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The limited screening value of insulin‐like growth factor‐i as a marker for alterations in body composition in very long‐term adult survivors of childhood cancer
Author(s) -
Blijdorp Karin,
van den HeuvelEibrink Marry,
Pieters Rob,
Boot Annemieke,
Sluimer Johanna,
van der Lelij AartJan,
Neggers Sebastian
Publication year - 2012
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.24015
Subject(s) - medicine , interquartile range , body mass index , lean body mass , gastroenterology , cancer , endocrinology , total body irradiation , body weight , chemotherapy , cyclophosphamide
Abstract Background The clinical relevance of low IGF‐I levels, caused by cranial radiotherapy, in adult childhood cancer survivors has not been studied extensively. We evaluated whether IGF‐I is a useful marker for altered body composition and growth hormone deficiency (GHD) in this group. Procedure We analyzed retrospective data from 610 adult childhood cancer survivors, retrieved from the late effects clinic. Median age at diagnosis was 6 years (interquartile range 3–11) and follow‐up time was 18 years (13–24). We assessed IGF‐I standard deviation scores (SDS), anthropometrical measures, growth hormone stimulation tests in patients with clinical signs of GHD, and measures of body composition (assessed by dual X‐ray absorptiometry, Lunar Prodigy). Results In 58 cranially irradiated acute leukemia survivors (25 Gy (24–25)) and 56 locally irradiated brain tumor survivors (42 Gy (35–54)) we found significantly lower IGF‐I SDS ( P < 0.001), lower height SDS ( P < 0.001), higher body mass index ( P = 0.01), higher waist–hip ratio (WHR; P = 0.001), higher total fat percentage SDS ( P < 0.001), and lower lean body mass SDS ( P < 0.001), as compared to 452 not cranially irradiated survivors. IGF‐I showed a weak inverse correlation with BMI (r = − 0.12, P = 0.04), WHR (r = − 0.15, P = 0.01), total fat percentage (r = − 0.14, P = 0.02), and a positive correlation with lean body mass (r = 0.15, P = 0.01). In patients with low IGF‐I levels, IGF‐I did not significantly differ between subjects with and without GHD as determined by GH‐stimulation testing ( P = 0.39). Conclusion This study shows that IGF‐I has limited value as a marker for alterations in body composition in adult childhood cancer survivors. Pediatr Blood Cancer 2012;59:711–716. © 2011 Wiley Periodicals, Inc.