Abdominal obesity, liver fat, and muscle composition in survivors of childhood acute lymphoblastic leukemia.
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.
Janiszewski
Peter M
PM
School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada K7L 3N6.
Oeffinger
Kevin C
KC
Church
Timothy S
TS
Dunn
Andrea L
AL
Eshelman
Debra A
DA
Victor
Ronald G
RG
Brooks
Sandra
S
Turoff
Alicia J
AJ
Sinclair
Erin
E
Murray
Jeffrey C
JC
Bashore
Lisa
L
Ross
Robert
R
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*
D020738:Leptin; D007334:Insulin-Like Growth Factor I