Document Detail


Characterization of insulin resistance in young adult survivors of childhood acute lymphoblastic leukaemia and non-Hodgkin lymphoma.
MedLine Citation:
PMID:  22967316     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION: An increased prevalence of metabolic disorders and cardiovascular (CV) disease has been reported in childhood acute lymphoblastic leukaemia (ALL) / Non-Hodgkin lymphoma (NHL) cancer survivors. OBJECTIVE: To characterize the determinants of insulin resistance (IR) observed in this population, according to the treatment received. METHODS: 91 patients (45 men, mean age: 24 ± 5 years; mean follow-up: 15 ± 5 years) previously treated for a childhood ALL (n=76) or NHL (n=15) were grouped according to their previous treatment: chemotherapy only (Group I; n=43), chemotherapy + cranial irradiation (CI) (Group II; n=32) and chemotherapy + bone marrow transplant (BMT) / total body irradiation (TBI) (Group III, n=16). RESULTS: A high prevalence of IR (HOMA-S < 60%) was observed in the BMT/TBI group (88%) compared to groups I (9%) and II (16%). The IR patients from groups [I+II] (12% of these groups) showed higher BMI, fat mass (FM) and visceral fat when compared with the non-IR patients. In contrast, the IR patients from group III had mean BMI and total FM similar to those of non-IR patients but showed a reduction of lean body mass and an increase in the relative proportion of trunk FM similar to the IR patients from groups [I+II]. This was associated with an altered lipid profile, high TNF-α and IL-6 levels, and reduced adiponectin levels compared to IR patients from group [I+II] and non-IR patients. CONCLUSION: Childhood ALL/NHL survivors treated by BMT/TBI frequently develop severe insulin resistance associated with peripheral-to-central fat redistribution, rather than increased total FM, and low adiponectin levels which may contribute to their increased CV risk. © 2012 Blackwell Publishing Ltd.
Authors:
Véronique Beauloye; Mélanie Steffens; Francis Zech; Christiane Vermylen; Dominique Maiter
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-12
Journal Detail:
Title:  Clinical endocrinology     Volume:  -     ISSN:  1365-2265     ISO Abbreviation:  Clin. Endocrinol. (Oxf)     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0346653     Medline TA:  Clin Endocrinol (Oxf)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 Blackwell Publishing Ltd.
Affiliation:
Pediatric Endocrinology, Université Catholique de Louvain, 1200, Brussels.
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