title: Is there an increased risk of metabolic syndrome among childhood acute lymphoblastic leukemia survivors? A developing country experience.
abstract: Data on metabolic syndrome (MS) in survivors of childhood acute lymphoblastic leukemia (ALL) from developing countries are lacking. The purpose of this single-center, uncontrolled, observational study was to assess the frequency of MS in our survivors. The survivors of ALL ≤15 years at diagnosis, who had completed therapy ≥2 years earlier, were enrolled. Anthropometric measurements (weight, height, waist circumference), biochemistry (glucose, insulin, triglycerides, high-density lipoprotein [HDL], thyroid function tests, C-reactive protein [CRP], magnesium), measurement of blood pressure, and Tanner staging were performed. MS was defined by International Diabetes Federation (IDF) and the National Cholesterol Education Program Third Adult Treatment Panel guidelines (NCEP ATP III) criteria, modified by Cook et al. (Arch Pediatr Adolesc Med. 2003;157:821-827) and Ford et al. (Diabetes Care. 2005;28:878-881). The median age of 76 survivors was 11.9 years (interquartile range [IQR]: 9.6-13.5). Twenty-four (32%) survivors were obese or overweight. The prevalence of insulin resistance (17%), hypertension (7%), hypertriglyceridemia (20%), and low HDL (37%) was comparable to the prevalence in children/adolescents in historical population-based studies from India. The prevalence of MS ranged from 1.3% to 5.2%, as per different defining criteria. Cranial radiotherapy, age at diagnosis, sex, or socioeconomic status were not risk factors for MS. The prevalence of MS in survivors of childhood ALL, at a median duration of 3 years from completion of chemotherapy, was comparable to the reference population. The prevalence of being obese or overweight was, however, greater than historical controls.
authors.affiliation: a Hematology-Oncology Unit, Advanced Pediatric Center, Post Graduate Institute of Medical Education and Research , Chandigarh , India.
authors.forename: Sonali
authors.initials: S
authors.lastname: Mohapatra
authors.affiliation: a Hematology-Oncology Unit, Advanced Pediatric Center, Post Graduate Institute of Medical Education and Research , Chandigarh , India.
authors.forename: Deepak
authors.initials: D
authors.lastname: Bansal
authors.affiliation: b Growth and Anthropology Unit, Advanced Pediatric Center, Post Graduate Institute of Medical Education and Research , Chandigarh , India.
authors.forename: A K
authors.initials: AK
authors.lastname: Bhalla
authors.affiliation: c Biochemistry Unit, Department of Pediatrics, Advanced Pediatric Center, Post Graduate Institute of Medical Education and Research , Chandigarh , India.
authors.forename: Savita
authors.initials: S
authors.lastname: Verma Attri
authors.affiliation: d Department of Endocrinology , Post Graduate Institute of Medical Education and Research , Chandigarh , India.
authors.forename: Naresh
authors.initials: N
authors.lastname: Sachdeva
authors.affiliation: a Hematology-Oncology Unit, Advanced Pediatric Center, Post Graduate Institute of Medical Education and Research , Chandigarh , India.
authors.forename: Amita
authors.initials: A
authors.lastname: Trehan
authors.affiliation: a Hematology-Oncology Unit, Advanced Pediatric Center, Post Graduate Institute of Medical Education and Research , Chandigarh , India.
authors.forename: R K
authors.initials: RK
authors.lastname: Marwaha
mesh_terms: D000293:Adolescent; D002097:C-Reactive Protein / Q000032:analysis; D002648:Child; D003906:Developing Countries; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000209:etiology*; D009765:Obesity / Q000453:epidemiology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000378:metabolism / Q000401:mortality; D015995:Prevalence; D012306:Risk; D017741:Survivors; D014280:Triglycerides / Q000097:blood
chemical_list: D014280:Triglycerides; D002097:C-Reactive Protein
keywords: Body mass index; India; children; insulin resistance; lipid profile