ESPE Abstracts (2019) 92 P2-109

Metabolic Syndrome in Children and Adolescents who Survived After Childhood Cancer

Elena Zhukovskaya, Anna Gavrilova, Tatiana Nasedkina, Serafima Chechelnitskaya, Tatiana Lisitsa, Alexander Karelin, Vladimir Kasatkin, Alexander Rumyantsev


Dmitry Rogachev National Medical Research Center Of Pediatric Hematology- Oncology and Immunology, Clinical Rehabilitation Research Center for patients in remission "Russkoye pole", Moscow, Russian Federation


Background/Objectives: During treatment of children and adolescents with cancer, an imbalance of carbohydrate and mineral metabolism may occur, leading to clinical manifestations of the components of the metabolic syndrome. The aim of the work was to study the frequency and severity of various clinical signs associated with metabolic syndrome in a cohort of patients from the Russian Field Clinical Rehabilitation Center.

Design/Methods: A group of 100 surviving leukemia patients and 160 children of the survivors of the posterior cranial fossa in 2017–2018 were formed through an exhaustive clinical examination, including toxicity analysis of chemotherapy, family history, and physical and psychological status. In general, more than 50 characteristics were determined in all patients, including biochemical parameters, such as insulin level, HOMA index, lipid profile, etc., as well as BMI, bio-impedance, exercise tolerance, sphygmometry, psychological testing. Statistical analysis was performed using the software package Statistica 8.0 (StatSoft Inc., USA).

A decrease in high-density lipoprotein levels was observed in 65% of patients; increased BMI in 44% of patients, which corresponded to the disproportion of adipose and muscle tissue. Insulin resistance, defined as a HOMA index higher than 3.2, was registered in 21% of patients, and arterial hypertension in 16% of patients. There are trends that obesity, insulin resistance and arterial hypertension adversely affect physical and psychological status. Genetic testing of surviving leukemia patients revealed a statistically significant association of rs11091046 polymorphisms in the AGTR2 and rs4833095 gene in the TLR1 gene with insulin resistance developed after chemotherapy.

Thus, the described algorithm allows identification of a combination of three potential components of the metabolic syndrome in 30% of survivors of childhood cancer. The findings can contribute to the development of an individual rehabilitation program for the prevention and treatment of metabolic syndrome in patients receiving anti-tumor therapy in children.

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