title: Cranial radiotherapy predisposes to abdominal adiposity in survivors of childhood acute lymphocytic leukemia.
abstract: BACKGROUND
  Advances in treatment of acute lymphocytic leukemia increased the likelihood of developing late treatment-associated effects, such as abdominal adiposity, increasing the risk of cardiovascular disease in this population. Cranial radiotherapy is one of the factors that might be involved in this process. The aim of this study was to determine the effect of cranial radiotherapy on adiposity indexes in survivors of acute lymphocytic leukemia.
  
  
  METHODS
  A comparative cross-sectional study of 56 acute lymphocytic leukemia survivors, chronological age between 15 and 24 years, assigned into two groups according to the exposure to cranial radiotherapy (25 irradiated and 31 non-irradiated), assessed according to body fat (dual energy X-ray absorptiometry), computed tomography scan-derived abdominal adipose tissue, lipid profile, and insulin resistance.
  
  
  RESULTS
  Cranial radiotherapy increased body fat and abdominal adipose tissue and altered lipid panel. Yet, lipids showed no clinical relevance so far. There were significantly more obese patients among those who received cranial radiotherapy (52% irradiated versus 22.6% non-irradiated), based on dual energy X-ray absorptiometry body fat measurements. Nonetheless, no association was observed between cranial radiotherapy and body mass index, waist circumference, waist-to-height ratio or insulin resistance.
  
  
  CONCLUSIONS
  Adolescent and young adult survivors of childhood acute lymphocytic leukemia showed an increase in body fat and an alteration of fat distribution, which were related to cranial radiotherapy. Fat compartment modifications possibly indicate a disease of adipose tissue, and cranial radiotherapy imports in this process.
authors: UNIFESP/EPM, Department of Pediatrics, Division of Pediatric Endocrinology, Federal University of Sao Paulo, Sao Paulo, Brazil.
authors: Adriana Aparecida
authors: AA
authors: Siviero-Miachon
authors: Angela Maria
authors: AM
authors: Spinola-Castro
authors: Maria Lúcia de Martino
authors: ML
authors: Lee
authors: Solange
authors: S
authors: Andreoni
authors: Bruno
authors: B
authors: Geloneze
authors: Henrique
authors: H
authors: Lederman
authors: Gil
authors: G
authors: Guerra-Junior
mesh_terms: D000005:Abdomen / Q000473:pathology; D050153:Abdominal Fat / Q000528:radiation effects*; D050154:Adiposity / Q000528:radiation effects*; D000293:Adolescent; D015992:Body Mass Index; D016371:Cranial Irradiation / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000528:radiation effects; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000532:radiotherapy*; D017741:Survivors / Q000706:statistics & numerical data; D055105:Waist Circumference; D055815:Young Adult