Author(s): Pietil S, Mkipernaa A, Sievnen H, Koivisto AM, Wigren T,
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Abstract BACKGROUND: A population based cross-sectional study was used to examine the prevalence of metabolic syndrome and its components in childhood brain tumor survivors. PROCEDURE: Fifty-two survivors were examined at a mean age of 14.4 years (range 3.8-28.7). Lipid and glucose metabolism, thyroid function, and plasma uric acid were evaluated. Fat mass and fat percentage were assessed by dual-energy X-ray absorptiometry (DXA). Metabolic syndrome was defined on International Diabetes Federation criteria. RESULTS: Ten (19\%) patients were overweight and four (8\%) were obese. According to DXA, 16/46 (35\%) patients were obese. Central obesity was found in 11 (21\%) patients. Cranial irradiation, hypothalamic/hypophyseal damage, growth hormone (GH) deficiency and impaired mobility were associated with overweight/obesity and central obesity. Thirteen (25\%) subjects had hypercholesterolemia, 14 (27\%) had raised low-density lipoprotein cholesterol (LDL-C), 12 (23\%) had raised blood pressure, four (8\%) had metabolic syndrome, two (4\%) had hyperinsulinemia and five (10\%) had hyperuricemia. Cranial irradiation was associated with hypercholesterolemia (P = 0.019), raised LDL-C (P = 0.028), raised blood pressure (P = 0.040), and metabolic syndrome (P = 0.018). Impaired mobility was associated with hypercholesterolemia (P = 0.034). Hypothalamic/hypophyseal damage was associated with metabolic syndrome (P = 0.003) and hyperuricemia (P = 0.011) as was GH deficiency (P = 0.034 and P = 0.008). GH supplementation alleviated adverse metabolic outcomes among brain tumor survivors with GH deficiency. CONCLUSIONS: Obesity/overweight, dyslipidemia, hypertension, metabolic syndrome, and hyperuricemia were common in young childhood brain tumor survivors. Cranial irradiation, hypothalamic/hypophyseal damage, growth hormone deficiency, and/or impaired mobility were associated with higher risk for obesity and metabolic changes among these patients. (c) 2009 Wiley-Liss, Inc.
This article was published in Pediatr Blood Cancer
and referenced in Journal of Steroids & Hormonal Science