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Ann Hematol. 2018 Dec;97(12):2471-2478. doi: 10.1007/s00277-018-3452-0. Epub 2018 Jul 27.

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

Author information

1
U.O.C. Oncoematologia, Servizio Trapianti di Midollo, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy.
2
Dipartimento di Medicina Interna e Specializzazioni Mediche, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy. lorena.airaghi@policlinico.mi.it.
3
Biostatistical Unit, Regina Elena National Cancer Institute, Rome, Italy.
4
Università degli Studi di Milano, Milan, Italy.
5
Dipartimento di Medicina Interna e Specializzazioni Mediche, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy.

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.

KEYWORDS:

Adipokines; Hematopoietic stem cell transplantation; Insulin resistance; Leptin; Metabolic syndrome

PMID:
30054704
DOI:
10.1007/s00277-018-3452-0
[Indexed for MEDLINE]

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