INSULIN RESISTANCE AND METABOLIC SYNDROME IN SURVIVORS OF ACUTE LYMPHOCYTIC

急性淋巴细胞白血病幸存者的胰岛素抵抗和代谢综合征

• 批准号: 8356755
• 负责人: Rona Yoffe Sonabend
• 金额: $ 0.36万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-12-01 至 2011-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8356755
• 关键词: Acute; Acute Lymphocytic Leukemia; Blood Pressure; Body Composition; Cancer Center; Caring; Cessation of life; Childhood Acute Lymphocytic Leukemia; Clinic; Clinical Research; Comorbidity; DEXA; Diagnosis; Dyslipidemias; Exhibits; Funding; Future; Grant; Hyperglycemia; Hypertension; Infection; Insulin Resistance; Lipids; Long-Term Survivors; Lymphocyte; Measurement; Measures; Metabolic syndrome; Methods; National Center for Research Resources; Neoadjuvant Therapy; OGTT; Obesity; Outcome; Principal Investigator; Prospective Studies; Recording of previous events; Research; Research Infrastructure; Resources; Risk; Role; Sampling; Scanning; Source; Survivors; Testing; Texas; United States National Institutes of Health; adverse outcome; base; cost; impaired glucose tolerance; obesity risk

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. Primary support for the subproject and the subproject's principal investigator may have been provided by other sources, including other NIH sources. The Total Cost listed for the subproject likely represents the estimated amount of Center infrastructure utilized by the subproject, not direct funding provided by the NCRR grant to the subproject or subproject staff. Background: Survivors of childhood Acute Lymphocytic Leukemia (ALL) are at increased risk for obesity, insulin resistance, and metabolic syndrome. While it is well established that hyperglycemia during treatment for ALL predicts adverse outcomes such as infections and death, the association with co-morbidities seen in survivors remains unknown. We hypothesize that survivors of childhood ALL with a history of hyperglycemia during induction are at increased risk to develop insulin resistance and metabolic syndrome when compared to euglycemic counterparts. Methods: We plan to conduct a prospective study of 40 survivors of childhood ALL who were diagnosed 1999-2006 and are currently cared for in the Texas Childrens Cancer Center Long-Term Survivor Clinic. Subjects will be divided equally into 2 groups based on presence or absence of hyperglycemia during induction therapy for ALL. Each subject will undergo an oral glucose tolerance test and a DEXA scan for body composition along with measurements of insulin resistance, lipids, and blood pressure. A 2 sample t-test will be used to compare mean insulin resistance between the 2 groups. A chi 2 analysis will be performed for outcomes such as metabolic syndrome, hypertension, dyslipidemia, and obesity. Results/Conclusions: We expect to detect a significant difference in insulin resistance, measured as HOMA, of 2.4 between our two groups. We predict that survivors of ALL with a history of hyperglycemia compared to those who remained euglycemic during induction will be more likely to exhibit insulin resistance. Additionally, we expect to find higher rates of co-morbidities such as impaired glucose tolerance, obesity, hypertension, dyslipidemia, and metabolic syndrome in the hyperglycemia group. If our hypotheses are proven, future studies will be needed to examine the role of hyperglycemia therapy during induction as a means of decreasing co-morbidities in ALL survivors.

这个子项目是许多利用资源的研究子项目之一 由NIH/NCRR资助的中心拨款提供。子项目的主要支持 而子项目的主要调查员可能是由其他来源提供的， 包括其它NIH来源。 列出的子项目总成本可能 代表子项目使用的中心基础设施的估计数量， 而不是由NCRR赠款提供给子项目或子项目工作人员的直接资金。 背景：儿童急性淋巴细胞白血病（ALL）的幸存者患肥胖、胰岛素抵抗和代谢综合征的风险增加。 虽然已经确定ALL治疗期间的高血糖可预测感染和死亡等不良结局，但与存活者中观察到的合并症的相关性仍未知。 我们假设，与血糖正常的儿童ALL患者相比，在诱导期有高血糖病史的儿童ALL幸存者发生胰岛素抵抗和代谢综合征的风险增加。 研究方法：我们计划对40名儿童ALL幸存者进行前瞻性研究，这些人在1999-2006年被诊断为ALL，目前在德克萨斯州儿童癌症中心长期幸存者诊所接受治疗。 根据ALL诱导治疗期间是否存在高血糖症，将受试者平均分为2组。 每名受试者将接受口服葡萄糖耐量试验和DEXA身体成分扫描，沿着胰岛素抵抗、血脂和血压的测量。 将使用双样本t检验比较两组之间的平均胰岛素抵抗。 将对代谢综合征、高血压、血脂异常和肥胖等结局进行卡方分析。 结果/结论：我们期望检测到胰岛素抵抗的显着差异，测量HOMA，我们两组之间的2.4。 我们预测有高血糖史的ALL存活者比那些在诱导期间血糖保持正常的患者更可能出现胰岛素抵抗。 此外，我们预计在高血糖组中发现更高的合并症发生率，如糖耐量受损、肥胖、高血压、血脂异常和代谢综合征。 如果我们的假设得到证实，未来的研究将需要检查诱导期间高血糖治疗作为降低ALL幸存者合并症的一种手段的作用。