title: The metabolic syndrome and its components in pediatric survivors of allogeneic hematopoietic stem cell transplantation.
abstract: Metabolic syndrome (MetS) is a known complication after hematopoietic stem cell transplantations (HSCT) that contributes to long-term morbidity. We assessed the prevalence of components of the MetS in pediatric survivors of allogeneic HSCT and identified associated risk factors. Thirty-eight patients, median age at HSCT, 8.5 years, were evaluated at a median of 3.9 years post-HSCT. Overweight or obesity was seen in 23.7% of the patients, 15.8% had hypertension, 15.8% had hypertriglyceridemia, and 13% had low high-density lipoprotein cholesterol levels according to age and gender. Four (10.5%) met the criteria of MetS; all were transplanted for malignant disease. Twelve patients (31.6%) had at least one component of the MetS. The 5-year probability of developing components of the MetS revealed that patients with BMI-Z score ≥0 at HSCT were significantly at higher risk than those with lower BMI-Z. Patients who developed components of the MetS had higher levels of insulin, homeostasis model assessment, uric acid, leptin, and lower adiponectin levels. Multivariable regression analysis revealed that BMI-Z-score >1.036 at time of evaluation was associated with 4.3-fold increased risk (P=.050) and adiponectin levels ≤6 μg/mL were associated with 6.7-fold increased risk of develop components of the MetS (P=.007). Overweight and obesity and adiponectin levels may be useful as markers in HSCT survivors.
authors.affiliation: Department of Pediatric Hematology-Oncology and BMT, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.|Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Bella
authors.initials: B
authors.lastname: Bielorai
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.|Pediatric Endocrinology and Diabetes Unit, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.
authors.forename: Yael
authors.initials: Y
authors.lastname: Weintraub
authors.affiliation: Department of Pediatric Hematology-Oncology and BMT, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.
authors.forename: Daphna
authors.initials: D
authors.lastname: Hutt
authors.affiliation: Institute of Endocrinology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.
authors.forename: Rina
authors.initials: R
authors.lastname: Hemi
authors.affiliation: Institute of Endocrinology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.
authors.forename: Hannah
authors.initials: H
authors.lastname: Kanety
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.|Pediatric Endocrinology and Diabetes Unit, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.
authors.forename: Dalit
authors.initials: D
authors.lastname: Modan-Moses
authors.affiliation: Department of Pediatric Hematology-Oncology and BMT, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.|Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Gal
authors.initials: G
authors.lastname: Goldstein
authors.affiliation: The Women and Children's Health Research Unit, Gertner Institute, Tel Hashomer, Israel.
authors.forename: Dana
authors.initials: D
authors.lastname: Hadar
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.|The Women and Children's Health Research Unit, Gertner Institute, Tel Hashomer, Israel.
authors.forename: Liat
authors.initials: L
authors.lastname: Lerner-Geva
authors.affiliation: Department of Pediatric Hematology-Oncology and BMT, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.|Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Amos
authors.initials: A
authors.lastname: Toren
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.|Pediatric Endocrinology and Diabetes Unit, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.
authors.forename: Orit
authors.initials: O
authors.lastname: Pinhas-Hamiel
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000175:diagnosis / Q000209:etiology*; D006085:Graft Survival; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D007557:Israel; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000209:etiology*; D009765:Obesity / Q000175:diagnosis / Q000209:etiology; D011183:Postoperative Complications; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D017741:Survivors; D014184:Transplantation, Homologous; D055815:Young Adult
keywords: dyslipidemia; hematopoietic stem cell transplantation; metabolic syndrome; obesity; overweight; total body irradiation; type 2 diabetes mellitus