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Visfatin is a positive predictor of bone mineral density in young survivors of acute lymphocytic leukemia

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Abstract

Bone mass acquisition may be compromised in survivors of childhood acute lymphocytic leukemia due to various factors, including adiposity. Fat accumulation can affect bone through the direct effect of adipokines or indirectly through the state of chronic inflammation. The aim of this study was to evaluate the effect of body composition and adipokines on bone mass in survivors of acute lymphocytic leukemia. This was a cross-sectional study of 56 survivors aged between 15 and 24 years, 44.6 % of whom received cranial radiotherapy (18–24 Gy), assessed according to body fat, lean mass, and bone mineral density (dual energy X-ray absorptiometry), computed tomography scan-derived abdominal adipose tissue, and adipokines by a multiple regression analysis. Both lumbar spine L1–L4 (trabecular bone) and total body (cortical bone) bone mineral density were positively correlated with visfatin (p < 0.050). Lean mass index was positively correlated, while waist-to-height ratio was negatively correlated with cortical bone (p < 0.010). Low bone mineral density for chronological age was detected in 5.4 % of patients in total body, and 8.9 % at the lumbar spine. In survivors of acute lymphocytic leukemia, visfatin may play an important role in the complex relationship between body composition and bone. At present, visfatin may represent a model for further study of bone metabolism, and could possibly explain the unknown mechanisms linking bone metabolism and cancer.

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Acknowledgments

The authors greatly thank the patients and their families. The authors appreciate the technical assistance of Henrique Lederman, M.D., Ph.D. for performing the body composition assessments, the support of Ricardo Silva Ribeiro for performing the CT scans and abdominal fat layer measurements, and the statistical revision by Gianni Santos and Mitti Koyama. This work was supported by grants from the Sao Paulo State Research Foundation (No. 06/06162-9 to G.G.-J.), and was presented at the 4th European Symposium on Late Complications after Childhood Cancer (ESCCC 14), which was held at The Royal College of Physicians of Edinburgh in Scotland, UK, September 2014.

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Authors and Affiliations

  1. Division of Pediatric Endocrinology, Department of Pediatrics, Federal University of Sao Paulo-UNIFESP/EPM, 307 Doutor Diogo de Faria Street, Sao Paulo, 04037-000, Brazil

    Adriana Aparecida Siviero-Miachon & Angela Maria Spinola-Castro

  2. Pediatric Oncology Institute-IOP/GRAACC, UNIFESP/EPM, 743 Botucatu Street, Sao Paulo, 04023-062, Brazil

    Adriana Aparecida Siviero-Miachon, Angela Maria Spinola-Castro & Maria Lucia de Martino Lee

  3. Laboratory of Investigation on Metabolism and Diabetes-LIMED, Faculty of Medical Sciences, State University of Campinas-UNICAMP, 420 Carlos Chagas Street, Campinas, 13083-878, Brazil

    Antonio Ramos Calixto & Bruno Geloneze

  4. Division of Endocrinology and Metabolism, Department of Medicine, Federal University of Sao Paulo-UNIFESP/EPM, 910 Pedro de Toledo Street, Sao Paulo, 04039-032, Brazil

    Marise Lazaretti-Castro

  5. Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medical Sciences, State University of Campinas-UNICAMP, “Zeferino Vaz” University City, 126 Tessalia Vieira de Camargo Street, Campinas, 13083-887, Brazil

    Gil Guerra-Junior

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  1. Adriana Aparecida Siviero-Miachon
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  2. Angela Maria Spinola-Castro
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Correspondence to Angela Maria Spinola-Castro.

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The authors Adriana Aparecida Siviero-Miachon, Angela Maria Spinola-Castro, Maria Lucia de Martino Lee, Antonio Ramos Calixto, Bruno Geloneze, Marise Lazaretti-Castro, and Gil Guerra-Junior declare that they have no competing interests.

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Siviero-Miachon, A.A., Spinola-Castro, A.M., de Martino Lee, M.L. et al. Visfatin is a positive predictor of bone mineral density in young survivors of acute lymphocytic leukemia. J Bone Miner Metab 35, 73–82 (2017). https://doi.org/10.1007/s00774-015-0728-5

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  • DOI: https://doi.org/10.1007/s00774-015-0728-5

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