title: Visfatin is a positive predictor of bone mineral density in young survivors of acute lymphocytic leukemia.
abstract: Bone mass acquisition may be compromised in survivors of childhood acute lymphocytic leukemia due to various factors, including adiposity. Fat accumulation can affect bone through the direct effect of adipokines or indirectly through the state of chronic inflammation. The aim of this study was to evaluate the effect of body composition and adipokines on bone mass in survivors of acute lymphocytic leukemia. This was a cross-sectional study of 56 survivors aged between 15 and 24 years, 44.6 % of whom received cranial radiotherapy (18-24 Gy), assessed according to body fat, lean mass, and bone mineral density (dual energy X-ray absorptiometry), computed tomography scan-derived abdominal adipose tissue, and adipokines by a multiple regression analysis. Both lumbar spine L1-L4(trabecular bone) and total body (cortical bone) bone mineral density were positively correlated with visfatin (p < 0.050). Lean mass index was positively correlated, while waist-to-height ratio was negatively correlated with cortical bone (p < 0.010). Low bone mineral density for chronological age was detected in 5.4 % of patients in total body, and 8.9 % at the lumbar spine. In survivors of acute lymphocytic leukemia, visfatin may play an important role in the complex relationship between body composition and bone. At present, visfatin may represent a model for further study of bone metabolism, and could possibly explain the unknown mechanisms linking bone metabolism and cancer.
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, Federal University of Sao Paulo-UNIFESP/EPM, 307 Doutor Diogo de Faria Street, Sao Paulo, 04037-000, Brazil.|Pediatric Oncology Institute-IOP/GRAACC, UNIFESP/EPM, 743 Botucatu Street, Sao Paulo, 04023-062, Brazil.
authors.forename: Adriana Aparecida
authors.initials: AA
authors.lastname: Siviero-Miachon
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, Federal University of Sao Paulo-UNIFESP/EPM, 307 Doutor Diogo de Faria Street, Sao Paulo, 04037-000, Brazil. endocrino@angelaspinola.com.br.|Pediatric Oncology Institute-IOP/GRAACC, UNIFESP/EPM, 743 Botucatu Street, Sao Paulo, 04023-062, Brazil. endocrino@angelaspinola.com.br.
authors.forename: Angela Maria
authors.initials: AM
authors.lastname: Spinola-Castro
authors.affiliation: Pediatric Oncology Institute-IOP/GRAACC, UNIFESP/EPM, 743 Botucatu Street, Sao Paulo, 04023-062, Brazil.
authors.forename: Maria Lucia
authors.initials: ML
authors.lastname: de Martino Lee
authors.affiliation: Laboratory of Investigation on Metabolism and Diabetes-LIMED, Faculty of Medical Sciences, State University of Campinas-UNICAMP, 420 Carlos Chagas Street, Campinas, 13083-878, Brazil.
authors.forename: Antonio Ramos
authors.initials: AR
authors.lastname: Calixto
authors.affiliation: Laboratory of Investigation on Metabolism and Diabetes-LIMED, Faculty of Medical Sciences, State University of Campinas-UNICAMP, 420 Carlos Chagas Street, Campinas, 13083-878, Brazil.
authors.forename: Bruno
authors.initials: B
authors.lastname: Geloneze
authors.affiliation: Division of Endocrinology and Metabolism, Department of Medicine, Federal University of Sao Paulo-UNIFESP/EPM, 910 Pedro de Toledo Street, Sao Paulo, 04039-032, Brazil.
authors.forename: Marise
authors.initials: M
authors.lastname: Lazaretti-Castro
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medical Sciences, State University of Campinas-UNICAMP, "Zeferino Vaz" University City, 126 Tessalia Vieira de Camargo Street, Campinas, 13083-887, Brazil.
authors.forename: Gil
authors.initials: G
authors.lastname: Guerra-Junior
mesh_terms: D050154:Adiposity; D000293:Adolescent; D000328:Adult; D015519:Bone Density; D003430:Cross-Sectional Studies; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000378:metabolism*; D008297:Male; D054409:Nicotinamide Phosphoribosyltransferase / Q000097:blood*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood / Q000532:radiotherapy; D011237:Predictive Value of Tests; D017741:Survivors
chemical_list: D016207:Cytokines; D054409:Nicotinamide Phosphoribosyltransferase; C085455:nicotinamide phosphoribosyltransferase, human
keywords: Adipokines; Body composition; Bone density; Metabolic syndrome X; Precursor cell lymphoblastic leukemia–lymphoma/complications