Metabolic syndrome in children and adolescents with acute lymphoblastic leukemia after the completion of chemotherapy
Metabolic syndrome in children and adolescents with acute lymphoblastic leukemia after the completion of chemotherapy
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DOI：
10.1097/01.mph.0000181428.63552.e9
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发表时间：
2005-09-01
影响因子：
1.2
通讯作者：
Athanassiadou, F
中科院分区：
文献类型：
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作者：
Kourti, M;Tragiannidis, A;Athanassiadou, F
代谢综合征是一组心血管疾病的潜在危险因素。为了提供急性淋巴细胞白血病（ALL）化疗晚期并发症的信息，作者前瞻性研究了ALL幸存者在治疗完成后最初几年内超重、肥胖和代谢综合征的发生率。如果儿童和青少年符合以下三项或三项以上标准，则被归类为患有代谢综合征：高脂血症、低水平的高密度脂蛋白（HDL）、高空腹血糖、肥胖和高血压。肥胖是根据体重指数（BMI）（kg/m2）标准差评分或z评分定义的。甘油三酯和HDL的临界点取自等同的儿科患者，其临界点由成人治疗组III（ATPIII）提出。使用ATP III截止点定义高血压。收缩压或舒张压升高定义为年龄、性别和身高大于第95百分位数。评价了52例受试者（29例男性和23例女性），中位年龄为15.2岁（范围6.1-22.6岁）。治疗结束后的中位间隔时间为3 - 7个月（范围13-121个月）。所有患者均按照ALL-BFM 90方案化疗，无患者接受过颅脑放疗。在52名受试者中，25名（48%）超重（BMI z评分> 1.5），3名（5.76%）肥胖（BMI z评分> 2）;其中，1名严重肥胖（BMI z评分> 2.5）。3例受试者（5.76%）符合代谢综合征的3项标准（高甘油三酯水平、葡萄糖耐受不良和肥胖）。29例受试者（55.7%）至少有一种代谢综合征风险因素。高血压和高血压不常见。及时识别代谢综合征的危险因素并进行干预似乎是确保ALL幸存者早期预防心血管疾病的必要条件。
The metabolic syndrome is a cluster of potent risk factors for cardiovascular diseases. To provide information on the late complications of chemotherapy for acute lymphoblastic leukemia (ALL), the authors prospectively studied the frequency of overweight, obesity, and metabolic syndrome in survivors of ALL in the initial years after the completion of therapy. Children and adolescents were classified as having the metabolic syndrome if they met three or more of the following criteria: hypertriglyceridemia, low levels of high-density lipoprotein (HDL), high fasting glucose, obesity, and hypertension. Obesity was defined on the basis of Body Mass Index (BMI) (kg/m(2)) standard deviation scores or z-scores. Cutoff points for triglycerides and HDL were taken from equivalent pediatric percentiles with the cutoff points proposed by the Adult Treatment Panel III (ATPIII). Hyperglycemia was defined using the ATPIII cutoff points. Elevated systolic or diastolic blood pressure was defined as a value greater than the 95th percentile for age, gender, and height. Fifty-two subjects (29 male and 23 female) with a median age of 15.2 years (range 6.1-22.6 years) were evaluated. Median interval since completion of therapy was 3 7 months (range 13-121 months). All of them had been treated according to the ALL-BFM 90 chemotherapy protocol and none had received cranial radiotherapy. Of the 52 subjects, 25 (48%) were overweight (BMI z-score > 1.5) and 3 (5.76%) were obese (BMI z-score > 2); among them, I was severely obese (BMI z-score > 2.5). Three criteria for the metabolic syndrome (high triglyceride levels, glucose intolerance, and obesity) were fulfilled by three subjects (5.76%). Twenty-nine subjects (55.7%) had at least one risk factor for metabolic syndrome. Hyperglycemia and hypertension were infrequent. Prompt recognition of the risk factors for metabolic syndrome and intervention seem mandatory to ensure early prevention of cardiovascular disease in survivors of ALL.