title: Metabolic syndrome traits in long-term survivors of pediatric sarcoma.
abstract: OBJECTIVE
  The metabolic syndrome (MS), a cluster of central obesity, dyslipidemia, hyperglycemia, and hypertension, conveys an increased risk of type 2 diabetes and cardiovascular disease. This cross-sectional study investigated the prevalence of metabolic syndrome traits (MST) in long-term survivors of pediatric sarcoma (SARC) who received multi-modality therapy (MMT).
  
  
  METHODS
  Thirty-two SARC survivors (predominantly Ewings; median age 36.5; median age at MMT 15) underwent body composition, activity, and psychosocial analysis. Serum endocrine and inflammatory parameters and urine beta(2)-microglobulin (B2M) were evaluated. The prevalence of MST was compared to age- and gender-matched U.S. population data.
  
  
  RESULTS
  SARC survivors were more likely to have two or more MST (OR 2.38 95% CI: [1.14, 5.04]). Analysis of individual MST demonstrated higher prevalence of hypertension (OR 2.61 95% CI: [1.20, 5.59]), hypertriglyceridemia (OR 3.63 95% CI: [1.75, 7.60]), and male visceral abdominal obesity (20-39 years old OR 4.63 95% CI: [0.91, 21.63], 40-59 years old OR infinity). Survivors 18-39 years old had a higher prevalence of the MS (OR 4.29 95% CI: [1.50, 11.21]), defined as three or more MST. Plasminogen activator inhibitory activity (P = 0.016) and B2M (P = 0.027) increased with increasing numbers of MST. In males, total testosterone declined (P = 0.0027) as the number of MST increased. Average (P = 0.014) and maximum (P = 0.021) activity levels decreased as the number of MST increased.
  
  
  CONCLUSIONS
  After a median follow up of 17 years, adult SARC survivors of MMT had an increased prevalence of MST, especially those less than 40 years old. The development of MST in this population was associated with decreased testosterone and activity levels.
authors.affiliation: Center for Cancer Research, National Cancer Institute, NIH, Bethesda, Maryland, USA.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Hoffman
authors.forename: Joanne
authors.initials: J
authors.lastname: Derdak
authors.forename: Donna
authors.initials: D
authors.lastname: Bernstein
authors.forename: James C
authors.initials: JC
authors.lastname: Reynolds
authors.forename: Nilo A
authors.initials: NA
authors.lastname: Avila
authors.forename: Lynn
authors.initials: L
authors.lastname: Gerber
authors.forename: Seth M
authors.initials: SM
authors.lastname: Steinberg
authors.forename: George
authors.initials: G
authors.lastname: Chrousos
authors.forename: Crystal L
authors.initials: CL
authors.lastname: Mackall
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Mansky
mesh_terms: D000293:Adolescent; D000328:Adult; D001823:Body Composition; D001859:Bone Neoplasms / Q000378:metabolism / Q000473:pathology / Q000523:psychology; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000378:metabolism* / Q000473:pathology / Q000523:psychology; D012509:Sarcoma / Q000378:metabolism* / Q000473:pathology / Q000523:psychology; D012512:Sarcoma, Ewing / Q000378:metabolism / Q000473:pathology / Q000523:psychology