Table 2. Metabolic syndrome according to... | American Society of Hematology

Table 2.

Metabolic syndrome according to therapeutic exposure

Therapeutic exposure	Relative risk⁸^,∗	Specific characteristics⁷^,⁹	Pathophysiology^10-12		Early detection¹²^,¹³	Treatment specificities
Therapeutic exposure	Relative risk⁸^,∗	Specific characteristics⁷^,⁹	Treatment-specific	All survivors	Early detection¹²^,¹³	Treatment specificities
HSCT with TBI	×6.3 (×9.2 in females)	Increased severity of metabolic syndrome Lower incidence of obesity and lower abdominal circumference, higher triglycerides, and glucose level	Radiation induced alteration of subcutaneous adipose tissue (preadipocyte differentiation) Additional role of pancreatic radiation, testosterone, and growth hormone deficiency	Low-grade chronic inflammation Poor eating habits and reduced activity during prolonged periods Genetic predisposition	Regular monitoring: Blood pressure Abdominal circumference Fasting glucose, triglyceride, HDL- and LDL-cholesterol Potential interest of early biomarkers (adipokines)?	Few specific data Moderate effect of lifestyle modifications in the LEA experience
HSCT without TBI	×2.2	Usually less severe than after HSCT with TBI	Largely unknown Role of testosterone deficiency
Chemotherapy and CNS irradiation	×2.3	More frequent abdominal obesity Low incidence of hypertension	Important role of obesity Leptin resistance and overproduction (damaged hypothalamic receptors) Growth hormone deficiency
Chemotherapy without CNS irradiation	×1.7	More frequent hypertension (compared to CNS irradiation)	Largely unknown Uncertain long-term role of steroid and asparaginase

Therapeutic exposure	Relative risk⁸^,∗	Specific characteristics⁷^,⁹	Pathophysiology^10-12		Early detection¹²^,¹³	Treatment specificities
Therapeutic exposure	Relative risk⁸^,∗	Specific characteristics⁷^,⁹	Treatment-specific	All survivors	Early detection¹²^,¹³	Treatment specificities
HSCT with TBI	×6.3 (×9.2 in females)	Increased severity of metabolic syndrome Lower incidence of obesity and lower abdominal circumference, higher triglycerides, and glucose level	Radiation induced alteration of subcutaneous adipose tissue (preadipocyte differentiation) Additional role of pancreatic radiation, testosterone, and growth hormone deficiency	Low-grade chronic inflammation Poor eating habits and reduced activity during prolonged periods Genetic predisposition	Regular monitoring: Blood pressure Abdominal circumference Fasting glucose, triglyceride, HDL- and LDL-cholesterol Potential interest of early biomarkers (adipokines)?	Few specific data Moderate effect of lifestyle modifications in the LEA experience
HSCT without TBI	×2.2	Usually less severe than after HSCT with TBI	Largely unknown Role of testosterone deficiency
Chemotherapy and CNS irradiation	×2.3	More frequent abdominal obesity Low incidence of hypertension	Important role of obesity Leptin resistance and overproduction (damaged hypothalamic receptors) Growth hormone deficiency
Chemotherapy without CNS irradiation	×1.7	More frequent hypertension (compared to CNS irradiation)	Largely unknown Uncertain long-term role of steroid and asparaginase

CNS, central nervous system; HDL, high-density lipoprotein; LDL, low-density lipoprotein.

Compared with age- and sex-matched controls.