Premature ovarian failure after childhood cancer and risk of metabolic syndrome: a cross-sectional analysis

in European Journal of Endocrinology
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  • 1 Department of Pediatrics, Helsingborg Hospital, Lund University, Helsingborg, Sweden
  • 2 Department of Pediatrics, Pediatric Oncology and Hematology, Skåne University Hospital, Lund University, Lund, Sweden
  • 3 Department of Reproductive Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
  • 4 Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmö, Sweden
  • 5 Department of Endocrinology, Pediatric Endocrinology, Skåne University Hospital, Lund University, Lund, Sweden
  • 6 Department of Pediatrics, Pediatric Endocrinology, Skåne University Hospital, Lund University, Lund, Sweden

Correspondence should be addressed to A Netterlid; Email: axel.netterlid@med.lu.se
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Objective

Female childhood cancer survivors (CCS) are at risk of several late effects, such as metabolic syndrome (MetS) and premature ovarian insufficiency (POI). The objective is to study if POI is associated with risk of MetS and increased cardiovascular risk in CSS.

Design

A cross-sectional study with a median time since the cancer diagnosis of 25 (12–41) years. Patients and controls were recruited from the South Medical Region of Sweden.

Methods

The study included 167 female CCS, median age 34 (19–57) years, diagnosed with childhood cancer at median age 8.4 (0.1–17.9) years together with 164 controls, matched for age, sex, ethnicity, residence, and smoking habits. All subjects were examined with fasting glucose, insulin, HbA1c, and lipid profile. Fat mass was calculated with dual-energy X-ray absorptiometry (DXA), and questionnaires for medication were obtained. Detailed information of cancer treatment was available.

Results

POI was present in 13% (22/167) among CCS (hypothalamic/pituitary cause excluded) and in none among controls. MetS was present in 14% (24/167) among all CCS (P  = 0.001), in 23% (5/22) of those with POI (P  < 0.001), compared with 4% (6/164) among controls. OR for MetS in all CCS compared with controls was 4.4 (95% CI: 1.8, 11.1) (P  = 0.002) and among CCS with POI the OR was 7.7 (CI: 2.1, 28.1) (P  = 0.002).

Conclusion

The prevalence of MetS was higher in females treated for childhood cancer compared with controls, and the presence of POI significantly increased the risk of developing MetS.

Supplementary Materials

    • Supplemental Table 1. Frequencies of MetS using the IDF-criteria and the NCEP ATP III-criteria among CCS without and with POI compared with controls, results presented as median and percent.
    • Supplemental Table 2. Odds ratio (OR) with confidence intervals (CI) for MetS defined according to IDF and NCEP APT III respectively after POI and after different treatments among CCS compared with controls. Binary logistic regression model was used for each subgroup analysis.

 

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