Faienza Maria Felicia, Delvecchio Maurizio, Giordano Paola, Cavallo Luciano, Grano Maria, Brunetti Giacomina, Ventura Annamaria
Department of Biomedical Sciences and Human Oncology, Pediatrics Unit, University of Bari 'A. Moro', Piazza G. Cesare, 11, 70124, Bari, Italy,
Endocrine. 2015 Jun;49(2):353-60. doi: 10.1007/s12020-014-0395-7. Epub 2014 Aug 26.
A significant number of long-term complications have been described in childhood leukemia survivors. In particular, these patients may present features of metabolic syndrome (MetS), and therefore increased risk for cardiovascular diseases. The aim of this meta-analysis is to evaluate the prevalence and the risk of MetS in survivors of childhood leukemia. Two authors independently performed a systematic literature search in PubMed and EMBASE to March 2014, reviewed and selected articles, based on pre-determined selection criteria. Twelve articles, comprising 2,337 participants (1,462 cases and 875 controls), were included in the meta-analysis. Only three of them were case-control studies eligible for the meta-analysis. The childhood leukemia survivors showed an increased risk of MetS as compared to healthy controls (OR = 4.36; 95 % CI 1.19-16.22). The risk was significantly increased only in patients treated with chemotherapy and radiotherapy (OR = 7.79; 95 % CI 1.27-47.77), and not in patients treated with only chemotherapy (OR = 2.35; 95 % CI 0.40-13.78). Childhood leukemia survivors, in particular if treated also with radiotherapy, are prone to develop MetS more than healthy controls. Monitoring of MetS components in these patients is necessary to avoid cardiovascular consequences later in life.
儿童白血病幸存者中已发现大量长期并发症。特别是,这些患者可能出现代谢综合征(MetS)的特征,因此患心血管疾病的风险增加。本荟萃分析的目的是评估儿童白血病幸存者中MetS的患病率和风险。两位作者独立于2014年3月在PubMed和EMBASE上进行了系统的文献检索,根据预先确定的选择标准对文章进行了审查和筛选。荟萃分析纳入了12篇文章,共2337名参与者(1462例病例和875名对照)。其中只有3篇是符合荟萃分析条件的病例对照研究。与健康对照相比,儿童白血病幸存者患MetS的风险增加(OR = 4.36;95% CI 1.19 - 16.22)。仅在接受化疗和放疗的患者中风险显著增加(OR = 7.79;95% CI 1.27 - 47.77),而仅接受化疗的患者中风险未增加(OR = 2.35;95% CI 0.40 - 13.78)。儿童白血病幸存者,特别是如果还接受了放疗,比健康对照更容易发生MetS。对这些患者的MetS成分进行监测对于避免日后生活中的心血管后果是必要的。