Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Jan;58(1):31-6.
doi: 10.1002/pbc.22964. Epub 2011 Jan 19.

Adipokines, body fatness, and insulin resistance among survivors of childhood leukemia

Emily S Tonorezos  1 , Gloria L Vega, Charles A Sklar, Joanne F Chou, Chaya S Moskowitz, Qianxing Mo, Timothy S Church, Robert Ross, Peter M Janiszewski, Kevin C Oeffinger
Affiliations

Adipokines, body fatness, and insulin resistance among survivors of childhood leukemia

Emily S Tonorezos et al. Pediatr Blood Cancer. 2012 Jan.

Abstract

Background: Following our previous reports of an increased prevalence of insulin resistance and adiposity among acute lymphoblastic leukemia (ALL) survivors, particularly women treated with cranial radiotherapy (CRT), we aimed to (1) assess the relationships between adipokines (leptin and adiponectin), CRT, and measures of body fatness and (2) determine correlates of insulin resistance, by gender.

Methods: We conducted cross-sectional evaluation of 116 ALL survivors (median age: 23.0 years; range: 18-37; average time from treatment: 17.5 years), including fasting laboratory testing (adiponectin, leptin, insulin, and glucose), anthropometric measurements (weight, height, and waist circumference), DXA (total body fat and truncal-to-lower-body-fat ratio), and abdominal CT (visceral fat). We estimated insulin resistance using the homeostasis model for assessment of insulin resistance (HOMA-IR). Analytic approaches included regression models and Wilcoxon rank sum testing.

Results: Mean leptin per kilogram fat mass was higher for females (0.7 ng/ml/kg) than males (0.4 ng/ml/kg, P < 0.01), and among subjects who had received CRT compared to those who had not received CRT (females CRT =0.9 ng/ml/kg, no CRT = 0.7 ng/ml/kg; P = 0.1; males CRT = 0.5 ng/ml/kg, no CRT = 0.3 ng/ml/kg; P < 0.01). Elevated HOMA-IR was nearly uniformly present, even among subjects with BMI < 25 kg/m(2), and was associated with higher leptin:adiponectin ratio (LA ratio; P < 0.01).

Conclusions: Among survivors of childhood leukemia, higher leptin levels were associated with measures of body fat and insulin resistance. Anthropomorphic and metabolic changes many years after ALL treatment remain a major health problem facing survivors and may be related to central leptin resistance.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Figure 2
Figure 2
Insulin resistance as measured by log-transformed homeostasis model of insulin resistance (HOMA-IR) versus serum leptin:adiponectin ratio (LA Ratio) in 116 survivors of childhood leukemia, separated by gender: men (A) and women (B).
See this image and copyright information in PMC

References

    1. Tonorezos ES, Oeffinger KC. Survivorship after childhood, adolescent, and young adult cancer. Cancer J. 2008;14(6):388–395. - PubMed
    1. LAG R, Harkins D, Krapcho M, et al. SEER Cancer Statistics Review. National Cancer Insitute; 1975–2003. [Accessed October 5, 2009]. < http://seer.cancer.gov/csr/1975_2003/>.
    1. Oeffinger KC, Mertens AC, Sklar CA, et al. Chronic health conditions in adult survivors of childhood cancer. N Eng J Med. 2006;355(15):1572–1582. - PubMed
    1. Oeffinger KC, Mertens AC, Sklar CA, et al. Obesity in adult survivors of childhood acute lymphoblastic leukemia: a report from the Childhood Cancer Survivor Study. J Clin Oncol. 2003;21(7):1359–1365. - PubMed
    1. Gurney JG, Ness KK, Sibley SD, et al. Metabolic syndrome and growth hormone deficiency in adult survivors of childhood acute lymphoblastic leukemia. Cancer. 2006;107(6):1303–1312. - PubMed

Publication types

MeSH terms