Background: A significant number of long-term complications are reported in childhood acute lymphatic leukemia (ALL) survivors, and among them metabolic syndrome (MetS).
Objective and hypotheses: To evaluate the prevalence of features of MetS. In addition, we evaluated the presence of steatohepatitis which is described in association with MetS in otherwise healthy subjects.
Method: We assessed waist circumference, triglycerides levels, blood pressure, HDL cholesterol, serum blood glucose and liver ultrasound in 92 (44 males) off therapy childhood LLA survivors (age at diagnosis 5.6±3.8 years, age at recruitment 10.6±4.2 years). IDF criteria for MetS were used.
Results: We found a waist circumference pathological in 54 (58.7%), hypertriglyceridemia in 6 (6.5%), hypertension in ten (10.9%), low HDL cholesterol in four (4.3%) and hyperglycemia in two (2.1%) patients. Hepatic steatosis was found in 24 (26.1%) patients, mild in 18 (19.5%), moderate in four (4.3%) and severe in two (2.1%) survivors. Only one patient presented the three criteria for the diagnosis of MetS, 16 patients only two and 43 only one. At least one metabolic abnormality was found in about 60% of our patients.
Conclusion: Survivors of childhood ALLL are prone to develop MetS, which can predispose to cardiovascular disease. A prevalence of 13.1% (95% CI 8.417.7) has been reported in these patients. In this study the rate of MetS is 1.1%, lower than what reported. Some reasons may account for that, overall lifestyle and age at recruitment. Our patients, living in South of Italy, have Mediterranean diet which is well acknowledged to prevent MetS. However we cannot exclude that a younger age at diagnosis in this study as compared to other study populations may play a role. Further studies focusing on the risk factors for MetS are mandatory in these patients.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology