Disorders of glucose homeostasis in young adults treated with total body irradiation during childhood: a pilot study
Disorders of glucose homeostasis in young adults treated with total body irradiation during childhood: a pilot study
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DOI：
10.1038/bmt.2009.40
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发表时间：
2009-09-01
影响因子：
4.8
通讯作者：
Sklar, C. A.
中科院分区：
文献类型：
--
作者：
Chemaitilly, W.;Boulad, F.;Sklar, C. A.
在儿童时期接受造血干细胞移植（HSCT）的患者，尤其是接受TBI治疗的患者中，已报告葡萄糖代谢受损（特别是胰岛素抵抗和2型糖尿病）。本初步研究旨在确定接受HSCT和TBI治疗的年轻成人中葡萄糖稳态受损的患病率和可能的潜在机制，这些患者既往未患糖尿病。共评价了10例受试者（6例男性，4例女性）。TBI时的平均年龄为13.0 ± 1.0岁，本研究时的平均年龄为24.0 ± 1.1岁。使用稳态模型评估和定量胰岛素敏感性检查指数，5例受试者有胰岛素抵抗的实验室证据。其中2例受试者空腹血糖受损，4例受试者血浆胰岛素样生长因子1水平降低。所有10例受试者均存在腹部肥胖的证据。在儿童时期接受TBI治疗的HSCT成年幸存者中经常观察到胰岛素抵抗。潜在的机制可能包括辐射引起的生长激素缺乏和身体成分的变化。骨髓移植（2009）44，339-343; doi：10.1038/bmt.2009.40; 2009年3月23日在线发表
Impairment of glucose metabolism (in particular insulin resistance and type 2 diabetes mellitus) has been reported in patients who have undergone hematopoietic SCT (HSCT) during childhood, especially those treated with TBI. This pilot study was conducted to determine prevalence of and possible underlying mechanisms for impaired glucose homeostasis in young adults treated with HSCT and TBI and who were not previously known to have diabetes mellitus. A total of 10 subjects (6 males, 4 females) were evaluated. Mean ages were 13.0 +/- 1.0 years at the time of TBI and 24.0 +/- 1.1 years at the time of this study. Five subjects had laboratory evidence of insulin resistance using the homeostasis model assessment and the quantitative insulin sensitivity check index indices. Two of these subjects had impaired fasting glucose and four had decreased plasma insulin-like growth factor 1 levels. All 10 subjects had evidence of abdominal obesity. Insulin resistance is frequently observed in adult survivors of HSCT treated with TBI in childhood. Underlying mechanisms may include radiation-induced growth hormone deficiency and changes in body composition. Bone Marrow Transplantation (2009) 44, 339-343; doi:10.1038/bmt.2009.40; published online 23 March 2009