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Obesity and metabolic changes are common in young childhood brain tumor survivors
Author(s) -
Pietilä Sari,
Mäkipernaa Anne,
Sievänen Harri,
Koivisto AnnaMaija,
Wigren Tuija,
Lenko Hanna L.
Publication year - 2009
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.21936
Subject(s) - medicine , metabolic syndrome , endocrinology , hyperuricemia , overweight , dyslipidemia , obesity , hyperinsulinemia , blood pressure , diabetes mellitus , childhood obesity , uric acid , insulin resistance
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. Pediatr Blood Cancer 2009;52:853–859. © 2009 Wiley‐Liss, Inc.