{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T10:09:45Z","timestamp":1790244585410,"version":"4.1.0"},"reference-count":72,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000038","name":"Natural Sciences and Engineering Research Council of Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000038","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Elevated visceral fat is associated with poor cardiovascular health but is not well characterized in survivors of childhood cancer. We examined central adiposity and associated risk factors in a pediatric acute lymphoblastic leukemia (ALL) survivorship cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Visceral adipose tissue (VAT) mass and estimated waist circumference (WC) were extracted from dual energy x\u2010ray absorptiometry (DXA) scans on 70 survivors of pediatric ALL &gt;10 years from diagnosis. Waist\u2010to\u2010height ratios (WHtRs), a body shape index (ABSI), ABSI\n                      <jats:italic>z<\/jats:italic>\n                      scores, and descriptive statistics were calculated to examine central adiposity. We tested sensitivity\/specificity of WHtR at established thresholds for identifying VAT \u226585th percentile (%le).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      VAT\n                      <jats:italic>z<\/jats:italic>\n                      scores were shifted positively relative to population norms with 25.7%\u00a0\u2265\u00a085th %le. Mean WHtR was 0.55\u00a0\u00b1\u00a00.06 with 82.9% above the \u201ctake action\u201d threshold of 0.5. A WHtR \u22650.59 had a sensitivity of 90.2% (95% CI 82.0\u201398.4) and specificity of 68.4% (95% CI 47.5\u201389.3) for identifying individuals with VAT \u226585th %le. The mean ABSI\n                      <jats:italic>z<\/jats:italic>\n                      score was 1.88\u00a0\u00b1\u00a00.85; higher in women, in high risk ALL, and post\u2010cranial radiation (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.01\u20130.02). The ABSI\n                      <jats:italic>z<\/jats:italic>\n                      scores for 94.3% of survivors fell in the highest quintile of population values.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Nearly the entire cohort of long\u2010term survivors of pediatric ALL have an elevated WC relative to height, weight, and population norms, regardless of their body mass index (BMI) or visceral fat. This suggests that a broader screening approach, which considers waist indices, may be better able to detect those at increased cardiometabolic risk. Evaluation and confirmation in a larger prospective cohort is indicated.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pbc.32162","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T05:12:11Z","timestamp":1763442731000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Central Adiposity and Visceral Fat in Long\u2010Term Survivors of Acute Lymphoblastic Leukemia in Childhood and Adolescence: Exploration of an Underappreciated Risk"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2199-6869","authenticated-orcid":false,"given":"Louise","family":"Guolla","sequence":"first","affiliation":[{"name":"Department of Pediatrics McMaster University  Hamilton Canada"},{"name":"Department of Health Research Methodology Evidence &amp; Impact McMaster University  Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashlyn","family":"Chou","sequence":"additional","affiliation":[{"name":"Faculty of Medicine McMaster University  Hamilton Canada"},{"name":"Department of Nuclear Medicine McMaster University  Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Troy H.","family":"Farncombe","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine McMaster University  Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lehana","family":"Thabane","sequence":"additional","affiliation":[{"name":"Department of Pediatrics McMaster University  Hamilton Canada"},{"name":"Department of Health Research Methodology Evidence &amp; Impact McMaster University  Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Morrison","sequence":"additional","affiliation":[{"name":"Department of Pediatrics McMaster University  Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5711-7440","authenticated-orcid":false,"given":"Ronald D.","family":"Barr","sequence":"additional","affiliation":[{"name":"Department of Pediatrics McMaster University  Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,17]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(19)30800-9"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2018.10.010"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.024735"},{"issue":"11","key":"e_1_2_14_5_1","first-page":"849","article-title":"Obesity and Metabolic Disease After Childhood Cancer","volume":"29","author":"Barnea D.","year":"2015","journal-title":"Oncology (Williston Park)"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0000000000001988"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.16.3527"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.31191"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejendo\/lvad139"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0043269"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0000000000002566"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2008.11"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(24)00316-4"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-1825"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ijo.0801401"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-789X.2011.00952.x"},{"issue":"1","key":"e_1_2_14_17_1","first-page":"207","article-title":"A Proposal for a Primary Screening Tool: 'Keep Your Waist Circumference to Less Than Half Your Height","volume":"12","author":"Ashwell M.","year":"2014","journal-title":"BMC Medicine [Electronic Resource]"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/sms.12780"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0039504"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m3324"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-71302-5"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/obr.12666"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2024.1341476"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21114083"},{"key":"e_1_2_14_25_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgae282"},{"key":"e_1_2_14_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.4097"},{"key":"e_1_2_14_27_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2024.1305330"},{"key":"e_1_2_14_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010022\u201012284\u20104"},{"key":"e_1_2_14_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnesp.2021.10.001"},{"key":"e_1_2_14_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40200\u2010021\u201000743\u20100"},{"key":"e_1_2_14_31_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006-2178"},{"key":"e_1_2_14_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13098-024-01262-7"},{"key":"e_1_2_14_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.25276"},{"key":"e_1_2_14_34_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0007038"},{"key":"e_1_2_14_35_1","volume-title":"Visceral Fat Evaluation and Clinical Significance","author":"Kelly T. 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