Metabolic Syndrome in Male Survivors of Pediatric Allogeneic Hematopoietic Stem Cell Transplantation: Impact of Total Body Irradiation, Low-Grade Inflammation, and Hypogonadism

Biological Aspects of Inflamm-Aging in Childhood Cancer Survivors

“…Some studies have shown that compared with controls, survivors who underwent HCT for a primary hematologic malignancy at age ≤21 had a similar BMI but a higher percent fat mass [18]. In particular, CCS show a high risk of long-term negative consequences after HSCT [19,20], among them metabolic syndrome [19,[21][22][23]. In the general population, metabolic syndrome pathophysiology is related to lifestyle factors, like reduced physical activity and incorrect diet, which are responsible for an increase of BMI and, consequently, low-grade inflammation [20,24].…”

“…In particular, CCS show a high risk of long-term negative consequences after HSCT [19,20], among them metabolic syndrome [19,[21][22][23]. In the general population, metabolic syndrome pathophysiology is related to lifestyle factors, like reduced physical activity and incorrect diet, which are responsible for an increase of BMI and, consequently, low-grade inflammation [20,24]. In cancer survivors, metabolic syndrome pathogenesis is not yet well known, and it is reported that it occurs in the absence of overt obesity [20,21].…”

“…In the general population, metabolic syndrome pathophysiology is related to lifestyle factors, like reduced physical activity and incorrect diet, which are responsible for an increase of BMI and, consequently, low-grade inflammation [20,24]. In cancer survivors, metabolic syndrome pathogenesis is not yet well known, and it is reported that it occurs in the absence of overt obesity [20,21]. Several studies reported that low-grade inflammation, caused by the cytokine release from abdominal fat, is related to metabolic syndrome in CCS of HSCT, as well as in the general population [20,[23][24][25].…”

“…In cancer survivors, metabolic syndrome pathogenesis is not yet well known, and it is reported that it occurs in the absence of overt obesity [20,21]. Several studies reported that low-grade inflammation, caused by the cytokine release from abdominal fat, is related to metabolic syndrome in CCS of HSCT, as well as in the general population [20,[23][24][25]. Furthermore, in HSCT survivors, other factors could contribute to inflammation: immune dysregulation and alloreactivity in the form of chronic GVHD [20].…”

“…Several studies reported that low-grade inflammation, caused by the cytokine release from abdominal fat, is related to metabolic syndrome in CCS of HSCT, as well as in the general population [20,[23][24][25]. Furthermore, in HSCT survivors, other factors could contribute to inflammation: immune dysregulation and alloreactivity in the form of chronic GVHD [20]. Definitely, low-grade inflammation has a key role in the pathogenesis of metabolic syndrome after HSCT; in particular, there is an important relation between inflammatory molecule levels and the increased android/ginoid fat ratio, indicating that central fat accumulation is responsible for the increased levels of these molecules [23,26].…”