Atherogenic low density lipoprotein phenotype in long-term survivors of childhood acute lymphoblastic leukemia

Malhotra, Jyoti; Tonorezos, Emily S.; Rozenberg, Marina; Vega, Gloria Lena; Sklar, Charles A.; Chou, Joanne F.; Moskowitz, Chaya S.; Eshelman-Kent, Debra; Janiszewski, Peter M.; Ross, Robert; Oeffinger, Kevin C.

doi:10.1194/jlr.p029785

Cited by 27 publications

(22 citation statements)

References 40 publications

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“…18,31 In our study, elevated blood pressure was significantly associated with male sex, which is also a known risk factor in the general population, especially among young and middle-aged adults. 32 This risk factor has already been described in adult survivors of childhood AL.…”

mentioning

confidence: 76%

“…Investigators in the USA have recently shown that CNS irradiation affects lipid profiles and in particular HDL cholesterol levels. 31 However, the long-term effect of CNS irradiation on blood pressure among adult survivors of childhood AL remains poorly understood. In several studies concerning acute lymphoblastic leukemia survivors, no significant difference in blood pressure between irradiated and non-irradiated patients has been described.…”

Section: Number Of Cases (%) 95% CImentioning

confidence: 99%

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Metabolic syndrome in long-term survivors of childhood acute leukemia treated without hematopoietic stem cell transplantation: an L.E.A. study

et al. 2016

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C ardiovascular conditions are serious long-term complications of childhood acute leukemia. However, few studies have investigated the risk of metabolic syndrome, a known predictor of cardiovascular disease, in patients treated without hematopoietic stem cell transplantation. We describe the overall and age-specific prevalence, and the risk factors for metabolic syndrome and its components in the L.E.A. (Leucémie de l'Enfant et de l'Adolescent) French cohort of childhood acute leukemia survivors treated without hematopoietic stem cell transplantation. The study included 650 adult patients (mean age at evaluation: 24.2 years; mean follow-up after leukemia diagnosis: 16.0 years). The prevalence of metabolic syndrome was 6.9% (95% CI 5.1-9.2). The age-specific cumulative prevalence at 20, 25, 30 and 35 years of age was 1.3%, 6.1%, 10.8% and 22.4%, respectively. The prevalence of decreased high-density lipoprotein cholesterol, increased triglycerides, increased fasting glucose, increased blood pressure and increased abdominal circumference was 26.8%, 11.7%, 5.8%, 36.7% and 16.7%, respectively. Risk factors significantly associated with metabolic syndrome in the multivariate analysis were male sex (OR 2.64; 95% CI 1.32-5.29), age at last evaluation (OR 1.10; 95% CI 1.04-1.17) and body mass index at diagnosis (OR 1.15; 95% CI 1.01-1.32). The cumulative steroid dose was not a significant risk factor. Irradiated and non-irradiated patients exhibited different patterns of metabolic abnormalities, with more frequent abdominal obesity in irradiated patients and more frequent hypertension in non-irradiated patients. Survivors of childhood acute leukemia are at risk of metabolic syndrome, even when treated without hematopoietic stem cell transplantation or central nervous system irradiation. A preventive approach with regular screening for cardiovascular risk factors is recommended.

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confidence: 76%

Section: Number Of Cases (%) 95% CImentioning

confidence: 99%

Metabolic syndrome in long-term survivors of childhood acute leukemia treated without hematopoietic stem cell transplantation: an L.E.A. study

et al. 2016

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“…The lipoprotein metabolism is previously shown to be affected by gender, age and BMI [27][28][29]. In the present study we performed gender-, age-and BMI-based analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Gender, age and BMI are previously shown to affect lipoprotein metabolism in healthy subjects [27][28][29]. Here, the study population was categorized into gender, BMI or age groups and plasma lipid concentrations in each patient group were compared to the respective control group.…”

Section: Lipid Profile Of Acute Leukemia Patients Versus Healthy Subjmentioning

confidence: 99%

Revisiting the dyslipidemia associated with acute leukemia

Usman

Rashid

Ameer

et al. 2015

Clinica Chimica Acta

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“…Survivors of childhood acute lymphoblastic leukemia (ALL) tend to have greater risk of obesity3711), glucose intolerance12), lipid abnormalities913), and cardiovascular events14) compared to equivalently aged members of the general population. Table 1 summarizes the possible mechanisms underlying metabolic syndrome development that induced by different cancer treatments.…”

Section: Characteristics Of Metabolic Syndrome In Cancer Survivorsmentioning

confidence: 99%

Metabolic syndrome induced by anticancer treatment in childhood cancer survivors

Chueh

Yoo

2017

Ann Pediatr Endocrinol Metab

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The number of childhood cancer survivors is increasing as survival rates improve. However, complications after treatment have not received much attention, particularly metabolic syndrome. Metabolic syndrome comprises central obesity, dyslipidemia, hypertension, and insulin resistance, and cancer survivors have higher risks of cardiovascular events compared with the general population. The mechanism by which cancer treatment induces metabolic syndrome is unclear. However, its pathophysiology can be categorized based on the cancer treatment type administered. Brain surgery or radiotherapy may induce metabolic syndrome by damaging the hypothalamic-pituitary axis, which may induce pituitary hormone deficiencies. Local therapy administered to particular endocrine organs directly damages the organs and causes hormone deficiencies, which induce obesity and dyslipidemia leading to metabolic syndrome. Chemotherapeutic agents interfere with cell generation and growth, damage the vascular endothelial cells, and increase the cardiovascular risk. Moreover, chemotherapeutic agents induce oxidative stress, which also induces metabolic syndrome. Physical inactivity caused by cancer treatment or the cancer itself, dietary restrictions, and the frequent use of antibiotics may also be risk factors for metabolic syndrome. Since childhood cancer survivors with metabolic syndrome have higher risks of cardiovascular events at an earlier age, early interventions should be considered. The optimal timing of interventions and drug use has not been established, but lifestyle modifications and exercise interventions that begin during cancer treatment might be beneficial and tailored education and interventions that account for individual patients' circumstances are needed. This review evaluates the recent literature that describes metabolic syndrome in cancer survivors, with a focus on its pathophysiology.

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Atherogenic low density lipoprotein phenotype in long-term survivors of childhood acute lymphoblastic leukemia

Cited by 27 publications

References 40 publications

Metabolic syndrome in long-term survivors of childhood acute leukemia treated without hematopoietic stem cell transplantation: an L.E.A. study

Metabolic syndrome in long-term survivors of childhood acute leukemia treated without hematopoietic stem cell transplantation: an L.E.A. study

Revisiting the dyslipidemia associated with acute leukemia

Metabolic syndrome induced by anticancer treatment in childhood cancer survivors

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