The metabolic syndrome and its components in pediatric survivors of allogeneic hematopoietic stem cell transplantation

Bella Bielorai, Yael Weintraub, Daphna Hutt, Rina Hemi, Hannah Kanety, Dalit Modan-Moses, Gal Goldstein, Dana Hadar, Liat Lerner-Geva, Amos Toren, Orit Pinhas-Hamiel

Research output: Contribution to journalArticlepeer-review

Abstract

Metabolic syndrome (MetS) is a known complication after hematopoietic stem cell transplantations (HSCT) that contributes to long-term morbidity. We assessed the prevalence of components of the MetS in pediatric survivors of allogeneic HSCT and identified associated risk factors. Thirty-eight patients, median age at HSCT, 8.5 years, were evaluated at a median of 3.9 years post-HSCT. Overweight or obesity was seen in 23.7% of the patients, 15.8% had hypertension, 15.8% had hypertriglyceridemia, and 13% had low high-density lipoprotein cholesterol levels according to age and gender. Four (10.5%) met the criteria of MetS; all were transplanted for malignant disease. Twelve patients (31.6%) had at least one component of the MetS. The 5-year probability of developing components of the MetS revealed that patients with BMI-Z score ≥0 at HSCT were significantly at higher risk than those with lower BMI-Z. Patients who developed components of the MetS had higher levels of insulin, homeostasis model assessment, uric acid, leptin, and lower adiponectin levels. Multivariable regression analysis revealed that BMI-Z-score >1.036 at time of evaluation was associated with 4.3-fold increased risk (P=.050) and adiponectin levels ≤6 μg/mL were associated with 6.7-fold increased risk of develop components of the MetS (P=.007). Overweight and obesity and adiponectin levels may be useful as markers in HSCT survivors.

Original languageEnglish
Article numbere12903
JournalClinical Transplantation
Volume31
Issue number3
DOIs
StatePublished - 1 Mar 2017

Keywords

  • dyslipidemia
  • hematopoietic stem cell transplantation
  • metabolic syndrome
  • obesity
  • overweight
  • total body irradiation
  • type 2 diabetes mellitus

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