title: Subcutaneous adipose tissue plays a beneficial effect on subclinical atherosclerosis in young survivors of acute lymphocytic leukemia.
abstract: OBJECTIVE
  The aim of this study was to evaluate the relationship between body composition, metabolic profile, adipokines, and carotid intima-media thickness (cIMT) in young survivors of childhood acute lymphocytic leukemia (ALL).
  
  
  METHODS
  This cross-sectional study compared 55 ALL survivors, of chronological age between 15 years and 24 years, assigned into two groups according to the exposure to cranial radiation therapy (CRT; 25 irradiated and 30 nonirradiated) with 24 leukemia-free controls, and assessed body fat mass (dual-energy X-ray absorptiometry), computed tomography scan-derived abdominal adipose tissue, lipid profile, blood pressure (BP), adipokines, and cIMT by a multiple regression analysis.
  
  
  RESULTS
  Treatment with CRT had an effect on all of the variables derived from the computed tomography scan: visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) (P<0.050). In a multiple linear regression model, cIMT positively correlated with exposure to CRT (P=0.029), diastolic BP (P=0.016), and leptin-to-adiponectin ratio (P=0.048), while negatively related to SAT (P=0.007).
  
  
  CONCLUSIONS
  In young survivors of childhood ALL, CRT modified the distribution of fat and played a critical role in determining cIMT. Leptin-to-adiponectin ratio, a biomarker of abdominal obesity and metabolic syndrome, and diastolic BP also influenced cIMT, a marker of subclinical atherosclerosis. Nonetheless, adiposity-associated vascular disease might be attenuated by SAT. Changes in body fat must be evaluated in this group of patients in the early course of survivorship in order to avoid premature cardiovascular disease associated with atherosclerosis. Yet, further research as regards the possible protective effect of SAT on vascular disease is warranted.
authors: Division of Pediatric Endocrinology, Department of Pediatrics, Federal University of Sao Paulo (UNIFESP/EPM), Sao Paulo, Brazil ; Pediatric Oncology Institute - IOP/GRAACC, Federal University of Sao Paulo (UNIFESP/EPM), Sao Paulo, Brazil.
authors: Adriana Aparecida
authors: AA
authors: Siviero-Miachon
authors: Division of Pediatric Endocrinology, Department of Pediatrics, Federal University of Sao Paulo (UNIFESP/EPM), Sao Paulo, Brazil ; Pediatric Oncology Institute - IOP/GRAACC, Federal University of Sao Paulo (UNIFESP/EPM), Sao Paulo, Brazil.
authors: Angela Maria
authors: AM
authors: Spinola-Castro
authors: Pediatric Oncology Institute - IOP/GRAACC, Federal University of Sao Paulo (UNIFESP/EPM), Sao Paulo, Brazil.
authors: Maria Lucia
authors: ML
authors: de Martino Lee
authors: Private Office, Castro Monteiro, Sao Paulo, Brazil.
authors: Carlos Manoel
authors: CM
authors: de Castro Monteiro
authors: Division of Cardiology, Federal University of Sao Paulo (UNIFESP/EPM), Brazil.
authors: Antonio Carlos
authors: AC
authors: de Camargo Carvalho
authors: Laboratory of Investigation on Metabolism and Diabetes (LIMED), Faculty of Medical Sciences, State University of Campinas (UNICAMP), Brazil.
authors: Antonio Ramos
authors: AR
authors: Calixto
authors: Laboratory of Investigation on Metabolism and Diabetes (LIMED), Faculty of Medical Sciences, State University of Campinas (UNICAMP), Brazil.
authors: Bruno
authors: B
authors: Geloneze
authors: Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Brazil.
authors: Gil
authors: G
authors: Guerra-Junior
mesh_terms: D015502:Absorptiometry, Photon; D052242:Adiponectin / Q000097:blood; D050154:Adiposity; D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D002340:Carotid Artery Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D016371:Cranial Irradiation / Q000009:adverse effects; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology / Q000528:radiation effects*; D020738:Leptin / Q000097:blood; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis / Q000532:radiotherapy*; D011237:Predictive Value of Tests; D012307:Risk Factors; D050151:Subcutaneous Fat / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology / Q000528:radiation effects*; D017741:Survivors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D015415:Biomarkers; D020738:Leptin
keywords: abdominal fat; adipokines; atherosclerosis; endothelium; metabolic syndrome X; precursor cell lymphoblastic leukemia–lymphoma/radiotherapy