The Metabolic Syndrome in Adult Survivors of Childhood Cancer, a Review

Abstract

The number of adult survivors of childhood cancer in the general population has increased. As reports on the prevalence of the metabolic syndrome in adult survivors of childhood cancer are scarce, we reviewed the available literature on the components of the metabolic syndrome in adult survivors of childhood cancer. Although there is a lack of studies estimating the prevalence of metabolic syndrome directly, especially prevalence of insulin resistance, obesity, and dyslipidemia is increased in certain groups. Therefore, adult survivors of childhood cancer are at increased risk of developing cerebrovascular and cardiovascular diseases. Accordingly, it is important to identify the predisposing factors of the metabolic syndrome in cohorts of survivors, to introduce medical interventions, and to subsequently decrease the risk of cerebrovascular and cardiovascular events.

Endocrine Complications and Components of the Metabolic Syndrome in Survivors of Childhood Malignant Non-Brain Solid Tumors

“…However, the prevalence of obesity was not high. Previous reports demonstrated an association between cancer and obesity, insulin resistance, and risk of premature cardiovascular disease [10], and an association of specific pediatric cancers, particularly acute lymphocytic leukemia, central nervous system tumors, lymphomas, testicular cancer, and sarcoma, and BMT treatment for cancer with late acquisition of metabolic syndrome traits [19,35,36,37]. The reasons are not entirely understood, although several contributing factors have been reported, including reduced physical activity [38], cranial irradiation with identified or presumed hormonal dysregulation [39], hormonal (such as GH) deficiencies, thyroid dysfunction, gonadal failure, drug or radiotherapy damage, endothelial impairment, adipose tissue dysfunction [40,41,42], familial factors [43], and early adiposity rebound [44].…”

The limited screening value of insulin‐like growth factor‐i as a marker for alterations in body composition in very long‐term adult survivors of childhood cancer

“…Consequently, the incidence of late, treatment-related complications is increasing. Endocrine sequelae, such as the metabolic syndrome, osteopenia, subfertility, thyroid dysfunction, and growth hormone deficiency (GHD), represent an important category of such late effects [3][4][5][6][7][8].…”

Endocrine late sequelae in long-term survivors of childhood non-Hodgkin lymphoma

“…Both normal and decreased bone mineral density (BMD) have been reported in long-term survivors of other malignancies treated with chemotherapy including corticosteroids [3][4][5][6][7][8][9]. In addition, altered body composition, especially obesity, was observed during and after treatment of acute lymphoblastic leukemia (ALL) [10][11][12][13][14][15][16][17][18][19]. Other endocrine or metabolic sequelae that have been described in NHL and ALL survivors are growth hormone deficiency, hypothyroidism, insulin resistance and dyslipidemia [18][19][20].…”

“…In addition, altered body composition, especially obesity, was observed during and after treatment of acute lymphoblastic leukemia (ALL) [10][11][12][13][14][15][16][17][18][19]. Other endocrine or metabolic sequelae that have been described in NHL and ALL survivors are growth hormone deficiency, hypothyroidism, insulin resistance and dyslipidemia [18][19][20]. Moreover, infertility or impaired reproductive outcome has been described in survivors of childhood cancer [21][22][23][24][25].…”