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Characterization of insulin resistance in young adult survivors of childhood acute lymphoblastic leukaemia and non-Hodgkin lymphoma

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Beauloye, Véronique [UCL] Steffens, Mélanie [UCL] Zech, Francis [UCL] Vermylen, Christiane [UCL] Maiter, Dominique [UCL]

INTRODUCTION: An increased prevalence of metabolic disorders and cardiovascular (CV) disease has been reported in childhood acute lymphoblastic leukaemia (ALL) / Non-Hodgkin lymphoma (NHL) cancer survivors. OBJECTIVE: To characterize the determinants of insulin resistance (IR) observed in this population, according to the treatment received. METHODS: 91 patients (45 men, mean age: 24 ± 5 years; mean follow-up: 15 ± 5 years) previously treated for a childhood ALL (n=76) or NHL (n=15) were grouped according to their previous treatment: chemotherapy only (Group I; n=43), chemotherapy + cranial irradiation (CI) (Group II; n=32) and chemotherapy + bone marrow transplant (BMT) / total body irradiation (TBI) (Group III, n=16). RESULTS: A high prevalence of IR (HOMA-S < 60%) was observed in the BMT/TBI group (88%) compared to groups I (9%) and II (16%). The IR patients from groups [I+II] (12% of these groups) showed higher BMI, fat mass (FM) and visceral fat when compared with the non-IR patients. In contrast, the IR patients from group III had mean BMI and total FM similar to those of non-IR patients but showed a reduction of lean body mass and an increase in the relative proportion of trunk FM similar to the IR patients from groups [I+II]. This was associated with an altered lipid profile, high TNF-α and IL-6 levels, and reduced adiponectin levels compared to IR patients from group [I+II] and non-IR patients. CONCLUSION: Childhood ALL/NHL survivors treated by BMT/TBI frequently develop severe insulin resistance associated with peripheral-to-central fat redistribution, rather than increased total FM, and low adiponectin levels which may contribute to their increased CV risk. © 2012 Blackwell Publishing Ltd.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès restreint
Publication date 2013
Language Anglais
Journal information "Clinical Endocrinology" - Vol. 78, no. 5, p. 790-798 (2013)
Peer reviewed yes
Publisher Wiley-Blackwell Publishing Ltd. ((United Kingdom) Oxford)
issn 0300-0664
e-issn 1365-2265
Publication status Publié
Affiliations UCL - (SLuc) Service d'endocrinologie et de nutrition
UCL - (SLuc) Service de médecine interne et maladies infectieuses (MIMI)
UCL - (SLuc) Service d'hématologie et d'oncologie pédiatrique
UCL - (SLuc) Service d'endocrinologie et diabétologie pédiatrique
UCL - SSS/IREC - Institut de recherche expérimentale et clinique
UCL - SSS/IREC/EDIN - Pôle d'endocrinologie, diabète et nutrition
UCL - SSS/IREC/PEDI - Pôle de Pédiatrie
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Bibliographic reference Beauloye, Véronique ; Steffens, Mélanie ; Zech, Francis ; Vermylen, Christiane ; Maiter, Dominique. Characterization of insulin resistance in young adult survivors of childhood acute lymphoblastic leukaemia and non-Hodgkin lymphoma. In: Clinical Endocrinology, Vol. 78, no. 5, p. 790-798 (2013)
Permanent URL http://hdl.handle.net/2078/125012