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Meta-Analysis
. 2021 Nov;22(11):e13312.
doi: 10.1111/obr.13312. Epub 2021 Jul 13.

Can biomarkers be used to improve diagnosis and prediction of metabolic syndrome in childhood cancer survivors? A systematic review

Vincent G Pluimakers  1 , Selveta S van Santen  1   2 , Marta Fiocco  1   3   4 , Marie-Christine E Bakker  1   5 , Aart J van der Lelij  2 , Marry M van den Heuvel-Eibrink  1 , Sebastian J C M M Neggers  1   2
Affiliations
Meta-Analysis

Can biomarkers be used to improve diagnosis and prediction of metabolic syndrome in childhood cancer survivors? A systematic review

Vincent G Pluimakers et al. Obes Rev. 2021 Nov.

Abstract

Childhood cancer survivors (CCS) are at increased risk to develop metabolic syndrome (MetS), diabetes, and cardiovascular disease. Common criteria underestimate adiposity and possibly underdiagnose MetS, particularly after abdominal radiotherapy. A systematic literature review and meta-analysis on the diagnostic and predictive value of nine newer MetS related biomarkers (adiponectin, leptin, uric acid, hsCRP, TNF-alpha, IL-1, IL-6, apolipoprotein B (apoB), and lipoprotein(a) [lp(a)]) in survivors and adult non-cancer survivors was performed by searching PubMed and Embase. Evidence was summarized with GRADE after risk of bias evaluation (QUADAS-2/QUIPS). Eligible studies on promising biomarkers were pooled. We identified 175 general population and five CCS studies. In the general population, valuable predictive biomarkers are uric acid, adiponectin, hsCRP and apoB (high level of evidence), and leptin (moderate level of evidence). Valuable diagnostic biomarkers are hsCRP, adiponectin, uric acid, and leptin (low, low, moderate, and high level of evidence, respectively). Meta-analysis showed OR for hyperuricemia of 2.94 (age-/sex-adjusted), OR per unit uric acid increase of 1.086 (unadjusted), and AUC for hsCRP of 0.71 (unadjusted). Uric acid, adiponectin, hsCRP, leptin, and apoB can be alternative biomarkers in the screening setting for MetS in survivors, to enhance early identification of those at high risk of subsequent complications.

Keywords: biomarker; childhood cancer survivors; systematic review; the metabolic syndrome.

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Conflict of interest statement

The authors have nothing to disclose.

Figures

FIGURE 1
FIGURE 1
Flow chart of included and excluded articles from the systematic literature search
FIGURE 2
FIGURE 2
Summary of conclusions: predictive and diagnostic value of novel biomarkers for the MetS
FIGURE 3
FIGURE 3
Forest plots for different study‐specific outcomes. (A) Odds ratio (OR) for hyperuricemia. (B) OR for per unit increase in uric acid. (C) Area under the curve (AUC) of hsCRP. The sizes of the square boxes on the forest plots are proportional to the total number of patients in the selected trials
See this image and copyright information in PMC

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