der; Hofer I; Janssens GO; Kremer LCM; Loonen JJ; Louwerens M; Pal HJ van der; Pluijm SMF; Tissing WJE; HM van Santen; ACH de Vries; Lely AJ van der; Heuvel-Eibrink MM van den; Neggers SJCMM

doi:10.1530/ey.22.9.7

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ESPE Yearbook of Paediatric Endocrinology (2025) 22 9.7 | DOI: 10.1530/ey.22.9.7

ESPEYB25 9. Oncology and Chronic Disease Metabolic Health after Childhood Cancer (1 abstracts)

9.7. Prevalence and determinants of dyslipidemia in 2338 Dutch childhood cancer survivors: a DCCSS-LATER 2 study

Bolier M , Pluimakers VG , de Winter DTC , Fiocco M , van den Berg SAA , Bresters D , van Dulmen-den Broeder E , van der Heiden-van der Loo M , Höfer I , Janssens GO , Kremer LCM , Loonen JJ , Louwerens M , van der Pal HJ , Pluijm SMF , Tissing WJE , van Santen HM , de Vries ACH , van der Lely AJ , van den Heuvel-Eibrink MM & Neggers SJCMM

Eur J Endocrinol. 2024 Nov 27;191(6):588-603. PMID: 39564675. doi: 10.1093/ejendo/lvae149. [email protected]; [email protected]

Brief summary: This cross-sectional analysis from the nationwide Dutch Childhood Cancer Survivor LATER 2 Study (DCCSS-LATER2) assessed dyslipidemia among 2,338 adult survivors of childhood cancer (51% male; median age 34.7 years; median follow-up 27.1years). Normative data from 132,226 adults without cancer history from the Lifelines cohort were used as a reference. Logistic regression compared the odds of dyslipidemia between groups (adjusted for age, sex and BMI). Multivariable models identified determinants of dyslipidemia, such as treatment exposures and lifestyle factors.

Childhood cancer survivors had higher odds of dyslipidemia than the reference population, 20.6% had elevated triglycerides (>1.7 mmol/l), 30.3% had low HDL-cholesterol (<1.0 mmol/l in males; <1.3 mmol/l in females), 29.9% had with high total cholesterol (>5.2 mmol/l), 7.3% had high LDL-cholesterol (>4.1 mmol/l), and 7.7% had elevated apolipoprotein-B (>130 mg/dl).

Independent predictors of dyslipidemia included: male sex, older age, higher BMI, smoking, and low physical activity. Treatment-related determinants were abdominal/pelvic RT, cranial RT, total body irradiation, alkylating chemotherapy and secondary endocrine disorders (growth hormone deficiency, diabetes mellitus).

Comment: This study confirms that childhood cancer survivors have an increased risk of dyslipidemia, with nearly one-third having abnormal HDL or cholesterol levels. The analysis, based on a large and representative cohort with long-term follow-up, enhances the generalizability of the findings. The increased risk is driven by both treatment-related exposures and lifestyle factors, highlighting the need for survivor-focused cardiovascular screening and preventive care. This underscores the importance of structured follow-up and early intervention to reduce long-term morbidity and mortality in this vulnerable population. Longitudinal studies are needed to understand the evolution of lipid profiles over time and to evaluate the effectiveness of risk-reduction strategies.