title: Abdominal obesity, liver fat, and muscle composition in survivors of childhood acute lymphoblastic leukemia.
abstract: BACKGROUND
  Survivors of childhood acute lymphoblastic leukemia (ALL) become obese, and are at increased risk for morbidity and mortality post therapy.
  
  
  OBJECTIVE
  We determined the association of cranial radiotherapy (CRT) and/or sex with levels of total, regional, and ectopic fat storage, metabolic risk, IGF-I, and leptin in adult ALL survivors.
  
  
  METHODS
  A cross-sectional analysis of 52 male (15 CRT treated) and 62 female (24 CRT treated) young adult ALL survivors was conducted.
  
  
  RESULTS
  We assessed levels of visceral fat, sc abdominal and thigh fat, and liver and muscle fat using computed tomography, total fat and lean body mass using dual-energy x-ray absorptiometry, and IGF-I and leptin levels by radioimmunoassay.
  
  
  RESULTS
  Controlled for age and race, ALL survivors treated with CRT had higher levels of abdominal and visceral fat, body fat percentage, metabolic risk (insulin resistance and dyslipidemia), and leptin but lower lean mass and IGF-I levels than non-CRT survivors (P </= 0.05 for each). Levels of IGF-I were inversely associated with total, abdominal, and visceral fat in both sexes (P < 0.05 for each). Female ALL survivors had less lean mass and visceral fat but higher total and sc abdominal fat than males (P < 0.05 for each). Neither sex nor CRT was associated with muscle and/or liver fat content (P > 0.1).
  
  
  CONCLUSIONS
  Among young adult ALL survivors, CRT is a risk factor for elevated total, abdominal, and visceral adiposity, a reduced fat-free mass, elevated metabolic risk, and altered IGF-I and leptin levels.
authors.affiliation: School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada K7L 3N6.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Janiszewski
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Oeffinger
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Church
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Dunn
authors.forename: Debra A
authors.initials: DA
authors.lastname: Eshelman
authors.forename: Ronald G
authors.initials: RG
authors.lastname: Victor
authors.forename: Sandra
authors.initials: S
authors.lastname: Brooks
authors.forename: Alicia J
authors.initials: AJ
authors.lastname: Turoff
authors.forename: Erin
authors.initials: E
authors.lastname: Sinclair
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Murray
authors.forename: Lisa
authors.initials: L
authors.lastname: Bashore
authors.forename: Robert
authors.initials: R
authors.lastname: Ross
mesh_terms: D050153:Abdominal Fat; D000328:Adult; D017668:Age of Onset; D001823:Body Composition; D050218:Body Fat Distribution; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D050152:Intra-Abdominal Fat; D020738:Leptin / Q000097:blood; D008099:Liver; D008297:Male; D009017:Morbidity; D018482:Muscle, Skeletal; D009765:Obesity / Q000453:epidemiology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000453:epidemiology*; D012307:Risk Factors; D017678:Sex Distribution; D017741:Survivors / Q000706:statistics & numerical data*
chemical_list: D020738:Leptin; D007334:Insulin-Like Growth Factor I