ESPE Abstracts (2019) 92 P1-419

Premature Ovarian Insufficiency in Women after Treatment for Childhoodcancer is a Risk Factor for Metabolic Syndrome

Axel Netterlid1, Helena Mörse2, Aleksander Giwercman3, Emir Henic3, Eva-Marie Erfurth4, Maria Elfving1


1Lund University, Skane University Hospital, Department of Pediatrics, Pediatric Endocrinology, Lund, Sweden. 2Lund University, Skane University Hospital, Department of Pediatrics, Pediatric Oncology and Hematology, Lund, Sweden. 3Lund University, Skane University Hospital, Department of Reproductive Medicine, Malmö, Sweden. 4Lund University, Skane University Hospital, Department of Endocrinology, Lund, Sweden


Background: Childhood cancer survivors (CSS) are at risk for several late effects, among them increased risk of metabolic syndrome (MetS). We wanted to study if female hypogonadism was a risk factor for MetS.

Method: This study included 167 female CCS, mean age 34.3 (19.3-57.8) years in the South region of Sweden and 164 matched controls, mean age 35.0 (19.3–58.0). The female CCS were diagnosed at mean age 8.9 (0.1-17.9) years with a mean follow up time of 25.4 (11.6-41.3) years. The distribution of childhood cancer diagnoses was representative compared to the distribution of diagnoses in Sweden for females < 19 years. The odds ratio (OR) for MetS after different treatments and also ovarian insufficiency was studied.

Results: MetS was present in 14.4% (24/167) among CCS and in 2.4% (4/164) among controls (P < 0.05). OR for MetS in all CCS compared to controls was 6.7 (95% CI 2.3, 19.8). The highest OR was noted after treatment with cranial irradiation 9.3 (2.8, 31.1) or alkylating agents 9.1 (2.9, 28.4), but also for those with premature ovarian insufficiency (POI) 8.9 (2.0, 38.6) (hypothalamic –pituitary POI excluded).

Conclusion: The incidence of MetS was higher in females treated for childhood cancer compared to controls. In addition to established risk factors as cranial irradiation and chemotherapy the presence of POI also significantly increased the risk for developing MetS.

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