Impaired glucose tolerance and dyslipidaemia as late effects after bone-marrow transplantation in childhood

This follow-up study aimed to assess the frequency of late effects on glucose and lipid metabolism after bone-marrow transplantation in childhood. 23 long-term survivors (median age 20 years) were studied 3–18 years after bone-marrow transplantation and compared with 23 healthy controls matched for...

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Bibliographic Details
Published in:The Lancet (British edition) 2000-09, Vol.356 (9234), p.993-997
Main Authors: Taskinen, Menrvi, Saarinen-Pihkala, Ulla M, Hovi, Liisa, Lipsanen-Nyman, Mania
Format: Article
Language:English
Subjects:
Adolescent
Adult
Analysis of Variance
Biological and medical sciences
Blood Glucose - metabolism
Bone marrow
Bone Marrow Transplantation - adverse effects
Case-Control Studies
Child
Children & youth
Diabetes Mellitus, Type 2 - etiology
Diabetes Mellitus, Type 2 - metabolism
Female
Finland
Follow-Up Studies
Glucose
Humans
Hypertriglyceridemia - etiology
Insulin - blood
Insulin - metabolism
Insulin Resistance
Investigative techniques, diagnostic techniques (general aspects)
Lipids
Male
Medical sciences
Metabolic diseases
Metabolism
Obesity - etiology
Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques
Transplants & implants
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Summary:This follow-up study aimed to assess the frequency of late effects on glucose and lipid metabolism after bone-marrow transplantation in childhood. 23 long-term survivors (median age 20 years) were studied 3–18 years after bone-marrow transplantation and compared with 23 healthy controls matched for age and sex and with 13 patients in remission from leukaemia. 12 (52%) of the 23 bone-marrow transplantation patients had insulin resistance, including impaired glucose tolerance in six and type 2 diabetes in four. The core signs of the metabolic syndrome (hyperinsulinaemia and hypertriglyceridaemia combined), were found in nine (39%) of the bone-marrow transplantation patients compared with one (8%) of the 13 leukaemia patients and none of the healthy controls (p=0·0015). The frequency of insulin resistance increased with the time since bone-marrow transplantation. Abdominal obesity, but not overweight, was common among the patients with insulin resistance. Long-term survivors of bone-marrow transplantation are at substantial risk of insulin resistance, impaired glucose tolerance, and type 2 diabetes even at normal weight and young age. They also develop typical signs of the metabolic syndrome. We advocate measurement of serum lipids, fasting blood glucose, and serum insulin for the follow-up of all patients who undergo transplants in childhood, to be continued regularly and possibly life-long.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(00)02717-3