Frisk Per, Arvidson Johan, Larsson Marita, Naessén Tord
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Pediatr Transplant. 2012 Jun;16(4):385-91. doi: 10.1111/j.1399-3046.2012.01693.x. Epub 2012 Apr 4.
We measured risk factors for CVD in 18 patients at a median of 18.2 yr after SCT and in sex and age-matched controls. Three patients (17%), but none of the controls, met the criteria for the MetS (p = 0.25). In the patients, we found higher levels of triglycerides (0.94 vs. 0.62 mm, p = 0.019), total cholesterol (5.1 vs. 4.0 mm, p = 0.017), LDL (3.4 vs. 2.6 mm, p = 0.019), apolipoprotein B (1.04 vs. 0.74 g/L, p = 0.004), apolipoprotein B/A1 ratio (0.7 vs. 0.5, p = 0.026), and lower levels of adiponectin (4.9 vs. 7.5 mg/L, p = 0.008) than in the controls. The patients had a lower GHmax (9 vs. 20.7 mU/L, p = 0.002). GHmax was significantly correlated inversely with triglycerides (r = -0.64, p = 0.008), total cholesterol (r = -0.61, p = 0.011), apolipoprotein B (r = -0.60, p = 0.014), and apolipoprotein B/A1 ratio (r = -0.66, p = 0.005). We recorded a significantly thicker carotid intima layer among the patients than among matched controls (0.15 vs. 0.13 mm, p = 0.034). The level of adiponectin correlated inversely with carotid intima thickness (r = -0.55, p = 0.023). After SCT in childhood, long-term survivors may be at risk of developing premature CVD.
我们在18例造血干细胞移植（SCT）后中位时间为18.2年的患者以及性别和年龄匹配的对照组中测量了心血管疾病（CVD）的危险因素。3例患者（17%）符合代谢综合征（MetS）标准，而对照组中无人符合（p = 0.25）。在患者中，我们发现甘油三酯水平较高（0.94对0.62 mmol/L，p = 0.019）、总胆固醇水平较高（5.1对4.0 mmol/L，p = 0.017）、低密度脂蛋白（LDL）水平较高（3.4对2.6 mmol/L，p = 0.019）、载脂蛋白B水平较高（1.04对0.74 g/L，p = 0.004）、载脂蛋白B/A1比值较高（0.7对0.5，p = 0.026），且脂联素水平较低（4.9对7.5 mg/L，p = 0.008）。患者的生长激素峰值（GHmax）较低（9对20.7 mU/L，p = 0.002）。GHmax与甘油三酯（r = -0.64，p = 0.008）、总胆固醇（r = -0.61，p = 0.011）、载脂蛋白B（r = -0.60，p = 0.014）以及载脂蛋白B/A1比值（r = -0.66，p = 0.005）呈显著负相关。我们记录到患者的颈动脉内膜层比匹配对照组显著更厚（0.15对0.13 mm，p = 0.034）。脂联素水平与颈动脉内膜厚度呈负相关（r = -0.55，p = 0.023）。儿童期进行造血干细胞移植后，长期存活者可能有发生过早心血管疾病的风险。
