title: [Markers of metabolic syndrome and peptides regulating metabolism in survivors of childhood acute lymphoblastic leukemia].
abstract: Along with the growing epidemic of overweight the risk of atherosclerosis, cardiovascular disease morbidity and mortality are increasing markedly. Metabolic syndrome (MS) is a condition clustering together several risk factors of those complications such as visceral obesity, glucose intolerance, arterial hypertension and dislipidemia. The risk of obesity in acute lymphoblastic leukemia (ALL) survivors is higher than in general population. We aimed to assess (1) the relationships between chosen adipokines and neuropeptides, chemotherapy, CRT, and body fatness and (2) evaluate adipokines and neuropeptides concentrations as a new markers of MS in children. We conducted cross-sectional evaluation of 82 ALL survivors (median age: 13.2 years; range: 4,8-26,2; median time from treatment: 3.2 years), including fasting laboratory testing: peptides (leptin, GLP-1, orexin, PYY, apelin), total cholesterol and its fractions, triglycerides; anthropometric measurements (weight, height), systolic and diastolic blood pressure. We estimated percentiles of body mass index and percentiles of blood pressure. Between 82 survivors overweight and diastolic hypertension was diagnosed in 31% of patients (35% in CRT group) and 15% respectively. At least one abnormality in lipids concentrations was found in 43%. Girls were more affected than boys. Statistically significant increased in leptin and apelin concentrations and decreased in soluble leptin receptor concentrations in the overweight group were observed compared to the non overweight subjects. Significant increase in orexin levels in females who had received CRT compared to those who had not received CRT was found. CRT is the main risk factor of elevated of body mass among survivors of childhood leukemia. Dyslipidemia and hypertension, along with increased adiposity indicate higher risk of MS development. Girls are more affected than boys. Leptin, orexin and apelin seem to be good markers of increased adiposity especially after CRT. Higher leptin levels may be related to central resistance to those peptides. Survivors of childhood acute lymphoblastic leukemia should be screened for markers of the metabolic syndrome.
authors.affiliation: Zakład Immunologii Klinicznej, Katedry Immunologii Klinicznej i Transplantologii, Polsko-Amerykański Instytut Pediatrii, Collegium Medicum Uniwersytetu Jagiellońskiego, Kraków. skoczenkr@interia.pl
authors.forename: Szymon
authors.initials: S
authors.lastname: Skoczeń
authors.forename: Przemysław
authors.initials: P
authors.lastname: Tomasik
authors.forename: Walentyna
authors.initials: W
authors.lastname: Balwierz
authors.forename: Marcin
authors.initials: M
authors.lastname: Surmiak
authors.forename: Krystyna
authors.initials: K
authors.lastname: Sztefko
authors.forename: Danuta
authors.initials: D
authors.lastname: Galicka-Latała
mesh_terms: D054392:Adipokines / Q000097:blood*; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000453:epidemiology; D047908:Intracellular Signaling Peptides and Proteins / Q000097:blood; D020738:Leptin / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000453:epidemiology; D009479:Neuropeptides / Q000097:blood*; D009765:Obesity / Q000097:blood / Q000453:epidemiology; D000068797:Orexins; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood* / Q000453:epidemiology / Q000532:radiotherapy; D012307:Risk Factors; D055815:Young Adult
chemical_list: D054392:Adipokines; D015415:Biomarkers; D047908:Intracellular Signaling Peptides and Proteins; D020738:Leptin; D009479:Neuropeptides; D000068797:Orexins