Prevalence and characteristics of metabolic syndrome in adults from the French childhood leukemia survivors' cohort: A comparison with controls from the French population

The prevalence of the metabolic syndrome among adults from the French childhood acute leukemia survivors’ cohort was prospectively evaluated considering the type of anti-leukemic treatment received, and compared with that of controls. The metabolic profile of those patients was compared with that of controls. 3203 patients from a French volunteer cohort were age- and sex-matched 3:1 to 1025 leukemia survivors (in both cohorts, mean age: 24.4 years, female individuals: 51%). Metabolic syndrome was defined according to the National Cholesterol Education Program’s Adult Treatment Panel III criteria. Metabolic syndrome was found in 10.3% of patients (mean follow-up duration: 16.3+/-0.2 years) and 4.5% of controls, (OR=2.49, p<0.001). Patients transplanted with total body irradiation presented the highest risk (OR=6.26, p<0.001); the other treatment groups also displayed a higher risk than controls, including patients treated with chemotherapy only. Odd ratios were 1.68 (p=0.005) after chemotherapy only, 2.32 (p=0.002) after chemotherapy and cranial irradiation, and 2.18 (p=0.057) in patients transplanted without irradiation. Total body irradiation recipients with metabolic syndrome displayed a unique profile compared with controls: smaller waist circumference (91 versus 99.6 cm, p=0.01), increased triglyceride levels (3.99 versus 1.5 mmol/l, p<0.001), fasting glucose levels (6.2 versus 5.6 mmol/l, p=0.049) and systolic blood pressure (137.9 versus 132.8 mmHg, p=0.005). By contrast, cranial irradiation recipients with metabolic syndrome had a larger waist circumference (109 versus 99.6 cm, p=0.007) than controls. Regardless of the anti-leukemic treatment, metabolic syndrome risk was higher among childhood leukemia survivors. Its presentation differed depending on the treatment type, thus suggesting divergent pathophysiology.