Body mass index, adipocytokines and insulin resistance in the survivors of acute leukemia

Late complications of chemotherapy in children with acute lymphoblastic leukemia in older age is the most important health problems. Side-effects of chemotherapy on the endocrin and metabolic system is not well-studied. In this study we investigated 73 children (%42,5 girl, %57,5 boy) aboutfrequency of obesity, adipocytokines and insulin resistance after completion of BFM-95 ALL chemotheraphy protocol.We obtained body mass indexes of patients at the time of diagnosis (T0), during chemoteraphy (T1-T2-T3-T4) and after cessation of theraphy (T5) from their patient records. When they refer to outpatient clinic for control, we write down their last BMI and blood samples were collected to study adipocytokines and insulin resistance. The mean age at diagnosis was 7,6±4,67 and the mean age at the last evaluation was 13,9±4 years. The patients were investigated average of 3,35±2,91 years after cessation of theraphy. At the time of the diagnosis %76,7 of patients were normal or low-weight, %23,3 was obese or overweight. At the time of T5, %65,6 was normal or low-weight,%33,7 was obese or overweight. The rate of becoming obese after chemotheraphy was %28,6. Prevalence of obesity at the duration of remission time berween 1-5 years was signifantly higher from <1 years and >5 years duration of remission. Obesity prevalence was not differ between cranial irradiated or not-irradiated patients. We compared HOMA-IR, leptin, adiponectin levels with the controls. Leptin levels were significantly higher 64in the patients but adiponectin and HOMA-IR did not differ between controls and patiets. Leptin levels were inversely proportional to adiponectin and directly proportional to HOMA-IR. The adipocytocine levels were not differ according to duration time of remission. There was no relationship between adipocytokine levels, HOMA-IR, age at the time of diagnosis, serum lipid profile and cranial irradiation.Our study demonstrated that despite the incerease in obesity prevalence and leptin, insulin resistance was not developed after completion of ALL chemotheraphy. However, the longer the duration of life after treatment was obtained, the patients should be monitored closely for the possibility of development of endocrine and metabolic disorders.