title: Prevalence and risk factors of the metabolic syndrome in adult survivors of childhood leukemia.
abstract: We evaluate the prevalence and risk factors of the metabolic syndrome (MS) in young adults surviving childhood leukemia. During the years 2007 to 2008, assessment of MS was proposed to all adults included in the Leucémie de l'Enfant et de l'Adolescent program, a French prospective multicentric cohort of leukemia survivors. Among 220 eligible patients, 184 (83.6%) had complete evaluation. Median age at evaluation and follow-up duration were 21.2 and 15.4 years. Overall prevalence of MS was 9.2% (95% confidence interval, 5.5-14.4). There was no association of MS with sex, age at diagnosis, leukemia subtype, steroid therapy, and central nervous system irradiation. Patients were stratified according to 4 therapeutic modalities: chemotherapy alone (n = 97), chemotherapy and central nervous system irradiation (n = 27), hematopoietic stem cell transplantation (HSCT) without (n = 17) or with (n = 43) total body irradiation (TBI). MS occurred in 5.2%, 11.1%, 5.9%, and 18.6% of them, respectively. The higher risk observed in the HSCT-TBI group was significant in univariate and in multivariate analysis (odds ratio [OR] = 3.9, P = .03). HSCT with TBI was associated with a higher rate of hypertriglyceridemia (OR = 4.5, P = .004), low level of high-density lipoprotein cholesterol (OR = 2.5, P = .02), and elevated fasting glucose (OR = 6.1, P = .04) So, TBI is a major risk factor for MS. Further studies are warranted to explain this feature.
authors.affiliation: Department of Pediatric Hematology, Hôpital de la Timone Enfants, Marseille, France. oudinc@marseille.fnclcc.fr
authors.forename: Claire
authors.initials: C
authors.lastname: Oudin
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Simeoni
authors.forename: Nicolas
authors.initials: N
authors.lastname: Sirvent
authors.forename: Audrey
authors.initials: A
authors.lastname: Contet
authors.forename: Audrey
authors.initials: A
authors.lastname: Begu-Le Coroller
authors.forename: Pierre
authors.initials: P
authors.lastname: Bordigoni
authors.forename: Catherine
authors.initials: C
authors.lastname: Curtillet
authors.forename: Maryline
authors.initials: M
authors.lastname: Poirée
authors.forename: Isabelle
authors.initials: I
authors.lastname: Thuret
authors.forename: Barbara
authors.initials: B
authors.lastname: Play
authors.forename: Mara Carazza
authors.initials: MC
authors.lastname: Massot
authors.forename: Pascal
authors.initials: P
authors.lastname: Chastagner
authors.forename: Hervé
authors.initials: H
authors.lastname: Chambost
authors.forename: Pascal
authors.initials: P
authors.lastname: Auquier
authors.forename: Gérard
authors.initials: G
authors.lastname: Michel
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015228:Hypertriglyceridemia / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000378:metabolism; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013256:Steroids / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D001786:Blood Glucose; D008076:Cholesterol, HDL; D013256:Steroids