Glucocorticoids and insulin resistance in children with acute lymphoblastic leukemia
Autor: | Stephanie J. Lee, Christian L. Roth, Jeannine S. McCune, K. Scott Baker, Debra L. Friedman, Catherine Pihoker, Claire Wharton, Eric J. Chow |
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Rok vydání: | 2012 |
Předmět: |
Male
medicine.medical_specialty Adolescent Antineoplastic Agents Overweight Article Body Mass Index Young Adult Insulin resistance Prednisone Hyperinsulinism Internal medicine medicine Humans Child Glucocorticoids business.industry nutritional and metabolic diseases Hematology Precursor Cell Lymphoblastic Leukemia-Lymphoma medicine.disease Obesity Endocrinology Oncology Child Preschool Pediatrics Perinatology and Child Health Homeostatic model assessment Female Insulin Resistance medicine.symptom business Body mass index Glucocorticoid medicine.drug |
Zdroj: | Pediatric Blood & Cancer. 60:621-626 |
ISSN: | 1545-5009 |
Popis: | Background Children treated for acute lymphoblastic leukemia (ALL) are more likely to become overweight. Prolonged exposure to high-dose glucocorticoids may cause insulin resistance and facilitate development of this phenotype. Procedure Body mass indices (BMI) and insulin resistance (homeostatic model assessment [HOMA]-IR) were prospectively measured among on- (n = 31) and off-therapy participants (n = 29). On-therapy participants were assessed prior to and while on glucocorticoids (5 days of prednisone 40 mg m−2 or dexamethasone 6 mg m−2) given as part of routine maintenance chemotherapy, with a subset (n = 10) receiving an intravenous glucose tolerance test (IVGTT) while on glucocorticoids. Results Baseline HOMA-IR values among on- and off-therapy participants were similar, but among on-therapy participants, HOMA-IR increased significantly with glucocorticoid exposure (median 3.39 vs. 1.26; P 4.39 (upper 2.5th percentile among normal weight adolescents). Although baseline HOMA-IR was significantly correlated with current BMI (r = 0.48, P |
Databáze: | OpenAIRE |
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