title: Risk factors for diabetes mellitus and impaired glucose tolerance following allogeneic hematopoietic stem cell transplantation in pediatric patients with hematological malignancies.
abstract: Long-term surviving recipients of allogeneic hematopoietic stem cell transplantation (HSCT) often suffer from diabetes mellitus (DM). We sought to identify risk factors for the development of post-transplant DM and impaired glucose tolerance (IGT) in pediatric HSCT patients. Glucose tolerance statuses were evaluated in 22 patients aged 6.3-21.8 years who had received allogeneic HSCT between the ages of 0.8-13.5 years. Five patients were diagnosed as having type 2 DM, and treated with insulin or oral hypoglycemic agents. Five patients were included in the IGT group, and the remaining 12 children were in the normal glucose tolerance (NGT) group. The cumulative incidence of DM plus IGT was 11.6 % at 5 years and 69.3 % at 10 years. None of the patients were obese/overweight and none had a family history of DM. There were no significant differences in serum levels of leptin and adiponectin between the DM + IGT and the NGT groups. An average preprandial glucose levels in the DM + IGT group were significantly higher than those in the NGT group from preparative conditioning to 60 days after HSCT. In multivariate analysis, an age of ≥6 years at the time of HSCT was significantly associated with the development of DM + IGT. Additionally, careful follow-up is necessary, even for NGT patients.
authors.affiliation: Department of Pediatrics, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621, Japan.
authors.forename: Kanae
authors.initials: K
authors.lastname: Hirabayashi
authors.forename: Yozo
authors.initials: Y
authors.lastname: Nakazawa
authors.forename: Hiroki
authors.initials: H
authors.lastname: Matsuura
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Hara
authors.forename: Takashi
authors.initials: T
authors.lastname: Kurata
authors.forename: Koichi
authors.initials: K
authors.lastname: Hirabayashi
authors.forename: Shoji
authors.initials: S
authors.lastname: Saito
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yoshikawa
authors.forename: Miyuki
authors.initials: M
authors.lastname: Tanaka
authors.forename: Ryu
authors.initials: R
authors.lastname: Yanagisawa
authors.forename: Kazuo
authors.initials: K
authors.lastname: Sakashita
authors.forename: Kenichi
authors.initials: K
authors.lastname: Koike
mesh_terms: D054392:Adipokines / Q000097:blood; D000293:Adolescent; D001786:Blood Glucose; D002648:Child; D002675:Child, Preschool; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D005260:Female; D005947:Glucose / Q000378:metabolism; D018149:Glucose Intolerance / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D019337:Hematologic Neoplasms / Q000150:complications* / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D054392:Adipokines; D001786:Blood Glucose; D005947:Glucose