Impaired glucose tolerance and dyslipidaemia as late effects after bone-marrow transplantation in childhood.
BACKGROUND
This follow-up study aimed to assess the frequency of late effects on glucose and lipid metabolism after bone-marrow transplantation in childhood.


METHODS
23 long-term survivors (median age 20 years) were studied 3-18 years after bone-marrow transplantation and compared with 23 healthy controls matched for age and sex and with 13 patients in remission from leukaemia.


RESULTS
12 (52%) of the 23 bone-marrow transplantation patients had insulin resistance, including impaired glucose tolerance in six and type 2 diabetes in four. The core signs of the metabolic syndrome (hyperinsulinaemia and hypertriglyceridaemia combined), were found in nine (39%) of the bone-marrow transplantation patients compared with one (8%) of the 13 leukaemia patients and none of the healthy controls (p=0.0015). The frequency of insulin resistance increased with the time since bone-marrow transplantation. Abdominal obesity, but not overweight, was common among the patients with insulin resistance.


CONCLUSIONS
Long-term survivors of bone-marrow transplantation are at substantial risk of insulin resistance, impaired glucose tolerance, and type 2 diabetes even at normal weight and young age. They also develop typical signs of the metabolic syndrome. We advocate measurement of serum lipids, fasting blood glucose, and serum insulin for the follow-up of all patients who undergo transplants in childhood, to be continued regularly and possibly life-long.
Taskinen
M
M
Hospital for Children and Adolescents, University of Helsinki, Finland. mervi.taskinen@hus.fi
Saarinen-Pihkala
U M
UM
Hovi
L
L
Lipsanen-Nyman
M
M
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001786:Blood Glucose / Q000378:metabolism*; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D016022:Case-Control Studies; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology* / Q000378:metabolism; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D015228:Hypertriglyceridemia / Q000209:etiology*; D007328:Insulin / Q000097:blood / Q000378:metabolism; D007333:Insulin Resistance; D008297:Male; D009765:Obesity / Q000209:etiology
D001786:Blood Glucose; D007328:Insulin