Department of Paediatric Oncology-Haematology, Erasmus Medical Centre, Sophia Children's Hospital, Rotterdam, The Netherlands.
Ann Oncol. 2010 May;21(5):1121-6. doi: 10.1093/annonc/mdp414. Epub 2009 Oct 22.
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). We measured total cholesterol, high-density lipoprotein-cholesterol, systolic and diastolic blood pressure, body mass index and the prevalence of diabetes mellitus. Data from the epidemiological Monitoring van Risicofactoren en Gezondheid in Nederland (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. Acute lymphoblastic leukaemia (ALL) survivors treated with cranial irradiation had an increased risk of developing the metabolic syndrome compared with ALL survivors not treated with cranial irradiation (23% versus 7%, P = 0.011), probably determined by higher prevalence of overweight and hypertension.
Adult survivors of childhood cancer, especially those treated with cranial irradiation, are at increased risk of developing the metabolic syndrome.
有报道称，儿童癌症的成年幸存者患晚期后遗症的风险增加。一组导致代谢综合征的异常可能表现得更为明显，因此会增加患糖尿病和心血管疾病的风险。
我们调查了一个由 500 名儿童癌症成年幸存者（228 名女性）组成的单中心队列，中位年龄为 28 岁（范围 18-59 岁），中位随访时间为 19 年（范围 6-49 年）。我们测量了总胆固醇、高密度脂蛋白胆固醇、收缩压和舒张压、体重指数和糖尿病的患病率。利用荷兰风险因素和健康监测（MORGEN）研究的流行病学数据，计算了标准偏差分数作为参考值。
总队列中有 13%符合代谢综合征的标准。与未接受颅脑照射的急性淋巴细胞白血病（ALL）幸存者相比，接受颅脑照射的 ALL 幸存者发生代谢综合征的风险增加（23%比 7%，P=0.011），这可能是由超重和高血压的患病率较高所决定的。
儿童癌症的成年幸存者，尤其是接受颅脑照射的幸存者，患代谢综合征的风险增加。
