The chance of osteopenia or osteoporosis may increase after childhood cancer treatment. of GC treatment for GVHD (OR, 1.12; 95% self-confidence period [CI], 1.05-1.20) and lower torso mass index (BMI) SDS (OR, 0.59; 95% CI, 0.36-0.95) were connected with decreased LBMD SDS. These results suggest that extended GC make use of and decrease in BMI are risk elements for reduced BMD in youth cancer survivors. Anticipatory suitable and follow-up treatment are essential, for the patients with risk factors especially. worth < 0.05 was regarded as significant statistically. SPSS for Screen (edition 18.0, SPSS Inc. Chicago, IL, USA) was employed for statistical evaluation. Distinctions in constant variables were analyzed using the College student t test. The differences in categorical factors between groups 60142-95-2 were analyzed by the Pearson's chi-square test and Fisher's exact test, as appropriate. Multivariate logistic regression analysis for decreased lumbar BMD and predictor variables was performed. Ethics statement The study protocol was reviewed and approved by the institutional review board of the Yeouido St. Mary's Hospital (No. SC13RISI0152). Informed consent was exempted by the board. RESULTS BMD measurement in male and female subjects 60142-95-2 The lumbar BMD (LBMD) SDS and femur neck BMD (FNBMD) SDS at initial BMD measurement were -0.91 1.41 and -1.13 1.79, respectively. The LBMD SDS at initial BMD measurement was -1.04 1.49 in boys and -0.80 1.35 in girls. Twenty (25.7%) patients had LBMD SDS lower than -2. Nineteen (24.4%) patients had FNBMD SDS lower than -2 (Table 2, Fig. 1). Fig. 1 BMD SDS distribution according to chronological 60142-95-2 age. CA, chronological age; LBMD, lumbar bone mineral density; FNBMD, femur neck bone mineral density; SDS, standard deviation score. Table 2 BMD measurement in subjected boys and girls Comparison of clinical parameters according to lumbar BMD SDS Fifty-eight (74.3%) patients had LBMD SDS greater than -2. The mean chronological age at cancer diagnosis was 9.1 3.5 yr in the patients with BMD SDS lower than -2, and 6.9 3.9 yr in the patients with BMD SDS greater than -2. The age at HSCT treatment was older in patients having LBMD SDS lower than -2 (10.2 2.9 vs 7.7 3.8). The mean chronological age at initial BMD measurement was 13.6 3.4 yr in the patients with BMD SDS lower than -2, and 12.0 3.3 yr in the patients with BMD SDS greater than -2. The duration of GC treatment for GVHD was longer in patients with LBMD SDS lower than -2 (21.0 20.8 vs 7.4 10.0). The duration of GC use for chemotherapy before HSCT, radiation dosage, BMI SDS, and IGF-1 weren't been shown to be statistically significant in relation to LBMD SDS (Desk 3). Desk 3 Assessment of medical and laboratory guidelines relating to lumbar BMD SDS There have been no variations in LBMD SDS and FNBMD SDS among ALL, AML, and additional disease organizations. The duration of GC treatment before HSCT was considerably much longer in 60142-95-2 the ALL group than additional disease organizations (2.0 1.5 months Vamp5 vs 0.2 0.7 months vs 0 month, < 0.001). The duration of GC treatment for GVHD had not been different among ALL, AML and additional disease organizations (3.5 9.2 months vs 10.0 16.1 months vs 2.2 1.six months). The patients treated with HSCT had lower LBMD SDS than those without HSCT (-1.17 1.39 vs -0.43 1.33, = 0.025). The patients diagnosed with cGVHD had lower LBMD SDS (-1.47 1.44 vs -0.57 1.30, = 0.006). The patients who received prolonged GC treatment for GVHD had lower LBMD SDS (-1.22 1.42 vs -0.56 1.32, = 0.037). However, neither radiation therapy nor hypogonadism had a significant impact on BMD difference (Fig. 2). Fig. 2 Clinical parameters of childhood cancer survivors with low bone mineral density. LBMD SDS, lumbar bone mineral.