目的：儿童癌症幸存者存在心脏晚期效应的增加风险，而这些风险可以通过体育活动和健康程度来减轻。我们的目标是：（1）比较幸存者和对照组之间的心血管疾病（CVD）风险，以及（2）研究中度至剧烈体育活动（MVPA）、心肺健身度（CRF）和肌肉骨骼健身度（MSF）与CVD风险因素之间的关联是否在幸存者和对照组之间有所不同。方法：在儿童癌症幸存者体育活动（PACCS）研究中，我们评估了157名儿童癌症幸存者和113名年龄和性别匹配的对照组（9-18岁）的CVD风险因素（安卓型脂肪质量、收缩压、总胆固醇/高密度脂蛋白胆固醇和糖化血红蛋白水平）。我们使用多变量混合线性回归模型比较幸存者和对照组的CVD风险因素，并评估MVPA、CRF和MSF与CVD风险因素之间的关联。结果：与对照组相比，幸存者的安卓型脂肪质量更高（861 vs. 648 g，p=0.001），而收缩压更低（114 vs. 118 mmHg，p=0.002）。在幸存者中，MVPA、CRF和MSF与安卓型脂肪质量和总胆固醇/高密度脂蛋白胆固醇水平下降以及收缩压升高有关。幸存者和对照组中MVPA、CRF和MSF与CVD风险因素的关联相似（P交互作用>0.05），除了CRF和MSF与安卓型脂肪质量的关联，在幸存者中强度更高，对照组中更低（P交互作用≤0.001）。结论：由于儿童癌症幸存者的安卓型脂肪质量较高且与身体健康程度的关联更强，幸存者应该接受针对性干预措施以提高身体健康程度，以减少未来患CVD的风险。

Purpose: Childhood cancer survivors have increased risk of cardiac late effects that can be potentially mitigated by physical activity and fitness. We aimed to (1) compare cardiovascular disease (CVD) risk between survivors and controls, and (2) examine whether the associations of moderate-to-vigorous physical activity (MVPA), cardiorespiratory fitness (CRF), and musculoskeletal fitness (MSF) with CVD risk factors differed between survivors and controls. Methods: Within the Physical Activity in Childhood Cancer Survivors (PACCS) study, we assessed CVD risk factors (android fat mass, systolic blood pressure [SBP], total cholesterol/high-density lipoprotein [HDL]-cholesterol, and glycosylated hemoglobin) in 157 childhood cancer survivors and 113 age- and sex-matched controls aged 9-18 years. We used multivariable mixed linear regression models to compare CVD risk factors between survivors and controls, and assess associations of MVPA, CRF, and MSF with CVD risk factors. Results: Compared with controls, survivors had more android fat mass (861 vs. 648 g, p = 0.001) and lower SBP (114 vs. 118 mmHg, p = 0.002). MVPA, CRF, and MSF were associated with lower levels of android fat mass and total cholesterol/HDL-cholesterol, and higher SBP in survivors. Associations of MVPA, CRF, and MSF with CVD risk factors were similar in survivors and controls (Pinteraction > 0.05), except the associations of CRF and MSF with android fat mass, which were stronger in survivors than in controls (Pinteraction ≤ 0.001). Conclusion: Owing to higher levels of android fat mass and its stronger association with physical fitness in childhood cancer survivors compared with controls, survivors should get targeted interventions to increase fitness to reduce future risk of CVD.