LAUSR

BACKGROUND Survivors of childhood brain tumours (SCBT) and teenage and young adult cancer survivors have an adverse cardiovascular risk profile, which translates into an increased vascular mortality. Data on cardiovascular risk profile in SCBT are limited and furthermore there are no data in adult-onset brain tumours. PATIENTS AND METHODS Fasting lipids, glucose, insulin, 24-hour blood pressure, and body composition were measured in 36 brain tumours survivors [20 adult-onset (AO); 16 childhood-onset (CO)] and 36 age- and gender-matched controls. RESULTS Compared with controls, patients had elevated total cholesterol (5.3±1.1 Vs. 4.6±1.0mmol/l, p=0.007), LDL-C (3.1±0.8 Vs. 2.7±0.9mmol/l, p=0.011), insulin (13.4±13.1 Vs. 7.6±3.3miu/l, p=0.014) and increased insulin resistance (HOMA-IR 2.90±2.84 Vs. 1.66±0.73, p=0.016). Patients showed adverse body composition, with increased total body fat mass (FM) (24.0±12.2 Vs. 15.7±6.6kg, p<0.001) and truncal FM (13.0±6.7 Vs. 8.2±3.7kg, p<0.001). After stratification by timing of onset, CO survivors showed significantly increased LDL-C, insulin, and HOMA-IR compared with controls. Body composition was characterized by increased total body and truncal FM. Truncal fat mass was increased by 84.1% compared with controls. AO survivors showed similar adverse cardiovascular risk profile, with increased total cholesterol and HOMA-IR. Truncal fat mass was increased by 41.0% compared with matched controls (p=0.029). No difference in mean 24hr BP was noted between patients and controls irrespective of timing of cancer diagnosis. CONCLUSION The phenotype of both CO and AO brain tumour survivors is characterized by an adverse metabolic profile and body composition, putatively placing long-term survivors at increased risk of vascular morbidity and mortality.