DOI QR코드

DOI QR Code

The metabolic syndrome and body composition in childhood cancer survivors

  • Sohn, Young-Bae (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Su-Jin (Center of Pediatric Oncology, National Cancer Center) ;
  • Park, Sung-Won (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Se-Hwa (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Cho, Sung-Yoon (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Soo-Hyun (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Yoo, Keon-Hee (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Sung, Ki-Woong (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Chung, Jae-Hoon (Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Koo, Hong-Hoe (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Jin, Dong-Kyu (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2010.12.13
  • Accepted : 2011.04.11
  • Published : 2011.06.15

Abstract

Purpose: Long-term survivors of childhood cancer appear to have an increased risk for the metabolic syndrome, subsequent type 2 diabetes and cardiovascular disease in adulthood compared to healthy children. The purpose of this study was to investigate the frequency of the metabolic syndrome and associated factors in childhood cancer survivors at a single center in Korea. Methods: We performed a retrospective review of medical records of 98 childhood cancer survivors who were diagnosed and completed anticancer treatment at Samsung Medical Center, Seoul, Korea between Jan. 1996 and Dec. 2007. Parameters of metabolic syndrome were evaluated between Jan. 2008 and Dec. 2009. Clinical and biochemical findings including body fat percentage were analyzed. Results: A total of 19 (19.4%) patients had the metabolic syndrome. The median body fat percentage was 31.5%. The body mass index and waist circumference were positively correlated with the cranial irradiation dose (r=0.38, P<0.001 and r=0.44, P<0.00, respectively). Sixty-one (62.2%) patients had at least one abnormal lipid value. The triglyceride showed significant positive correlation with the body fat percentage (r=0.26, P=0.03). The high density lipoprotein cholesterol showed significant negative correlation with the percent body fat (r=- 0.26, P=0.03). Conclusion: Childhood cancer survivors should have thorough metabolic evaluation including measurement of body fat percentage even if they are not obese. A better understanding of the determinants of the metabolic syndrome during adolescence might provide preventive interventions for improving health outcomes in adulthood.

Keywords

References

  1. Hoffman KE, Derdak J, Bernstein D, Reynolds JC, Avila NA, Gerber L, et al. Metabolic syndrome traits in long-term survivors of pediatric sarcoma. Pediatr Blood Cancer 2008;50:341-6. https://doi.org/10.1002/pbc.21363
  2. Johnson WD, Kroon JJ, Greenway FL, Bouchard C, Ryan D, Katzmarzyk PT. Prevalence of risk factors for metabolic syndrome in adolescents: National Health and Nutrition Examination Survey (NHANES), 2001-2006. Arch Pediatr Adolesc Med 2009;163:371-7. https://doi.org/10.1001/archpediatrics.2009.3
  3. Zimmet P, Alberti KG, Kaufman F, Tajima N, Silink M, Arslanian S, et al. The metabolic syndrome in children and adolescents: an IDF consensus report. Pediatr Diabetes 2007;8:299-306. https://doi.org/10.1111/j.1399-5448.2007.00271.x
  4. Saland JM. Update on the metabolic syndrome in children. Curr Opin Pediatr 2007;19:183-91. https://doi.org/10.1097/MOP.0b013e3280208519
  5. Talvensaari KK, Lanning M, Tapanainen P, Knip M. Long-term survivors of childhood cancer have an increased risk of manifesting the metabolic syndrome. J Clin Endocrinol Metab 1996;81:3051-5. https://doi.org/10.1210/jc.81.8.3051
  6. Park MJ. Epidemiology of the metabolic syndrome among Korean children and adolescents. Korean J Pediatr 2008;51:564-8. https://doi.org/10.3345/kjp.2008.51.6.564
  7. Lee SY, Kim JH, Oh KW, Kim YN, Kang YJ. Development of growth curves and the criteria of obesity in Korean children and adolescents, final report. Seoul: Ministry of Health and Welfare, 2007.
  8. Tanner JM, Whitehouse RH. Clinical longitudinal standards for height, weight, height velocity, weight velocity, and stages of puberty. Arch Dis Child 1976;51:170-9. https://doi.org/10.1136/adc.51.3.170
  9. Cook S, Weitzman M, Auinger P, Nguyen M, Dietz WH. Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988-1994. Arch Pediatr Adolesc Med 2003;157:821-7. https://doi.org/10.1001/archpedi.157.8.821
  10. Kim HM, Park J, Kim HS, Kim DH, Park SH. Obesity and cardiovascular risk factors in Korean children and adolescents aged 10- 18 years from the Korean National Health and Nutrition Examination Survey, 1998 and 2001. Am J Epidemiol 2006;164:787-93. https://doi.org/10.1093/aje/kwj251
  11. Pietilä S, Mäkipernaa A, Sievänen H, Koivisto AM, Wigren T, Lenko HL. Obesity and metabolic changes are common in young childhood brain tumor survivors. Pediatr Blood Cancer 2009;52:853-9. https://doi.org/10.1002/pbc.21936
  12. Jarfelt M, Lannering B, Bosaeus I, Johannsson G, Bjarnason R. Body composition in young adult survivors of childhood acute lymphoblastic leukaemia. Eur J Endocrinol 2005;153:81-9. https://doi.org/10.1530/eje.1.01931
  13. Didi M, Didcock E, Davies HA, Ogilvy-Stuart AL, Wales JK, Shalet SM. High incidence of obesity in young adults after treatment of acute lymphoblastic leukemia in childhood. J Pediatr 1995;127:63-7. https://doi.org/10.1016/S0022-3476(95)70258-X
  14. Oeffinger KC, Mertens AC, Sklar CA, Yasui Y, Fears T, Stovall M, et al. Obesity in adult survivors of childhood acute lymphoblastic leukemia: a report from the Childhood Cancer Survivor Study. J Clin Oncol 2003;21:1359-65. https://doi.org/10.1200/JCO.2003.06.131
  15. Taskinen M, Saarinen-Pihkala UM, Hovi L, Lipsanen-Nyman M. Impaired glucose tolerance and dyslipidaemia as late effects after bonemarrow transplantation in childhood. Lancet 2000;356:993-7. https://doi.org/10.1016/S0140-6736(00)02717-3
  16. Sardinha LB, Teixeira PJ, Guedes DP, Going SB, Lohman TG. Subcutaneous central fat is associated with cardiovascular risk factors in men independently of total fatness and fitness. Metabolism 2000;49:1379-85. https://doi.org/10.1053/meta.2000.17716
  17. Bjorntorp P. Body fat distribution, insulin resistance, and metabolic diseases. Nutrition 1997;13:795-803. https://doi.org/10.1016/S0899-9007(97)00191-3
  18. van der Sluis IM, de Ridder MA, Boot AM, Krenning EP, de Muinck Keizer-Schrama SM. Reference data for bone density and body composition measured with dual energy x ray absorptiometry in white children and young adults. Arch Dis Child 2002;87:341-7. https://doi.org/10.1136/adc.87.4.341
  19. Higgins PB, Gower BA, Hunter GR, Goran MI. Defining health-related obesity in prepubertal children. Obes Res 2001;9:233-40. https://doi.org/10.1038/oby.2001.27
  20. Vatanparast H, Chilibeck PD, Cornish SM, Little JP, Paus-Jenssen LS, Case AM, et al. DXA-derived abdominal fat mass, waist circumference, and blood lipids in postmenopausal women. Obesity (Silver Spring) 2009;17:1635-40. https://doi.org/10.1038/oby.2009.80
  21. Park HJ. Long-term follow-up study and long-term care of childhood cancer survivors. Korean J Pediatr 2010;53:465-70 https://doi.org/10.3345/kjp.2010.53.4.465
  22. Nandagopal R, Laverdière C, Mulrooney D, Hudson MM, Meacham L. Endocrine late effects of childhood cancer therapy: a report from the Children's Oncology Group. Horm Res 2008;69:65-74. https://doi.org/10.1159/000111809

Cited by

  1. Design, implementation, and evaluation of a pediatric and adolescent type 2 diabetes management program at a tertiary pediatric center vol.7, pp.None, 2011, https://doi.org/10.2147/jmdh.s63842
  2. Impairments that Influence Physical Function among Survivors of Childhood Cancer vol.2, pp.1, 2011, https://doi.org/10.3390/children2010001
  3. Metabolic syndrome induced by anticancer treatment in childhood cancer survivors vol.22, pp.2, 2011, https://doi.org/10.6065/apem.2017.22.2.82
  4. Prevalence of cardiovascular late sequelae in long‐term survivors of childhood cancer: A systematic review and meta‐analysis vol.64, pp.7, 2017, https://doi.org/10.1002/pbc.26428
  5. The Frequency of Metabolic Syndrome and Serum Osteopontin Levels in Survivors of Childhood Acute Lymphoblastic Leukemia vol.7, pp.4, 2018, https://doi.org/10.1089/jayao.2017.0129
  6. Metabolic Disturbances in Children Treated for Solid Tumors vol.11, pp.12, 2011, https://doi.org/10.3390/nu11123062
  7. Factors affecting weight and body composition in childhood cancer survivors—cross-sectional study vol.14, pp.None, 2020, https://doi.org/10.3332/ecancer.2020.999
  8. Intestinal Dysbiosis and Development of Cardiometabolic Disorders in Childhood Cancer Survivors: A Critical Review vol.34, pp.3, 2011, https://doi.org/10.1089/ars.2020.8102