Body composition in young adult survivors of childhood acute lymphoblastic leukaemia.
OBJECTIVE
Obesity is frequently reported in patients treated for childhood leukaemia. Obesity, particularly abdominal obesity, is one of the main characteristics of the metabolic syndrome and a risk factor for cardiovascular disease and non-insulin-dependent diabetes mellitus (NIDDM).


METHODS
All patients treated for acute lymphoblastic leukaemia (ALL) before the onset of puberty in the region of western Sweden, between 1973 and 1985, and in first remission, were included. 35 out of 47 patients aged 20-32 years participated. 19 patients had received cranial radiotherapy, and the median follow-up time was 20 years. The focus of this report was to study body composition and signs of the metabolic syndrome and correlate the findings to spontaneous growth hormone (GH) secretion.


METHODS
Body composition was assessed using dual-energy X-ray absorbtiometry (DEXA). We analyzed serum concentrations of insulin, glucose, leptin and lipids.


RESULTS
No patient was obese according to World Health Organization criteria (body mass index, BMI > or = 30 kg/m2) but one-third were overweight (BMI 25-29.9 kg/m2). The maximal GH peak during 24 h (GHmax) was correlated to percentage of total body fat (r = -0.42; P = 0.017), trunk fat (r = -0.5; P = 0.005) and fat-free mass (r = 0.42; P = 0.017). GHmax was also correlated to s-triglycerides (r = -0.54; P = 0.001), low-density lipoprotein-cholesterol (r = -0.382; P = 0.024) and high-density lipoprotein-cholesterol (r = 0.45; P = 0.007).


CONCLUSIONS
We found little effect on BMI but an increased percentage of total body fat, especially trunk fat, and a tendency for an unfavourable lipid profile in adult survivors of childhood leukaemia. These findings were related to low endogenous GH secretion due to cranial irradiation.
Jarfelt
M
M
Department of Pediatrics, Division of Haematology and Oncology, Göteborg Paediatric Growth Research Center, University of Göteborg, Göteborg, Sweden. marianne.jarfelt@vgregion.se
Lannering
B
B
Bosaeus
I
I
Johannsson
G
G
Bjarnason
R
R
D000273:Adipose Tissue; D000328:Adult; D001823:Body Composition; D015992:Body Mass Index; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007333:Insulin Resistance; D020738:Leptin / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D009765:Obesity / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000453:epidemiology / Q000532:radiotherapy*; D012074:Remission Induction; D012307:Risk Factors; D017741:Survivors; D049629:Waist-Hip Ratio
D020738:Leptin; D008055:Lipids