title: Atherogenic low density lipoprotein phenotype in long-term survivors of childhood acute lymphoblastic leukemia.
abstract: Survivors of childhood acute lymphoblastic leukemia (ALL) have an increased risk of cardiovascular disease. Small density lipoproteins are atherogenic but have not been studied in this population. We conducted a cross-sectional analysis of 110 ALL survivors (mean age, 24.3 years) to determine prevalence of small dense LDL (pattern B) phenotype in ALL survivors and identify associated factors. Lipid subfractions were measured using Vertical Auto Profile-II. Participants with greater than 50% of LDL-cholesterol (LDL-c) in small dense LDL fractions (LDL(3+4)) were classified as LDL pattern B. Visceral and subcutaneous adipose tissue (VAT, SAT) volumes were also measured by computed tomography. While the mean LDL-c level of ALL survivors was 108.7 ± 26.8 mg/dl, 36% (40/110) of survivors had atherogenic LDL pattern B. This pattern was more common in males (26/47; 55%) than in females (14/63; 22%, P = 0.001) and more common in survivors treated with cranial radiotherapy (15/33; 45%) than in those who were treated with chemotherapy alone (25/77; 33%; P = 0.04, adjusted for age, gender, history of hypertension, and smoking history). VAT was associated with atherogenic lipids: LDL pattern B and LDL(3+4) levels. This association was independent of other measures of body fat. We conclude that a substantial proportion of ALL survivors had an atherogenic LDL phenotype despite normal mean LDL-c levels. An atherogenic LDL phenotype may contribute to the increase in cardiovascular mortality and morbidity in this population.
authors.affiliation: Mount Sinai Medical Center, New York, NY, USA.
authors.forename: Jyoti
authors.initials: J
authors.lastname: Malhotra
authors.forename: Emily S
authors.initials: ES
authors.lastname: Tonorezos
authors.forename: Marina
authors.initials: M
authors.lastname: Rozenberg
authors.forename: Gloria L
authors.initials: GL
authors.lastname: Vega
authors.forename: Charles A
authors.initials: CA
authors.lastname: Sklar
authors.forename: Joanne
authors.initials: J
authors.lastname: Chou
authors.forename: Chaya S
authors.initials: CS
authors.lastname: Moskowitz
authors.forename: Debra A
authors.initials: DA
authors.lastname: Eshelman-Kent
authors.forename: Peter
authors.initials: P
authors.lastname: Janiszewski
authors.forename: Robert
authors.initials: R
authors.lastname: Ross
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Oeffinger
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D008077:Lipoproteins, LDL / Q000097:blood* / Q000235:genetics; D008297:Male; D010641:Phenotype; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood* / Q000175:diagnosis / Q000235:genetics; D017741:Survivors; D055815:Young Adult
chemical_list: D008077:Lipoproteins, LDL