美国圣犹德儿童研究医院Yutaka Yasui、Yadav Sapkota等研究人员合作发现，遗传风险评分加强对儿童癌症成年幸存者严重肥胖的风险预测。2022年7月25日，《自然—医学》杂志在线发表了这项成果。

研究人员展示了遗传风险评分（GRS）对增加预测那些成年后有严重肥胖风险（身体质量指数≥40 kg m^-2）的儿童癌症幸存者的贡献。在圣裘德终身队列研究中的2,548名欧洲血统的儿童癌症5年幸存者中，研究人员发现GRS与严重肥胖的几率高53倍有关。将GRS加入到基于癌症治疗暴露和生活方式因素的风险预测模型中，分析结果显著提高了模型的预测能力（曲线下面积从0.68增加到0.75，从而识别出4.3倍的高风险幸存者），这在儿童癌症幸存者研究的6,064人中得到了独立验证。遗传预测器改善了对那些可以从加强监测和干预中受益的病人的识别，从而可减轻严重肥胖和相关心脑代谢并发症的风险。

据悉，儿童癌症成年幸存者的肥胖率很高，再加上特定癌症疗法的心脏毒性作用，使他们处于心血管疾病的高风险之中。

附：英文原文

Title: Genetic risk score enhances the risk prediction of severe obesity in adult survivors of childhood cancer

Author: Sapkota, Yadav, Qiu, Weiyu, Dixon, Stephanie B., Wilson, Carmen L., Wang, Zhaoming, Zhang, Jinghui, Leisenring, Wendy, Chow, Eric J., Bhatia, Smita, Armstrong, Gregory T., Robison, Leslie L., Hudson, Melissa M., Delaney, Angela, Yasui, Yutaka

Issue&Volume: 2022-07-25

Abstract: Adult survivors of childhood cancer have high rates of obesity, which, in combination with the cardiotoxic effects of specific cancer therapies, places them at high risk for cardiovascular morbidity. Here we show the contribution of genetic risk scores (GRSs) to increase prediction of those survivors of childhood cancer who are at risk for severe obesity (body mass index ≥40kgm2) as an adult. Among 2,548 individuals of European ancestry from the St. Jude Lifetime Cohort Study who were 5-year survivors of childhood cancer, the GRS was found to be associated with 53-fold-higher odds of severe obesity. Addition of GRSs to risk prediction models based on cancer treatment exposures and lifestyle factors significantly improved model prediction (area under the curve increased from 0.68 to 0.75, resulting in the identification of 4.3-times more high-risk survivors), which was independently validated in 6,064 individuals from the Childhood Cancer Survivor Study. Genetic predictors improve identification of patients who could benefit from heightened surveillance and interventions to mitigate the risk of severe obesity and associated cardio-metabolic complications.

DOI: 10.1038/s41591-022-01902-3

Source: https://www.nature.com/articles/s41591-022-01902-3