ESPEYB18 9. Oncology and Chronic Disease Cardiometabolic risk in chronic disease (2 abstracts)
9.13. Biomarkers of cardiometabolic complications in survivors of childhood acute lymphoblastic leukemia
Morel S , Léveillé P , Samoilenko M , Franco A , England J , Malaquin N , Tu V , Cardin GB , Drouin S , Rodier F , Lippé S , Krajinovic M , Laverdière C , Sinnett D , Lefebvre G , Levy E & Marcil V.
Sci Rep. 2020 Dec 9; 10: 21507. https://pubmed.ncbi.nlm.nih.gov/33299020/
This cross-sectional study of 246 childhood acute lymphoblastic leukemia (cALL) survivors aimed to analyze the relationships between various blood biomarkers and cardiovascular risk, and to test the link between endotoxemia and cardiometabolic complications. A high leptin-adiponectin ratio was associated with obesity, insulin resistance and the metabolic syndrome. Higher levels of plasminogen activator inhibitor-1 and tumor necrosis factor-α were related to obesity. Elevated C-reactive protein levels correlated with insulin resistance and metabolic syndrome. Oxidized-LDL (Ox-LDL) concentrations, as biomarkers of oxidative stress, were associated with dyslipidemia.
Oxidative stress, chronic inflammation, adipose tissue dysfunction, endocrine disorders and accelerated cellular aging have been implicated in the development of cardiometabolic complications in cALL survivors. High circulating levels of adipokines and pro-inflammatory cytokines have been demonstrated during and after chemotherapy. Endothelial dysfunction has been reported in long-term survivors of cALL, contributing to their risk for early cardiovascular disease. The infiltration and retention of low-density lipoprotein (LDL) in the arterial intima triggers the inflammatory process evolving to plaque formation. Modification of LDL through oxidation causes endothelial cells to express leucocyte adhesion molecules leading to the progression of atherosclerosis.
This study includes a large number of biomarkers of endotoxemia, inflammation, oxidative stress and endothelial function in a well-characterized cohort of cALL survivors. The monocentric design, with a relatively small sample size and the absence of a control group of healthy subjects are limitations. Additionally, all the studied subjects were Caucasian and the results may not be generalizable to other ethnicities, because epidemiological studies have clearly shown that biomarkers of cardiometabolic risk can significantly vary in different ethnic groups.
Volume 18
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ESPE Yearbook of Paediatric Endocrinology
ISSN 1662-4009 (Online)
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