Childhood cancer survivors with premature ovarian insufficiency have low bone mineral density at long term follow-up.
cross_sectional · Level IV
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- Record sourced from PubMed, PMID 42302906.
- Also identified by DOI 10.1016/j.bone.2026.117984.
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Abstract
Childhood cancer survivors (CCS) are reported to have decreased bone mineral density (BMD). Is premature ovarian insufficiency (POI) an important risk factor for low BMD in CCS at long term follow-up? Altogether 167 female CCS, median age 34 (19-57) years, treated for childhood cancer under age 18 years between 1964 and 2008, with a follow-up time of 25 (12-41) years, and 164 matched controls took part in this cross-sectional study, including blood samples, anthropometric measurements, dual-energy X-ray absorptiometry (DXA), and questionnaires. CCS with primary POI (n = 22) had lower BMD in lumbar spine L1-L4 1.13 (0.79-1.39) g/cm<sup>2</sup> compared with controls 1.20 (0.84-1.56) g/cm<sup>2</sup> (p = 0.005) and lower BMD in femoral neck 0.89 (0.72-1.16) g/cm<sup>2</sup> compared with controls 1.00 (0.69-1.48) g/cm<sup>2</sup> (p = 0.020). CCS with primary POI had significantly reduced levels of androgens and low BMI < 20 kg/m<sup>2</sup> (p = 0.003). Odds Ratio for a low BMD < - 1 SD in L1-L4 was increased among CCS with primary POI (2.76 (1.01-7.52)), but also after abdominal irradiation (3.42 (1.52-7.70)) and all irradiation (1.98 (1.05-3.76)). Female childhood cancer survivors are at risk of low BMD and POI is an additional risk factor at long term follow-up. Besides hypogonadism and insufficient Hormone Replacement Therapy (HRT), abdominal radiotherapy, low levels of androgens and low BMI may confer to the risk.