Background: Hematopoietic stem cell transplantation (HSCT) recipients exhibit excess adiposity that may result in an increased metabolic risk. Studies have shown that BMI is a poor predictor of body fatness in pediatric HSCT survivors population where diminished lean mass has been documented. The visceral adiposity index (VAI) has recently been proposed as a predictor of cardio-metabolic risk in both adults and children. However, the predictive value of this index in metabolic risk assessment has not been studied in survivors of childhood TCSH. Therefore, we aimed to estimate the potential relationship between VAI, markers of insulin resistance (HOMA index) and body adiposity measured by dual-energy x-ray absorptiometry (DXA) in a cohort of pediatric TCSH survivors after chemotherapy-only conditioning. .
Material and Method: Anthropometric measurements and metabolic/hormonal profile were obtained from 28 paediatric HSCT survivors that were not exposed to TBI conditioning. DXA was performed to measure total body fat and android/gynoid (A/G) ratio in 21 subjects.
Results: Our study showed a statistically significant correlation between VAI and HOMA index (r²=0.384, P=0.001) and serum glucose level (r²=0.140, P=0.046), respectively, in survivors of paediatric HSCT, but we found no association between VAI and total body fat or A/G ratio in our patients.
Conclusion: Although VAI correlated with serum glucose level and HOMA index in our group of survivors of paediatric HSCT who underwent chemotherapy-only conditioning, we found no association between VAI and densitometric parameters of adiposity. Therefore, we suggest that VAI should be used with caution in this population to predict the metabolic risk.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology