Adipokines, insulin resistance, and adiposity as a predictors of metabolic syndrome in child survivors of lymphoma and acute lymphoblastic leukemia of a developing country.

BACKGROUND: There is a growing body of evidence indicating that pediatric survivors of cancer are at a greater risk of developing metabolic syndrome. This study evaluated some probable predictors of metabolic syndrome (MS), such as leptin and adiponectin concentrations, the leptin/adiponectin ratio, insulin resistance, and adiposity, in a sample of child survivors of lymphoma and leukemia in Mexico City. METHODS: Fifty two children (leukemia n = 26, lymphoma n = 26), who were within the first 5 years after cessation of therapy, were considered as eligible to participate in the study. Testing included fasting insulin, glucose, adipokines and lipids; body fat mass was measured by DXA. The MS components were analyzed according to tertiles of adipokines, insulin resistance, and adiposity. Comparisons between continuous variables were performed according to the data distribution. The MS components were analyzed according to tertiles of adipokines, insulin resistance, and adiposity. With the purpose of assessing the risk of a present MS diagnosis, odds ratios (OR) with a 95% confidence interval (95% IC) were obtained using logistic regression analysis according to the various metabolic markers. RESULTS: The median children age was 12.1 years, and the interval time from the completion of therapy to study enrollment was 4 years. Among the MS components, the prevalence of HDL-C low was most common (42%), followed by central obesity (29%). The HOMA-IR (OR 9.0, 95% CI 2.0; 41.1), body fat (OR 5.5, 95% CI 1.6; 19.3), leptin level (OR 5.7, 95% CI 1.6; 20.2) and leptin/adiponectin ratio (OR 9.4, 95% CI 2.0; 49.8) in the highest tertile, were predictive factors of developing MS; whereas the lowest tertile of adiponectin was associated with a protective effect but not significant. CONCLUSIONS: Biomarkers such as HOMA-IR, leptin and leptin/adiponectin are associated with each of the components of the MS and with a heightened risk of suffering MS among children survivors of cancer. Given the close relationship between MS with risk of developing type 2 diabetes and cardiovascular disease, it is imperative to implement prevention measures in this population and especially in developing countries where these pathologies have become the leading cause of death.

Insulin and leptin levels in obese patients with and without breast cancer.

BACKGROUND: Leptin has been associated with progression and poor survival in BC. Moreover, it is still controversial as to whether the effect of leptin depends only on its correlation with body mass index (BMI), or could be a direct role of adipokine in the development of BC. The aim of this study was to identify if there was a difference between serum leptin levels and insulin in obese patients with and without BC. PATIENTS AND METHODS: A cross-sectional study was made in 156 women, a group of 78 with obesity and BC and 78 with obesity without BC. When subjects agreed to participate, written informed consent was obtained from all subjects. Biochemical variables such as glucose, triglycerides, high-density and low-density lipoprotein, cholesterol, insulin, and leptin were measured and homeostasis model assessment (HOMA-IR) was calculated. RESULTS: The age, number of parities, glucose, HOMA-IR, and leptin were significantly different at P < .05. CONCLUSION: Serum leptin levels and leptin/BMI ratio were statistically significantly increased in patients with BC.