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成人急性淋巴细胞白血病和造血干细胞移植后患者的 2 型糖尿病、代谢综合征及其组分。

Type 2 Diabetes Mellitus, the Metabolic Syndrome, and Its Components in Adult Survivors of Acute Lymphoblastic Leukemia and Hematopoietic Stem Cell Transplantations.

机构信息

Department of Pediatric Hematology-Oncology and BMT, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.

Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

Curr Diab Rep. 2018 Apr 18;18(6):32. doi: 10.1007/s11892-018-0998-0.

Abstract

PURPOSE OF REVIEW

A growing number of pediatric acute lymphoblastic leukemia (ALL) and hematopoietic stem cell transplantation (HSCT) survivors reach adulthood and face long-term health-related problems. We review risk factors and the prevalence of the metabolic syndrome (MetS), a cluster of obesity-related comorbidities, including abdominal obesity, atherogenic dyslipidemia, elevated blood pressure, impaired glucose metabolism, and type 2 diabetes in ALL and HSCT survivors.

RECENT FINDINGS

Components of the MetS are already detected during the first year of ALL maintenance therapy and significantly worsen over time. The prevalence of MetS increases at a faster rate in this setting than in the general population. Factors found to be of the greatest potential risk to the development of the MetS are central obesity, increased BMI, irradiation therapy, older age, poor diet, and low level of physical activity. The early onset of MetS and its components among ALL and HSCT survivors calls for early and continuous screening to identify those at risk and to implement preventive measures.

摘要

目的综述

越来越多的儿科急性淋巴细胞白血病 (ALL) 和造血干细胞移植 (HSCT) 幸存者进入成年期,面临长期的健康相关问题。我们综述了代谢综合征(MetS)的危险因素和流行率,代谢综合征是一组与肥胖相关的并存疾病,包括腹部肥胖、动脉粥样硬化性血脂异常、血压升高、葡萄糖代谢受损和 2 型糖尿病。

最新发现

在 ALL 维持治疗的第一年就已经检测到 MetS 的成分,并且随着时间的推移而显著恶化。在这种情况下,MetS 的患病率增长速度比一般人群更快。被认为对 MetS 发展风险最大的因素是中心性肥胖、BMI 增加、放疗、年龄较大、不良饮食和低水平的身体活动。ALL 和 HSCT 幸存者的 MetS 及其成分的早期发病呼吁进行早期和持续的筛查,以识别有风险的人群,并采取预防措施。

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