Components of the Metabolic Syndrome in 500 Adult Long-Term Survivors of Childhood Cancer.

Adult survivors of childhood cancer have been reported to have an increased risk of late sequels. A cluster of abnormalities that contribute to the metabolic syndrome may be expressed at a higher level and therefore result in an increased risk for diabetes mellitus and cardiovascular diseases.

We investigated a single centre cohort of 500 adult survivors (228 females) of childhood cancer, median age 28 years (range 18-59 years) and median follow-up time 19 years (range 6–49 years). This cohort included 164 acute lymphoblastic leukaemia (ALL) survivors (75 females). We measured total cholesterol, high-density lipoprotein-cholesterol (HDL), systolic and diastolic blood pressure, body mass index and the prevalence of diabetes mellitus. Data from the Dutch epidemiologic MORGEN-study were used to calculate standard deviation scores as normative values.

The criteria of the metabolic syndrome were met in 13% of the total cohort. ALL survivors treated with cranial irradiation had an increased risk of developing the metabolic syndrome compared to ALL survivors not treated with cranial irradiation (23% vs. 7%, P=0.011). ALL survivors who received CRT had higher total cholesterol levels compared to ALL survivors who did not (mean SDS 0.38 vs. mean SDS –0.05, P=0.027), whereas their HDL levels did not differ. Also, ALL survivors treated with CRT were more often hypertensive compared to ALL survivors not treated with CRT (22% vs. 10%, P=0.036) and more often overweight (59% vs. 34%, P=0.003), however they were not more often obese (12% vs. 9%, ns).

Adult survivors of childhood cancer, especially ALL survivors treated with cranial irradiation, are at increased risk of developing the metabolic syndrome. This increased risk is probably determined by higher prevalence of overweight and hypertension in ALL survivors.

No relevant conflicts of interest to declare.