Obesity, Dyslipidemia and Insulin Resistance in Survivors of Childhood Cancer

IF 0.4 Q4 PEDIATRICS

Iranian Journal of Pediatric Hematology and Oncology Pub Date : 2019-01-01 DOI:10.18502/ijpho.v9i1.290

Soundarya Mahalingam MD, K. G. Md, Anita Dhulipalli Mbbs, Saravanan Ramaswamy MD

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引用次数: 2

Abstract

Abstract Background: With the increased survival rates following the treatment of childhood cancer, it becomes equally important that the need for evidence based surveillance of long term effects of cancer therapy is addressed. This includes the risk of development of metabolic syndrome features like obesity, altered lipid and sugar profile, which was attempted in the present study. Materials and Methods: In this cross sectional case study, 50 survivors of childhood cancer aged between 5 – 18 years were recruited. Positive history of obesity, diabetes mellitus, dyslipidemia, and stroke in family were recorded and their anthropometry was noted with calculation of their Body Mass Index (BMI). Fasting lipid profile, blood sugar, and serum insulin levels were tested; the Homeostatic model assessment of Insulin Resistance (HOMA IR) value and the Fasting Glucose to Insulin Ratio(FGIR) were derived as markers of insulin sensitivity. The data were analyzed using SPSS (version 17.0). Results: In these fifty children, the risk factors studied for dyslipidemia and insulin resistance due to chemotherapy were: age at diagnosis, sex, radiation exposure, steroid, and L-asparaginase use during the treatment for cancer. Among the fifty survivors, 7 were found obese, 32 normal, and 11 underweight as per the age specific BMI charts. Their metabolic parameters showed that 12 had raised cholesterol levels, 8 had raised triglyceride levels, and 4 had lowered HDL-C levels. Nine survivors also had raised HOMA-IR levels. However, these metabolic derangements were not found to be statistically significant (p value>0.05) and no correlation was found between the risk factors and obesity, dyslipidemia, or insulin resistance. Conclusion: As against the prior evidence, there was no risk of developing obesity, dyslipidemia, and insulin resistance in survivors of childhood cancers. Keywords: Dyslipidemias, Insulin Resistance, Obesity, Survivors of childhood cancer

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儿童癌症幸存者的肥胖、血脂异常和胰岛素抵抗

背景:随着儿童癌症治疗后生存率的提高，对癌症治疗长期效果的循证监测变得同样重要。这包括发展代谢综合征特征的风险，如肥胖、脂质和糖谱的改变，这是本研究的尝试。材料和方法:在这个横断面病例研究中，招募了50名年龄在5 - 18岁之间的儿童癌症幸存者。记录家族中肥胖、糖尿病、血脂异常、脑卒中的阳性病史，并对其进行人体测量，计算其身体质量指数(BMI)。检测空腹血脂、血糖和血清胰岛素水平;胰岛素抵抗的稳态模型评估(HOMA IR)值和空腹葡萄糖胰岛素比(FGIR)作为胰岛素敏感性的标志物。数据采用SPSS(17.0版)分析。结果:在这50名儿童中，研究了化疗引起的血脂异常和胰岛素抵抗的危险因素:诊断时年龄、性别、辐射暴露、类固醇和l -天冬酰胺酶在癌症治疗期间的使用。在50名幸存者中，根据年龄特定的BMI图表，发现7人肥胖，32人正常，11人体重不足。他们的代谢参数显示，12人的胆固醇水平升高，8人的甘油三酯水平升高，4人的HDL-C水平降低。9名幸存者的HOMA-IR水平也有所升高。然而，这些代谢紊乱没有统计学意义(p值为0.05)，危险因素与肥胖、血脂异常或胰岛素抵抗之间没有相关性。结论:与先前的证据相反，儿童癌症幸存者没有发生肥胖、血脂异常和胰岛素抵抗的风险。关键词:血脂异常，胰岛素抵抗，肥胖，儿童癌症幸存者

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来源期刊

Iranian Journal of Pediatric Hematology and Oncology PEDIATRICS-

CiteScore

0.80

自引率

33.30%

发文量