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العنوان
Obesity and Metabolic Syndrome among Survivors of Childhood Acute Lymphoblastic Leukemia /
المؤلف
Hamama, Eman Samy Mohammed.
هيئة الاعداد
باحث / Eman Samy Mohammed Hamama
مشرف / Mohamed Abo-El-Asrar Mohamed El-Bayoumy Afifi
مشرف / Marwa Salah El-Sherif
مناقش / Sara Mostafa Makkeyah
تاريخ النشر
2018.
عدد الصفحات
119 P. :
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
طب الأطفال ، الفترة المحيطة بالولادة وصحة الطفل
تاريخ الإجازة
1/1/2018
مكان الإجازة
جامعة عين شمس - كلية الطب - قسم طب الاطفال
الفهرس
Only 14 pages are availabe for public view

from 119

from 119

Abstract

Childhood acute lymphoblastic leukemia (ALL) with the current cure rates reaching more than 80% emphasizes the necessity to determine treatment related long-term effects. Late effects may occur soon after stopping the therapy but also many years or decades later, and include secondary malignancy, cardiotoxicity, neurotoxicity, endocrine abnormalities, obesity and metabolic syndrome (MS).
In the current study we aimed to evaluate the frequency and risk factors for the development of obesity and metabolic syndrome in ALL survivors, and to study alterations in their body composition in comparison to healthy controls.
The study was conducted on 29 patients with cured ALL recruited from Pediatric Oncology Clinic at Ain Shams University Children’s Hospital during the period from December 2016 to December 2017. Another 30 healthy subjects were enrolled as controls. All participants were subjected to full history taking, full clinical examination including full anthropometric assessment (weight, height, body mass index (BMI), waist circumference (WC), hip circumference (HC) and waist: hip ratio (WHr) as well as body composition analysis, and laboratory investigation including complete blood count (CBC), fasting glucose, fasting insulin, lipid profile and serum leptin.
In the present study, around one third of ALL survivors had increased BMI as compared to only 13.3% for the control group (P =0.025). Of those, central obesity was found in 17.9% of ALL survivors versus 3.3% in healthy controls. On the other hand, none of the study participant had lower than normal BMI. None of the subjects (ALL survivors or control) had hypertension or diabetes mellitus in our study. Furthermore, ALL survivors had significantly higher levels of total cholesterol when compared to healthy control (P = 0.03), however, HDL-C and LDL-C levels were comparable for both groups. Two out of the 29 ALL survivors had high TG (> 150mg), while all the controls had normal levels. ALL survivors had significantly higher levels of serum leptin (P = 0.02).
Body composition analysis including body fat %, muscle mass % and total body water % did not differ between both groups (P = 0.890, 0.685 and 0.080 respectively).
This data showed an increased risk of isolated components of MS in childhood leukemia survivors as compared to healthy controls, but no patient fulfilled the IDF criteria for diagnosis of metabolic syndrome.
Among the ALL survivor group time from end of therapy was the only identified risk factor between patients with normal vs abnormal BMI patients being significantly higher in the overweight/obese group (P < 0.001). Other factors including age at diagnosis, gender, immunophenotype, CNS status, duration of therapy, use of cranial irradiation and family history of metabolic syndrome components were comparable in both groups.
Alterations in body composition among the overweight/obese survivors were found in the form of increased body fat %, decreased muscle mass % and total body water %. The obese/overweight group also had significantly higher levels of serum leptin than control group (P = 0.02), whereas no difference was found in serum levels of triglycerides, total cholesterol, LDL-C and HDL-C.