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

Emily S. Tonorezos, 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

Research output: Contribution to journalArticle

45 Scopus citations

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 (0.7ng/ml/kg) than males (0.4ng/ml/kg, P<0.01), and among subjects who had received CRT compared to those who had not received CRT (females CRT=0.9ng/ml/kg, no CRT=0.7ng/ml/kg; P=0.1; males CRT=0.5ng/ml/kg, no CRT=0.3ng/ml/kg; P<0.01). Elevated HOMA-IR was nearly uniformly present, even among subjects with BMI<25kg/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.

Original languageEnglish (US)
Pages (from-to)31-36
Number of pages6
JournalPediatric Blood and Cancer
Volume58
Issue number1
DOIs
StatePublished - Jan 2012

Keywords

  • ALL
  • Adiponectin
  • Insulin resistance
  • Leptin
  • Leukemia

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

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    Tonorezos, E. S., Vega, G. L., Sklar, C. A., Chou, J. F., Moskowitz, C. S., Mo, Q., Church, T. S., Ross, R., Janiszewski, P. M., & Oeffinger, K. C. (2012). Adipokines, body fatness, and insulin resistance among survivors of childhood leukemia. Pediatric Blood and Cancer, 58(1), 31-36. https://doi.org/10.1002/pbc.22964