Document Detail

Energy expenditure, energy intake and prevalence of obesity after therapy for acute lymphoblastic leukemia during childhood.
MedLine Citation:
PMID:  11044803     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To investigate the prevalence and potential risk factors of obesity after therapy for childhood acute lymphoblastic leukemia (ALL). STUDY DESIGN: 39 ALL patients (age 10.7-20.5 years) who were in first remission for 3.4-14.6 years after standardized treatment with chemotherapy plus cranial irradiation (n = 25) or with chemotherapy alone (n = 14) were examined. After fasting overnight, the following parameters were investigated: body mass index (BMI) of patients and their parents; patients' BMI before ALL therapy; serum free thyroxin, growth hormone-dependent factors, estradiol, testosterone, cortisol, leptin and c-peptide; fat-free mass (bioelectrical impedance); resting metabolic rate (RMR, indirect calorimetry); caloric intake (24-hour recall); and physical activity (questionnaire). RMR data were applied to the fat-free mass and compared with 83 controls. RESULTS: The prevalence of obesity (criterion: BMI > 2 SDS) was significantly (p < 0.05) higher after ALL therapy (38%; irradiated patients 48%, non-irradiated patients 21%) than before therapy (3%). Compared to non-irradiated patients, irradiated patients had significantly lower RMRs (-1.07 +/- 0.24 vs. -0.32 +/- 0.21 SDS; p < 0.05), reduced physical activity levels (1.41 +/- 0.03 vs. 1.52 +/- 0.03; p < 0.05), and lower concentrations of insulin-like growth factor-binding protein-3 (-0.65 +/- 0.17 vs. 0.25 +/- 0.33 SDS; p < 0.05) and of free thyroxin (1.17 +/- 0.06 vs. 1.38 +/- 0.08 ng/dl; p < 0.05). Caloric intake was adequate. CONCLUSIONS: After ALL during childhood, patients face a higher risk of obesity. In the cranially irradiated patients, the likely causes are low physical activity, RMRs and hormonal insufficiency.
E I Mayer; M Reuter; R E Dopfer; M B Ranke
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Hormone research     Volume:  53     ISSN:  0301-0163     ISO Abbreviation:  Horm. Res.     Publication Date:  2000  
Date Detail:
Created Date:  2000-11-15     Completed Date:  2000-11-30     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0366126     Medline TA:  Horm Res     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  193-9     Citation Subset:  IM    
Copyright Information:
Copyright 2000 S. Karger AG, Basel
University Children's Hospital, Tübingen, Germany.
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MeSH Terms
Basal Metabolism
Body Composition
Body Mass Index
C-Peptide / blood
Energy Intake*
Energy Metabolism*
Estradiol / blood
Hydrocortisone / blood
Leptin / analysis
Obesity / epidemiology*
Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy,  radiotherapy,  therapy*
Remission Induction
Testosterone / blood
Thyroxine / blood
Reg. No./Substance:
0/C-Peptide; 0/Leptin; 50-23-7/Hydrocortisone; 50-28-2/Estradiol; 58-22-0/Testosterone; 7488-70-2/Thyroxine

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