Prevalence and risk factors of the metabolic syndrome in adult survivors of childhood leukemia
Prevalence and risk factors of the metabolic syndrome in adult survivors of childhood leukemia
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DOI：
10.1182/blood-2010-09-304899
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发表时间：
2011-04-28
期刊：
影响因子：
20.3
通讯作者：
Michel, Gerard
中科院分区：
文献类型：
--
作者：
Oudin, Claire;Simeoni, Marie-Claude;Michel, Gerard
我们评估了在儿童白血病中存活的年轻人中代谢综合征(MS)的患病率和危险因素。2007年至2008年间，对L儿童和L青少年项目的所有成年人提出了多发性硬化症的评估建议，该项目是一个法国白血病幸存者多中心队列前瞻性研究项目。在220例符合条件的患者中，184例(83.6%)获得了完整的评估。评估和随访时间的中位年龄分别为21.2岁和15.4岁。MS的总患病率为9.2%(95%可信区间为5.5-14.4)。MS与性别、确诊年龄、白血病亚型、类固醇治疗和中枢神经系统放疗无关。按4种治疗方法进行分层：单纯化疗97例，化疗加中枢神经系统照射27例，造血干细胞移植(HSCT)17例，全身照射(TBI)43例。MS发生率分别为5.2%、11.1%、5.9%和18.6%。在单因素和多因素分析中，HSCT-TBI组的风险较高(优势比[OR]=3.9，P=0.03)。HSCT合并颅脑损伤与高甘油三酯血症(OR=4.5，P=0.004)、低高密度脂蛋白胆固醇(OR=2.5，P=0.02)和空腹血糖升高(OR=6.1，P=0.04)相关，因此，脑外伤是MS的主要危险因素，有必要进一步研究来解释这一特征。(血。2011；117(17)：4442-4448)
We evaluate the prevalence and risk factors of the metabolic syndrome (MS) in young adults surviving childhood leukemia. During the years 2007 to 2008, assessment of MS was proposed to all adults included in the Leucemie de l'Enfant et de l'Adolescent program, a French prospective multicentric cohort of leukemia survivors. Among 220 eligible patients, 184 (83.6%) had complete evaluation. Median age at evaluation and follow-up duration were 21.2 and 15.4 years. Overall prevalence of MS was 9.2% (95% confidence interval, 5.5-14.4). There was no association of MS with sex, age at diagnosis, leukemia subtype, steroid therapy, and central nervous system irradiation. Patients were stratified according to 4 therapeutic modalities: chemotherapy alone (n = 97), chemotherapy and central nervous system irradiation (n = 27), hematopoietic stem cell transplantation (HSCT) without (n = 17) or with (n = 43) total body irradiation (TBI). MS occurred in 5.2%, 11.1%, 5.9%, and 18.6% of them, respectively. The higher risk observed in the HSCT-TBI group was significant in univariate and in multivariate analysis (odds ratio [OR] = 3.9, P = .03). HSCT with TBI was associated with a higher rate of hypertriglyceridemia (OR = 4.5, P = .004), low level of high-density lipoprotein cholesterol (OR = 2.5, P = .02), and elevated fasting glucose (OR = 6.1, P = .04) So, TBI is a major risk factor for MS. Further studies are warranted to explain this feature. (Blood. 2011; 117(17): 4442-4448)