Prediabetes and associated risk of cardiovascular events and chronic kidney disease among adult survivors of childhood cancer

Little is known about the prevalence of prediabetes (fasting glucose 100-125 mg/dl and/or HbA1c 5.7-6.4%) and associated risk of cardiovascular events and chronic kidney disease (CKD) in survivors of childhood cancer. Analysis among 3529 adult survivors in the St Jude Lifetime cohort and 448 controls stratified by age found that prediabetes is highly prevalent among survivors. By age 40-49 years more than half of survivors had prediabetes (45.5%) or diabetes (14.0%). Compared with survivors with normal glucose control, those with prediabetes were at increased risk of future myocardial infarction (HR 2.4; 95% CI 1,2-4.8) and CKD (2.9; 1.04-8.15), while those with diabetes were also at increased risk of future cardiomyopathy (3.8; 1.4-10.5) and stroke (3.4; 1.3-8.9). The authors conclude that prediabetes, a modifiable risk factor among childhood cancer survivors, represents a new target for intervention that may prevent subsequent morbidity and mortality.