Periodic Monitoring of Components of the Metabolic Syndrome in Adolescent Survivors of Childhood Cancer

Purpose: The components of metabolic syndrome (MS) have been tended to increase and associated with cardiovascular risks in long-term survivors of childhood cancer. We investigated the prevalence of components of MS in adolescent survivors of childhood cancer and tried to monitor them periodically.

Materials and methods: We investigated 44 adolescent survivors of childhood cancer, median age 14.9 years (range 10–19.8 years) and median follow-up time elapsed after off-therapy 7.4 years (range 5–16.5 years). We measured body mass index (BMI), systolic and diastolic blood pressure, triglycerides (TG), high-density lipoprotein (HDL)–cholesterol, and fasting glucose. Fatty liver was evaluated by ultrasound examinations during follow-up period.

Results: No survivors demonstrated MS with 3 components, however, 18% of survivors (8/44) have 2 abnormal components and 43% (19/44) have 1 abnormal components, respectively. The frequency of each component was: increased BMI, 11%; elevated blood pressure, 0%; elevated TG level, 41%, low HDL cholesterol, 27%; and elevated fasting glucose, 0%. Among these components, the increased TG levels were highly prevalent in survivors than in general population (p=0.000). Fatty liver was identified in 8 survivors (18.2%). Sixteen of 44 survivors (36.4%) received at least 3 repeated examinations annually. Twelve out of 16 survivors have 1 or 2 abnormal components at initial examination. Their number of metabolic components have been shown to decrease in 4, persisted in 3, and increased in 5 survivors. Three of 4 survivors who have no components of MS at initial examination showed at least 1 abnormal component during follow-up.

Conclusions: We observed the high incidence of increased TG level in adolescent survivors of childhood cancer, and detected abnormal components of MS during periodic follow-up. Lifestyle interventions and periodic long-term follow-up monitoring would be needed to reduce the metabolic risks in childhood cancer survivors.