A comparison between metabolic syndrome post-hematopoietic stem cell transplantation and spontaneously occurring metabolic syndrome

2011 ◽  
Vol 34 (1) ◽  
pp. e6-e11 ◽  
Author(s):  
L. Airaghi ◽  
P. Usardi ◽  
S. Forti ◽  
A. Orsatti ◽  
M. Baldini ◽  
...  
Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 2732-2732
Author(s):  
Giorgio Lambertenghi Deliliers ◽  
Lorena Airaghi ◽  
Patrizia Usardi ◽  
Alessandra Orsatti ◽  
Marina Baldini ◽  
...  

Abstract Metabolic syndrome (MS), formerly known as X-syndrome, is a clinical and laboratory entity involving obesity, hypertension, and borderline fasting glucose, high triglyceride and low HDL cholesterol levels, that is considered to be a counterpart of insulin resistance with overweight playing a key role; increased insulin, leptin, adiponectin and resistin levels link its various features and some common flanking findings such as hypercholesterolemia, hyperuricemia and hyperferritinemia. Clinical and laboratory data reminiscent of metabolic syndrome are commonly observed after hematopoietic stem cell transplantation (HSCT). We evaluated the body mass index (BMI), routine lipid and glucidic markers, and common endocrinologic parameters in 37 HSCT recipients (19 males; median age 45 years, range 26–60; 22 autologous, 15 allogeneic) whose continuous CR lasted at least five years; insulin (baseline and after an oral glucose test), leptin, resistin, TNF-alpha and adiponectin levels were also detemined. Diabetic HSCT recipients were excluded. The control group consisted of 23 healthy volunteers of comparable age and sex without a family history of diabetes. In comparison with the controls, the HSCT recipients had significantly increased levels of TNF (median 10.05 vs 9.3 pg/mL, p=0.034), insulin (13.6 vs 10.1 mIU/mL, p=0.029) and leptin (13.71 vs 3.69 ng/mL, p= 0.02); there were no significant differences in adiponectin and resistin levels, BMI or the other considered parameters. In comparison with the other HSCT recipients, the 16 patients with higher baseline insulin levels (>15 mIU/mL) had significantly higher leptin levels (median 23.665 vs 8.3, p<0.001), and also different total cholesterol (231 vs 202 mg/dL, p<0.01), HDL-cholesterol (58 vs 68 mg/dL, p<0.01), triglyceride (150 vs 92 mg/dL, p<0.01) and ferritin levels (635 vs 491 ng/mL, p<0.01). This preliminary investigation show an increased prevalence of MS findings in HSCT recipients, and a relationship between baseline insulin levels and some common laboratory features of MS. Unlike in spontaneously occurring cases, obesity does not seem to play a primary role; furthermore, BMI and adiponectin were not significantly increased. However, the significant increase in TNF (another inducer of insulin resistance) suggests a possible pathogenetic sequence of post-HSCT MS linking TNF, insulin and leptin. The association between MS and the development of cardiovascular diseases is well known, but HSCT may, in alternative ways, induce a long-term metabolic derangement that affects the life expectancy of patients already cured of their baseline neoplastic disease.


2014 ◽  
Vol 23 (1) ◽  
pp. 25
Author(s):  
Maria Cláudia Bernardes Spexoto ◽  
Maria Rita Marques de Oliveira

ObjectiveThis study assessed early manifestations of metabolic syndrome determinants in patients submitted to hematopoietic stem cell transplantation.MethodsTwenty-seven individuals participated in the study (20 with autologous and 7 with allogeneic hematopoietic stem cell transplantation). Anthropometric variables and biochemical indicators of lipid and glucose metabolism were determined before and 100 days after hematopoietic stem cell transplantation.ResultsThe mean total cholesterol (p=0.086), very low density lipoprotein-cholesterol (p=0.069) and triglycerides (p=0.086) of all patients did not change significantly between the two study periods, but when the patients were separated by type of hematopoietic stem cell transplantation, triglycerides and very low density lipoprotein-cholesterol were close to the critical level of significance for individuals with allogeneic hematopoietic stem cell transplantation (p=0.060) and total cholesterol was significant in individualswith autologous hematopoietic stem cell transplantation (p=0.027). Anthropometric variables did not change significantly between before and 100 days after hematopoietic stem cell transplantation.ConclusionMetabolic syndrome risk factors may be associated with lipid metabolism in the early phase of allogeneic and autologous hematopoietic stem cell transplantation.Indexing terms: Body composition. Hematopoietic stem cell transplantation. Lipids. Metabolic syndrome.


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