Kyriakakis Nikolaos, Giannoudi Marilena, Kumar Satish S, Seejore Khyatisha, Dimitriadis Georgios K, Randeva Harpal, Glaser Adam, Kwok-Williams Michelle, Gerrard Georgina, Loughrey Carmel, Al-Qaissi Ahmed, Ajjan Ramzi, Lynch Julie, Murray Robert D
Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Leeds Institute for Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds, UK.
Endocr Connect. 2023 Jul 12;12(8):e220491. doi: 10.1530/EC-22-0491.
Survivors of childhood brain tumours (SCBT) and teenage and young adult cancer survivors have an adverse cardiovascular risk profile, which translates into an increased vascular mortality. Data on cardiovascular risk profiles in SCBT are limited, and furthermore, there are no data in adult-onset (AO) brain tumours.
methods: Fasting lipids, glucose, insulin, 24-h blood pressure (BP), and body composition were measured in 36 brain tumour survivors (20 AO; 16 childhood-onset (CO)) and 36 age- and gender-matched controls.
Compared with controls, patients had elevated total cholesterol (5.3 ± 1.1 vs 4.6 ± 1.0 mmol/L, P = 0.007), LDL-C (3.1 ± 0.8 vs 2.7 ± 0.9 mmol/L, P = 0.011), insulin (13.4 ± 13.1 vs 7.6 ± 3.3 miu/L, P = 0.014), and increased insulin resistance (homeostatic model assessment for insulin resistance (HOMA-IR) 2.90 ± 2.84 vs 1.66 ± 0.73, P = 0.016). Patients showed adverse body composition, with increased total body fat mass (FM) (24.0 ± 12.2 vs 15.7 ± 6.6 kg, P < 0.001) and truncal FM (13.0 ± 6.7 vs 8.2 ± 3.7 kg, P < 0.001). After stratification by timing of onset, CO survivors showed significantly increased LDL-C, insulin, and HOMA-IR compared with controls. Body composition was characterized by the increased total body and truncal FM. Truncal fat mass was increased by 84.1% compared with controls. AO survivors showed similar adverse cardiovascular risk profiles, with increased total cholesterol and HOMA-IR. Truncal FM was increased by 41.0% compared with matched controls (P = 0.029). No difference in mean 24-h BP was noted between patients and controls irrespective of the timing of cancer diagnosis.
The phenotype of both CO and AO brain tumour survivors is characterized by an adverse metabolic profile and body composition, putatively placing long-term survivors at increased risk of vascular morbidity and mortality.
儿童脑肿瘤幸存者（SCBT）以及青少年和年轻成人癌症幸存者具有不良的心血管风险特征，这会导致血管性死亡率增加。关于SCBT心血管风险特征的数据有限，此外，成人发病（AO）脑肿瘤方面尚无相关数据。
对36名脑肿瘤幸存者（20名成人发病；16名儿童期发病（CO））以及36名年龄和性别匹配的对照者测量空腹血脂、血糖、胰岛素、24小时血压（BP）和身体成分。
与对照组相比，患者的总胆固醇（5.3±1.1 vs 4.6±1.0 mmol/L，P = 0.007）、低密度脂蛋白胆固醇（LDL-C）（3.1±0.8 vs 2.7±0.9 mmol/L，P = 0.011）、胰岛素（13.4±13.1 vs 7.6±3.3 miu/L，P = 0.014）升高，胰岛素抵抗增加（胰岛素抵抗稳态模型评估（HOMA-IR）2.90±2.84 vs 1.66±0.73，P = 0.016）。患者表现出不良的身体成分，全身脂肪量（FM）增加（24.0±12.2 vs 15.7±6.6 kg，P < 0.001）和躯干FM增加（13.0±6.7 vs 8.2±3.7 kg，P < 0.001）。按发病时间分层后，CO幸存者与对照组相比，LDL-C、胰岛素和HOMA-IR显著升高。身体成分的特征是全身和躯干FM增加。与对照组相比，躯干脂肪量增加了84.1%。AO幸存者表现出类似的不良心血管风险特征，总胆固醇和HOMA-IR升高。与匹配的对照组相比，躯干FM增加了41.0%（P = 0.029）。无论癌症诊断时间如何，患者与对照组之间的24小时平均血压均无差异。
CO和AO脑肿瘤幸存者的表型特征均为不良的代谢特征和身体成分，这可能使长期幸存者面临血管发病和死亡风险增加。
