儿童癌症幸存者患血脂异常和动脉粥样硬化性心血管疾病（ASCVD）的风险增加。本研究的目的是评估儿童癌症幸存者中特定血脂异常的患病率和相关心血管风险。对 4,115 名 5 年幸存者进行了全面的血脂检测，其中 3,406 名（评估时的平均年龄为 35.2±10.4 岁）未患有血脂异常。既往血脂异常诊断，以及 624 名年龄、性别和种族/民族匹配的社区对照。既往未诊断的血脂异常，伴有异常 LDL-C (>160 mg/dL)、非 HDL-C (>190 mg/dL)、HDL -C（男性<40mg/dL，女性<50mg/dL）和甘油三酯（>150mg/dL）分别占4%、6%、30%和17%。与社区对照相比，既往未诊断出血脂异常的幸存者的 LDL-C 和非 HDL-C 较高，HDL-C 较低。颅脑放疗（对于非 HDL-C，RR 2.2，95% CI 1.6-3.0）和造血细胞移植全身照射（对于非 HDL-C，RR 6.7，95% CI 3.5-13.0；RR 9.9，95% CI甘油三酯（甘油三酯为 6.0-16.3）与血脂异常风险较高相关。低 HDL-C（HR 2.9，95%CI 1.8-4.7）和甘油三酯升高（HR 3.1，95%CI 1.9-5.1）的诊断与心肌梗死风险增加相关，而高 LDL-C 的诊断（HR 2.2）与心肌梗死风险增加相关。 ，95%CI 1.3-3.7），高非 HDL-C（HR 2.2，95%CI 1.3-3.7），低 HDL-C（HR 3.9，95%CI 2.8-5.4）和甘油三酯升高（HR 3.8， 95% CI 2.7-5.5）与心肌病风险增加相关。儿童癌症幸存者中先前未确诊的血脂异常与心肌梗死和心肌病风险增加相关。需要进行全面的血脂异常评估和治疗，以降低该人群的心血管发病率。© 作者 2023。由牛津大学出版社出版。版权所有。如需权限，请发送电子邮件至：journals.permissions@oup.com。

Childhood cancer survivors have increased risk of dyslipidemia and atherosclerotic cardiovascular disease (ASCVD). The aim of this study was to evaluate the prevalence and associated cardiovascular risks of specific lipid abnormalities among childhood cancer survivors.Comprehensive lipid panel measurements were obtained from 4,115 5-year survivors, with 3,406 (mean age at evaluation 35.2 ± 10.4 years) not having previous dyslipidemia diagnosis, as well as 624 age, sex, and race/ethnicity matched community controls.Previously undiagnosed dyslipidemia with abnormal LDL-C (>160 mg/dL), non-HDL-C (>190 mg/dL), HDL-C (<40 mg/dL for men, <50 mg/dL for women), and triglycerides (>150 mg/dL) were identified in 4%, 6%, 30%, and 17%, respectively. Survivors without previous dyslipidemia diagnosis had higher LDL-C and non-HDL-C and lower HDL-C than community controls. Cranial radiotherapy (RR 2.2, 95%CI 1.6-3.0 for non-HDL-C) and total body irradiation for hematopoietic cell transplantation (RR 6.7, 95%CI 3.5-13.0 for non-HDL-C; RR 9.9, 95%CI 6.0-16.3 for triglycerides) were associated with greater risk of dyslipidemia. Diagnoses of low HDL-C (HR 2.9, 95%CI 1.8-4.7) and elevated triglycerides (HR 3.1, 95%CI 1.9-5.1) were associated with increased risk for myocardial infarction, and diagnoses of high LDL-C (HR 2.2, 95%CI 1.3-3.7), high non-HDL-C (HR 2.2, 95%CI 1.3-3.7), low HDL-C (HR 3.9, 95%CI 2.8-5.4), and elevated triglycerides (HR 3.8, 95%CI 2.7-5.5) were associated with increased risk for cardiomyopathy.Previously undiagnosed dyslipidemia among childhood cancer survivors was associated with increased risk for myocardial infarction and cardiomyopathy. Comprehensive dyslipidemia evaluation and treatment are needed to reduce cardiovascular morbidity in this population.© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.