Prevalence of metabolic syndrome in long-term survivors of hematopoietic stem cell transplantation
Prevalence of metabolic syndrome in long-term survivors of hematopoietic stem cell transplantation
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DOI：
10.1038/sj.bmt.1705972
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发表时间：
2008-05-01
影响因子：
4.8
通讯作者：
Deliliers, G. Lambertenghi
中科院分区：
文献类型：
--
作者：
Annaloro, C.;Usardi, P.;Deliliers, G. Lambertenghi
我们的目的是确定代谢综合征（MS）在一系列长期造血干细胞移植（HSCT）存活者中的患病率和特征。我们评估了85例HSCT受者的临床、代谢和内分泌数据，以及血浆TNF、瘦素、β-内酰胺酶和脂联素水平。MS是根据国家胆固醇教育计划-成人治疗小组III标准诊断的。将其患病率与意大利人群中观察到的患病率进行比较，并单变量和多变量评估其与临床和实验室参数的关系。29例HSCT受者患有MS，而不是预期的12.8例（P < 0.0001），高甘油三酯血症是最常见的特征。单因素分析显示高胰岛素、瘦素水平、低脂联素水平和性腺功能减退与MS的诊断显著相关;多因素分析显示血浆瘦素、胰岛素抵抗、年龄和性腺功能减退与MS的诊断显著相关。我们的结论是，HSCT受者的风险增加的MS形式，具有特定的临床特征。血浆瘦素水平是独立相关的MS，从而表明瘦素抵抗可能发挥作用的发病线索，在其他条件下，MS发生作为一个次要的现象。MS值得考虑作为可能治愈其基础疾病的患者的危及生命的并发症。
Our purpose was to determine the prevalence and features of metabolic syndrome (MS) in a series of long-term hematopoietic stem cell transplantation (HSCT) survivors. We assessed the clinical, metabolic and endocrinological data, and plasma TNF, leptin, resistin and adiponectin levels relating to 85 HSCT recipients. MS was diagnosed on the basis of the National Cholesterol Education Program-Adult Treatment Panel III criteria. Its prevalence was compared with that observed in an Italian population, and its relationship with the clinical and laboratory parameters was assessed univariately and multivariately. Twenty-nine HSCT recipients had MS instead of the 12.8 expected (P < 0.0001), with hyper-triglyceridemia being the most common feature. Univariate analysis indicated that high insulin and leptin levels, low-adiponectin levels and hypogonadism were significantly related to a diagnosis of MS; multivariate analysis indicated plasma leptin, insulin resistance, age and hypogonadism. We conclude that HSCT recipients are at increased risk of a form of MS that has particular clinical features. Plasma leptin levels are independently related to MS, thus suggesting that leptin resistance may play a role as a pathogenetic clue, as in other conditions in which MS occurs as a secondary phenomenon. MS deserves consideration as a life-threatening complication in patients who are probably cured of their underlying disease.