Subcutaneous adipose tissue plays a beneficial effect on subclinical atherosclerosis in young survivors of acute lymphocytic leukemia

• Published in: Vascular health and risk management Vol. 11; no. default; pp. 479 - 488
• Main Authors: Siviero-Miachon, Adriana Aparecida, Spinola-Castro, Angela Maria, de Martino Lee, Maria Lucia, de Castro Monteiro, Carlos Manoel, de Camargo Carvalho, Antonio Carlos, Calixto, Antonio Ramos, Geloneze, Bruno, Guerra-Junior, Gil
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01-01-2015; Taylor & Francis Ltd; Dove Medical Press
• Subjects: Absorptiometry, Photon; Acute lymphocytic leukemia; Adiponectin - blood; Adipose tissues; Adiposity; Adolescent; Age; Atherosclerosis; Biomarkers - blood; Blood pressure; Body composition; Body fat; Body mass index; Bone marrow; Cancer therapies; Cardiology; Cardiovascular disease; Care and treatment; Carotid Artery Diseases - blood; Carotid Artery Diseases - diagnostic imaging; Carotid Artery Diseases - etiology; Carotid Artery Diseases - physiopathology; Carotid Intima-Media Thickness; Case-Control Studies; Cranial Irradiation - adverse effects; Cross-Sectional Studies; Development and progression; Diabetes; Disease control; Endocrinology; Family medical history; Female; Health aspects; Homeostasis; Humans; Hypertension; Insulin resistance; Insulin-like growth factors; Intra-Abdominal Fat - diagnostic imaging; Intra-Abdominal Fat - metabolism; Intra-Abdominal Fat - physiopathology; Intra-Abdominal Fat - radiation effects; Leptin - blood; Leukemia; Linear Models; Male; Metabolic syndrome; Multivariate Analysis; Original Research; Patients; Pediatrics; Physiological aspects; Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis; Precursor Cell Lymphoblastic Leukemia-Lymphoma - radiotherapy; Predictive Value of Tests; Radiation therapy; Risk Factors; Subcutaneous Fat - diagnostic imaging; Subcutaneous Fat - metabolism; Subcutaneous Fat - physiopathology; Subcutaneous Fat - radiation effects; Survivors; Tomography, X-Ray Computed; Treatment Outcome; Young Adult; Young adults; Brazil; United States > US; atherosclerosis; endothelium; abdominal fat; adipokines; metabolic syndrome X; precursor cell lymphoblastic leukemia–lymphoma/radiotherapy
• ISSN: 1178-2048; 1176-6344; 1178-2048
• DOI: 10.2147/VHRM.S86883

The aim of this study was to evaluate the relationship between body composition, metabolic profile, adipokines, and carotid intima-media thickness (cIMT) in young survivors of childhood acute lymphocytic leukemia (ALL).
This cross-sectional study compared 55 ALL survivors, of chronological age between 15 years and 24 years, assigned into two groups according to the exposure to cranial radiation therapy (CRT; 25 irradiated and 30 nonirradiated) with 24 leukemia-free controls, and assessed body fat mass (dual-energy X-ray absorptiometry), computed tomography scan-derived abdominal adipose tissue, lipid profile, blood pressure (BP), adipokines, and cIMT by a multiple regression analysis.
Treatment with CRT had an effect on all of the variables derived from the computed tomography scan: visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) (P<0.050). In a multiple linear regression model, cIMT positively correlated with exposure to CRT (P=0.029), diastolic BP (P=0.016), and leptin-to-adiponectin ratio (P=0.048), while negatively related to SAT (P=0.007).
In young survivors of childhood ALL, CRT modified the distribution of fat and played a critical role in determining cIMT. Leptin-to-adiponectin ratio, a biomarker of abdominal obesity and metabolic syndrome, and diastolic BP also influenced cIMT, a marker of subclinical atherosclerosis. Nonetheless, adiposity-associated vascular disease might be attenuated by SAT. Changes in body fat must be evaluated in this group of patients in the early course of survivorship in order to avoid premature cardiovascular disease associated with atherosclerosis. Yet, further research as regards the possible protective effect of SAT on vascular disease is warranted.