Oncology Medical News about insulin resistance;risk factors;cardiovascular disease;childhood ALL;young adult survivors

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Insulin resistance and risk factors for cardiovascular disease in young adult survivors of childhood acute lymphoblastic leukemia
Journal of Clinical Oncology, 07/08/09

Oeffinger KC et al. - In a study to determine the prevalence of insulin resistance and other risk factors for cardiovascular disease (CVD) in young adult survivors of childhood acute lymphoblastic leukemia (ALL), it was reported that ALL survivors had an increased prevalence of insulin resistance in comparison with a cohort of older individuals from the same community. Women treated with CRT seem to have an increased prevalence of multiple CVD risk factors, warranting close monitoring and risk-reducing strategies.

Methods

In this cross-sectional evaluation of 118 survivors of childhood ALL (median age, 23.0 yrs), insulin resistance was estimated using the homeostasis model for assessment of insulin resistance (HOMA-IR).
Sex-specific comparisons were made with a cohort of 30- to 37-yr-old individuals from the same region.
ALL survivors were stratified by treatment with and without cranial radiotherapy (CRT).

Results

Female ALL survivors had a significantly higher HOMA-IR (CRT, mean 4.6; no CRT, mean 3.3) in comparison with DHS women (mean 2.4).
80% of women treated with CRT had at least 3 of 6 CVD risk factors and were significantly more likely to have 3 or more risk factors vs DHS women.
Male ALL survivors had a significantly higher HOMA-IR (CRT, mean 4.0; no CRT, mean 3.4) in comparison with DHS men (mean 2.3), but were not more likely to have multiple CVD risk factors.

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