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A comparison between metabolic syndrome post-hematopoietic stem cell transplantation and spontaneously occurring metabolic syndrome

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Abstract

Background: Hematopoietic stem cell transplantation (HSCT) is used in the treatment of several hematological and non-hematological disorders. An increasing number of long-term survivors recover from their primary disease, but they are at risk of adverse late effects, including metabolic syndrome (MS), which seems to be common in long-term survivors of HSCT. Aim: To compare common metabolic parameters and adipohormone profiles in post-transplant and spontaneously occurring or “classic” MS patients. Subjects and methods: Post-transplant MS patients (15 women and 14 men; 49.8±9.3 yr) were compared to “classic” MS patients (15 women and 14 men; 52.9±8.0 yr). For each subject a record of conventional clinical parameters was made; moreover, serum leptin, insulin, quantitative C-reactive protein (CRP), tumor necrosis factor-α [TNF-α], and adiponectin concentrations were measured. Results: The patients with post-HSCT MS had significantly higher levels of leptin, CRP, and TNF-α than the patients with “classic” MS. A generalized linear model comprising serum insulin (p=0.022), body mass index (p<0.001), gender (p<0.001), and group (i.e. healthy, post-HSCT with MS, or suffering from “classic” MS; p<0.001) explained serum leptin variability (adjusted R2=0.741). Serum leptin concentrations and BMI were related in the patients with “classic” MS but not in those with post-HSCT MS. Conclusions: A possible pathogenetic mechanism in the development of MS after HSCT could be hyperleptinemia. A potential interaction among circulating leptin, components of MS, and immune function might explain the role of this adipokine in mediating cardiovascular risk after HSCT.

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Authors and Affiliations

  1. First Internal Medicine Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy

    L. Airaghi MD & M. Baldini

  2. First Hematological Unit and Bone Marrow Transplantation Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico and University of Milan, Milan, Italy

    P. Usardi, C. Annaloro & G. Lambertenghi Deliliers

  3. Audiology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy

    S. Forti

  4. Department of Internal Medicine, University of Milan, Milan, Italy

    A. Orsatti

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  1. L. Airaghi MD
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  2. P. Usardi
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  3. S. Forti
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  4. A. Orsatti
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  5. M. Baldini
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  7. G. Lambertenghi Deliliers
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Correspondence to L. Airaghi MD.

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Airaghi, L., Usardi, P., Forti, S. et al. A comparison between metabolic syndrome post-hematopoietic stem cell transplantation and spontaneously occurring metabolic syndrome. J Endocrinol Invest 34, e6–e11 (2011). https://doi.org/10.1007/BF03346702

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