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Prospective evaluation of metabolic syndrome and its features in a single-center series of hematopoietic stem cell transplantation recipients

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Abstract

Available studies on metabolic syndrome (MS) after hematopoietic stem cell transplantation (HSCT) are retrospective with heterogeneous inclusion criteria, and little is known about the early post-transplant phase. In our prospective study, clinical and laboratory data were collected in 100 HSCT recipients, 48 allogeneic and 52 autologous, at baseline, at + 30, + 100 and + 360 days. At baseline, MS was observed in 24 patients, significantly associated with insulin resistance and leptin on multivariate analysis. At + 30, the diagnosis of MS was confirmed in 43 patients, significantly related to insulin resistance and allogeneic transplants. If the whole series was considered, patients with MS had significantly higher mortality from any cause. The baseline presence of any MS feature was a predictor of + 30 MS. Isolated occurrences of MS features were related to hyperleptinemia and hyperinsulinemia, except in the case of low HDL cholesterol, linked to adiponectin and resistin. Our data confirm that patients undergoing HSCT have a high prevalence of MS, with hyperleptinemia playing a major role. The early peak of new MS cases is primarily attributable to insulin resistance, notably but not exclusively immunosuppression-induced; the subsequent long-term increase in MS cases may be an effect of persistent adipokine imbalance.

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References

  1. Gami AS, Witt BJ, Howard DE, Erwin PJ, Gami LA, Somers VK, Montori VM (2007) Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol 49(4):403–414

    Article  CAS  Google Scholar 

  2. Stebbing J, Sharma A, North B, Athersuch TJ, Zebrowski A, Pchejetski D, Coombes RC, Nicholson JK, Keun HC (2012) A metabolic phenotyping approach to understanding relationships between metabolic syndrome and breast tumour responses to chemotherapy. Ann Oncol 23:860–866

    Article  CAS  Google Scholar 

  3. Wethal T, Kjekshus J, Røislien J, Ueland T, Andreassen AK, Wergeland R, Aukrust P, Fosså SD (2007) Treatment-related differences in cardiovascular risk factors in long-term survivors of testicular cancer. J Cancer Surviv 1:8–16

    Article  CAS  Google Scholar 

  4. Nuver J, Smit AJ, Wolffenbuttel BH et al (2005) The metabolic syndrome and disturbances in hormone levels in long-term survivors of disseminated testicular cancer. J Clin Oncol 23:3718–3725

    Article  CAS  Google Scholar 

  5. Fazelzadeh A, Mehdizadeh A, Ostovan MA, Raiss-Jalali GA (2006) Incidence of cardiovascular risk factors and complications before and after kidney transplantation. Transplant Proc 38:506–508

    Article  CAS  Google Scholar 

  6. Jerico C, Knobel H, Montero M, Ordonez-Llanos J, Guelar A, Gimeno JL, Saballs P, Lopez-Colomes JL, Pedro-Botet J (2005) Metabolic syndrome among HIV-infected patients: prevalence, characteristics, and related factors. Diabetes Care 28:132–137

    Article  Google Scholar 

  7. Munoz SJ, Elgenaidi H (2005) Cardiovascular risk factors after liver transplantation. Liver Transpl 11(Suppl 2):S52–S56

    Article  Google Scholar 

  8. Chung CP, Oeser A, Solus JF, Avalos I, Gebretsadik T, Shintani A, Raggi P, Sokka T, Pincus T, Stein CM (2008) Prevalence of the metabolic syndrome is increased in rheumatoid arthritis and is associated with coronary atherosclerosis. Atherosclerosis 196:756–763

    Article  CAS  Google Scholar 

  9. Abella V, Scotece M, Conde J et al (2014) Adipokines, metabolic syndrome and rheumatic diseases. J Immunol Res 2014:343746

    Article  Google Scholar 

  10. Paris C, Yates L, Lama P, Zepeda AJ, Gutiérrez D, Palma J (2012) Evaluation of metabolic syndrome after hematopoietic stem cell transplantation in children and adolescents. Pediatr Blood Cancer 59:306–310

    Article  Google Scholar 

  11. Annaloro C, Airaghi L, Saporiti G, Onida F, Cortelezzi A, Deliliers GL (2012) Metabolic syndrome in patients with hematological diseases. Expert Rev Hematol 5:439–458

    Article  CAS  Google Scholar 

  12. Oudin C, Simeoni MC, Sirvent N, Contet A, Begu-le Coroller A, Bordigoni P, Curtillet C, Poiree M, Thuret I, Play B, Massot MC, Chastagner P, Chambost H, Auquier P, Michel G (2011) Prevalence and risk factors of the metabolic syndrome in adult survivors of childhood leukemia. Blood 117:4442–4448

    Article  CAS  Google Scholar 

  13. Oudin C, Auquier P, Bertrand Y, Contet A, Kanold J, Sirvent N, Thouvenin S, Tabone MD, Lutz P, Ducassou S, Plantaz D, Dalle JH, Gandemer V, Beliard S, Berbis J, Vercasson C, Barlogis V, Baruchel A, Leverger G, Michel G (2015) Metabolic syndrome in adults who received hematopoietic stem cell transplantation for acute childhood leukemia: a LEA study. Bone Marrow Transplant 50:1438–1444

    Article  CAS  Google Scholar 

  14. DeFilipp Z, Duarte RF, Snowden JA, Majhail NS, Greenfield DM, Miranda JL, Arat M, Baker KS, Burns LJ, Duncan CN, Gilleece M, Hale GA, Hamadani M, Hamilton BK, Hogan WJ, Hsu JW, Inamoto Y, Kamble RT, Lupo-Stanghellini MT, Malone AK, McCarthy P, Mohty M, Norkin M, Paplham P, Ramanathan M, Richart JM, Salooja N, Schouten HC, Schoemans H, Seber A, Steinberg A, Wirk BM, Wood WA, Battiwalla M, Flowers MED, Savani BN, Shaw BE, CIBMTR Late Effects and Quality of Life Working Committee, EBMT Complications and Quality of Life Working Party (2016 Aug) Metabolic syndrome and cardiovascular disease after hematopoietic cell transplantation: screening and preventive practice recommendations from the CIBMTR and EBMT. Biol Blood Marrow Transplant 22(8):1493–1503

    Article  Google Scholar 

  15. Chatterjee R, Palla K, McGarrigle HH et al (2005) Syndrome ‘X’ in adult female recipients of bone marrow transplantation for haematological malignancies. Bone Marrow Transplant 35:209–210

    Article  CAS  Google Scholar 

  16. Majhail NS, Flowers ME, Ness KK, Jagasia M, Carpenter PA, Arora M, Arai S, Johnston L, Martin PJ, Baker KS, Lee SJ, Burns LJ (2009) High prevalence of metabolic syndrome after allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 43:49–54

    Article  CAS  Google Scholar 

  17. Shalitin S, Phillip M, Stein J, Goshen Y, Carmi D, Yaniv I (2006) Endocrine dysfunction and parameters of the metabolic syndrome after bone marrow transplantation during childhood and adolescence. Bone Marrow Transplant 37:1109–1117

    Article  CAS  Google Scholar 

  18. Taskinen M, Saarinen-Pihkala UM, Hovi L, Lipsanen-Nyman M (2000) Impaired glucose tolerance and dyslipidaemia as late effects after bone marrow transplantation in childhood. Lancet 356:993–997

    Article  CAS  Google Scholar 

  19. Bizzarri C, Pinto RM, Ciccone S, Brescia LP, Locatelli F, Cappa M (2015) Early and progressive insulin resistance in young, non-obese cancer survivors treated with hematopoietic stem cell transplantation. Pediatr Blood Cancer 62:1650–1655

    Article  CAS  Google Scholar 

  20. McMillen KK, Schmidt EM, Storer BE et al (2014) Metabolic syndrome appears early after hematopoietic cell transplantation. Metab Syndr Relat Disord 12:367–371

    Article  Google Scholar 

  21. Turcotte LM, Yingst A, Verneris MR (2016) Metabolic syndrome after hematopoietic cell transplantation: at the intersection of treatment toxicity and immune dysfunction. Biol Blood Marrow Transplant 22:1159–1166

    Article  CAS  Google Scholar 

  22. Tauchmanovà L, Matarese G, Carella C et al (2004) High serum leptin in patients with chronic graft versus-host disease after hematopoietic stem cell transplantation. Transplantation 78:1376–1383

    Article  Google Scholar 

  23. Annaloro C, Usardi P, Airaghi L, Giunta V, Forti S, Orsatti A, Baldini M, Delle Volpe A, Lambertenghi Deliliers G (2008) Prevalence of metabolic syndrome in long-term survivors of hematopoietic stem cell transplantation. Bone Marrow Transplant 41:797–804

    Article  CAS  Google Scholar 

  24. Airaghi L, Usardi P, Forti S, Orsatti A, Baldini M, Annaloro C, Lambertenghi Deliliers G (2011) A comparison between metabolic syndrome post hematopoietic stem cell transplantation and spontaneously occurring metabolic syndrome. J Endocrinol Investig 34:e6–e11

    Article  CAS  Google Scholar 

  25. World Health Organization (2010) Global recommendations on physical activity for health. World Health Organization, Geneva, CH

    Google Scholar 

  26. Grundy SM, Brewer HB Jr, Cleeman JI et al (2004) Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation 109:433–438

    Article  Google Scholar 

  27. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC Jr, Spertus JA, Costa F, American Heart Association, National Heart, Lung, and Blood Institute (2005) Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 112:2735–2752

    Article  Google Scholar 

  28. Miccoli R, Bianchi C, Odoguardi L, Penno G, Caricato F, Giovannitti MG, Pucci L, del Prato S (2005) Prevalence of the metabolic syndrome among Italian adults according to ATP III definition. Nutr Metab Cardiovasc Dis 15:250–254

    Article  Google Scholar 

  29. Passweg JR, Baldomero H, Bader P et al (2016) Hematopoietic stem cell transplantation in Europe 2014: more than 40 000 transplants annually. Bone Marrow Transplant 51:786–792

    Article  CAS  Google Scholar 

  30. Saultier P, Auquier P, Bertrand Y, et al. Metabolic syndrome in long-term survivors of childhood acute leukemia treated without hematopoietic stem cell transplantation: an L.E.A. study. Haematologica, 2016, e-pub ahead of print 11 August 2016. doi:https://doi.org/10.3324/haematol.2016.148908

    Article  CAS  Google Scholar 

  31. DiCarlo J, Agarwal-Hashmi R, Shah A, Kim P, Craveiro L, Killen R, Rosenberg-Hasson Y, Maecker H (2014) Cytokine and chemokine patterns across 100 days after hematopoietic stem cell transplantation in children. Biol Blood Marrow Transplant 20:361–369

    Article  CAS  Google Scholar 

  32. Frisk P, Rössner SM, Norgren S, Arvidson J, Gustafsson J (2011) Glucose metabolism and body composition in young adults treated with TBI during childhood. Bone Marrow Transplant 46:1303–1308

    Article  CAS  Google Scholar 

  33. Mayson SE, Parker VE, Schutta MH, Semple R, Rickels M (2013) Severe insulin resistance and hypertriglyceridemia after childhood total body irradiation. Endocr Pract 19:51–58

    Article  Google Scholar 

  34. Baker EH, Wood DM, Brennan AL, Clark N, Baines DL, Philips BJ (2006) Hyperglycaemia and pulmonary infection. Proc Nutr Soc 65:227–235

    Article  CAS  Google Scholar 

  35. Van Cromphaut SJ, Vanhorebeek I, Van den Berghe G (2008) Glucose metabolism and insulin resistance in sepsis. Curr Pharm Des 14:1887–1899

    Article  Google Scholar 

  36. Li L, Messina JL (2009) Acute insulin resistance following injury. Trends Endocrinol Metab 20:429–435

    Article  CAS  Google Scholar 

  37. Mukherjee K, Sowards KJ, Brooks SE et al (2014) Insulin resistance increases before ventilator-associated pneumonia in euglycemic trauma patients. Surg Infect 16:713–720

    Article  Google Scholar 

  38. Parra-Salcedo F, Contreras-Yáñez I, Elías-López D et al (2015) Prevalence, incidence and characteristics of the metabolic syndrome (MetS) in a cohort of Mexican Mestizo early rheumatoid arthritis patients treated with conventional disease modifying anti-rheumatic drugs: the complex relationship between MetS and disease activity. Arthritis Res Ther 17:34–44

    Article  Google Scholar 

  39. Giulivo M, Lopez de Alda M, Capri E, et al. Human exposure to endocrine disrupting compounds: their role in reproductive systems, metabolic syndrome and breast cancer. A review. Environ Res, 2016, 151: 251–264

    Article  CAS  Google Scholar 

  40. Micucci C, Valli D, Matacchione G, Catalano A (2016) Current perspectives between metabolic syndrome and cancer. Oncotarget 7:38959–38972

    Article  Google Scholar 

  41. Kojima C, Kubota M, Nagai A, Adachi S, Watanabe KI, Nakahata T (2013) Adipocytokines in childhood cancer survivors and correlation with metabolic syndrome components. Pediatr Int 55:438–442

    Article  CAS  Google Scholar 

  42. Arguelles B, Barrios V, Buno M, Madero L, Argente J (2000) Anthropometric parameters and their relationship to serum growth hormone-binding protein and leptin levels in children with acute lymphoblastic leukemia: a prospective study. Eur J Endocrinol 143:243–250

    Article  CAS  Google Scholar 

  43. Lennon H, Sperrin M, Badrick E et al (2016) The obesity paradox in cancer: a review. Curr Oncol Rep 18:1–8

    Article  Google Scholar 

  44. Ersoy A, Baran B, Ersoy C et al (2008) Calcineurin inhibitors and post-transplant weight gain. Nephrology (Carlton) 13:433–439

    Article  CAS  Google Scholar 

  45. Follin C, Thilen U, Osterberg K et al (2010) Cardiovascular risk, cardiac function, physical activity, and quality of life with and without long-term growth hormone therapy in adult survivors of childhood acute lymphoblastic leukemia. J Clin Endocrinol Metab 95:3726–3735

    Article  CAS  Google Scholar 

  46. Law YM, Yim R, Agatisa P, Boyle GJ, Miller SA, Lawrence K, Webber SA (2006) Lipid profiles in pediatric thoracic transplant recipients are determined by their immunosuppressive regimens. J Heart Lung Transplant 25:276–282

    Article  Google Scholar 

  47. Sui W, Zou H, Zou G, Yan Q, Chen H, Che W, Xie S (2008) Clinical study of the risk factors of insulin resistance and metabolic syndrome after kidney transplantation. Transpl Immunol 20:95–98

    Article  CAS  Google Scholar 

  48. Baker KS, Chow E, Steinberger J (2012) Metabolic syndrome and cardiovascular risk in survivors after hematopoietic cell transplantation. Bone Marrow Transplant 47:619–625

    Article  CAS  Google Scholar 

  49. Ordovas JM (2007) Genetic links between diabetes mellitus and coronary atherosclerosis. Curr Atheroscler Rep 9:204–210

    Article  CAS  Google Scholar 

  50. Xie D, Bollag WB (2016) Obesity, hypertension and aldosterone: is leptin the link? J Endocrinol 230:F7–F11

    Article  CAS  Google Scholar 

  51. Norata GD, Ongari M, Garlaschelli K, Raselli S, Grigore L, Catapano AL (2007) Plasma resistin levels correlate with determinants of the metabolic syndrome. Eur J Endocrinol 156:279–284

    Article  CAS  Google Scholar 

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Acknowledgments

The authors would like to thank Mrs. Carla Corti and the nursing staff for the technical support.

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Authors and Affiliations

  1. U.O.C. Oncoematologia, Servizio Trapianti di Midollo, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy

    Claudio Annaloro, Gabriella Mometto, Giorgia Saporiti, Federica Irene Grifoni, Elena Tagliaferri, Daniele Vincenti, Francesco Onida & Agostino Cortelezzi

  2. Dipartimento di Medicina Interna e Specializzazioni Mediche, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy

    Lorena Airaghi, Alessandra Orsatti, Marina Baldini & Diletta Maira

  3. Biostatistical Unit, Regina Elena National Cancer Institute, Rome, Italy

    Diana Giannarelli

  4. Università degli Studi di Milano, Milan, Italy

    Gabriella Mometto, Alessandra Orsatti, Diletta Maira, Francesco Onida & Agostino Cortelezzi

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  1. Claudio Annaloro
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  2. Lorena Airaghi
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  3. Diana Giannarelli
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  4. Gabriella Mometto
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  6. Giorgia Saporiti
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  7. Federica Irene Grifoni
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  8. Marina Baldini
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  9. Elena Tagliaferri
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  12. Francesco Onida
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  13. Agostino Cortelezzi
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Corresponding author

Correspondence to Lorena Airaghi.

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The study design informed consent form and database model were approved by the local Ethics Commission.

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Annaloro, C., Airaghi, L., Giannarelli, D. et al. Prospective evaluation of metabolic syndrome and its features in a single-center series of hematopoietic stem cell transplantation recipients. Ann Hematol 97, 2471–2478 (2018). https://doi.org/10.1007/s00277-018-3452-0

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  • DOI: https://doi.org/10.1007/s00277-018-3452-0

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