Hyperleptinaemia in young adults following cranial irradiation in childhood: growth hormone deficiency or leptin insensitivity?
OBJECTIVE In order to explore the mechanism of obesity in long‐term survivors of childhood leukaemia, fat mass, lean body mass and serum leptin were assessed in a cohort of 32 (17 males) adults who had received cranial irradiation (XRT) in childhood as part of their treatment for acute lymphoblastic...
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| Veröffentlicht in: | Clinical endocrinology (Oxford) 1999-02, Vol.50 (2), p.163-169 |
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| creator | BRENNAN, B. M. D RAHIM, A BLUM, W. F ADAMS, J. A EDEN, O. B SHALET, S. M |
| description | OBJECTIVE
In order to explore the mechanism of obesity in long‐term survivors of childhood leukaemia, fat mass, lean body mass and serum leptin were assessed in a cohort of 32 (17 males) adults who had received cranial irradiation (XRT) in childhood as part of their treatment for acute lymphoblastic leukaemia (ALL), and compared with 35 age and body mass index (BMI) matched young adults (18 male).
DESIGN
Thirty‐one patients and 18 controls had fat mass and lean body mass assessed by dual x‐ray absorptiometry (DEXA), using a lunar DPX‐L scanner. Serum leptin concentrations were also measured in 27 patients and all controls. Growth hormone status had previously been determined using an insulin tolerance test and arginine stimulation test. Nine patients were classified as severe growth hormone (GH) deficient (group 1), 12 patients as GH insufficient (group 2) and 11 patients as normal (group 3).
RESULTS
BMI and absolute fat mass were not significantly different between the patients and controls regardless of their gender (P = 0.1 and P = 0.14 respectively). In contrast, absolute lean mass was significantly reduced (P |
| doi_str_mv | 10.1046/j.1365-2265.1999.00622.x |
| format | Article |
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In order to explore the mechanism of obesity in long‐term survivors of childhood leukaemia, fat mass, lean body mass and serum leptin were assessed in a cohort of 32 (17 males) adults who had received cranial irradiation (XRT) in childhood as part of their treatment for acute lymphoblastic leukaemia (ALL), and compared with 35 age and body mass index (BMI) matched young adults (18 male).
DESIGN
Thirty‐one patients and 18 controls had fat mass and lean body mass assessed by dual x‐ray absorptiometry (DEXA), using a lunar DPX‐L scanner. Serum leptin concentrations were also measured in 27 patients and all controls. Growth hormone status had previously been determined using an insulin tolerance test and arginine stimulation test. Nine patients were classified as severe growth hormone (GH) deficient (group 1), 12 patients as GH insufficient (group 2) and 11 patients as normal (group 3).
RESULTS
BMI and absolute fat mass were not significantly different between the patients and controls regardless of their gender (P = 0.1 and P = 0.14 respectively). In contrast, absolute lean mass was significantly reduced (P < 0.01) and leptin concentrations were significantly increased (P < 0.001) in patients compared with controls. BMI, fat mass and leptin concentrations but not lean mass were significantly different between the three GH status groups (P < 0.01, P < 0.01, P = 0.004, and P = 0.67 respectively). When leptin concentrations were expressed per unit of fat mass, they were increased in the patients compared with the controls (P = 0.03) with significant differences between the GH status groups (P = 0.004), being significantly higher in the severe GH deficient group.
CONCLUSIONS
Young adults who receive cranial irradiation in childhood are prone to GH deficiency and hyperleptinaemia. The pathophysiological significance of the hyperleptinaemia remains to be established but it has occurred either as a consequence of radiation induced hypothalamic damage or GH deficiency.</description><identifier>ISSN: 0300-0664</identifier><identifier>EISSN: 1365-2265</identifier><identifier>DOI: 10.1046/j.1365-2265.1999.00622.x</identifier><identifier>PMID: 10396357</identifier><identifier>CODEN: CLECAP</identifier><language>eng</language><publisher>Oxford BSL: Blackwell Science Ltd</publisher><subject>Adolescent ; Adult ; Analysis of Variance ; Biological and medical sciences ; Body Composition ; Case-Control Studies ; Child ; Endocrinopathies ; Female ; Follow-Up Studies ; Growth Hormone - deficiency ; Humans ; Hypothalamus - radiation effects ; Hypothalamus. Hypophysis. Epiphysis (diseases) ; Leptin ; Linear Models ; Male ; Medical sciences ; Non tumoral diseases. Target tissue resistance. Benign neoplasms ; Obesity - blood ; Obesity - etiology ; Pituitary Irradiation - adverse effects ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - radiotherapy ; Proteins - analysis ; Statistics, Nonparametric</subject><ispartof>Clinical endocrinology (Oxford), 1999-02, Vol.50 (2), p.163-169</ispartof><rights>Blackwell Science Ltd, Oxford</rights><rights>1999 INIST-CNRS</rights><rights>Copyright Blackwell Scientific Publications Ltd. Feb 1999</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4582-82443042d11fa79d585f272a69a2681f35345a927232016801bb89e3d1575dc53</citedby><cites>FETCH-LOGICAL-c4582-82443042d11fa79d585f272a69a2681f35345a927232016801bb89e3d1575dc53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1046%2Fj.1365-2265.1999.00622.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1046%2Fj.1365-2265.1999.00622.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1702807$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10396357$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>BRENNAN, B. M. D</creatorcontrib><creatorcontrib>RAHIM, A</creatorcontrib><creatorcontrib>BLUM, W. F</creatorcontrib><creatorcontrib>ADAMS, J. A</creatorcontrib><creatorcontrib>EDEN, O. B</creatorcontrib><creatorcontrib>SHALET, S. M</creatorcontrib><title>Hyperleptinaemia in young adults following cranial irradiation in childhood: growth hormone deficiency or leptin insensitivity?</title><title>Clinical endocrinology (Oxford)</title><addtitle>Clinical Endocrinology</addtitle><description>OBJECTIVE
In order to explore the mechanism of obesity in long‐term survivors of childhood leukaemia, fat mass, lean body mass and serum leptin were assessed in a cohort of 32 (17 males) adults who had received cranial irradiation (XRT) in childhood as part of their treatment for acute lymphoblastic leukaemia (ALL), and compared with 35 age and body mass index (BMI) matched young adults (18 male).
DESIGN
Thirty‐one patients and 18 controls had fat mass and lean body mass assessed by dual x‐ray absorptiometry (DEXA), using a lunar DPX‐L scanner. Serum leptin concentrations were also measured in 27 patients and all controls. Growth hormone status had previously been determined using an insulin tolerance test and arginine stimulation test. Nine patients were classified as severe growth hormone (GH) deficient (group 1), 12 patients as GH insufficient (group 2) and 11 patients as normal (group 3).
RESULTS
BMI and absolute fat mass were not significantly different between the patients and controls regardless of their gender (P = 0.1 and P = 0.14 respectively). In contrast, absolute lean mass was significantly reduced (P < 0.01) and leptin concentrations were significantly increased (P < 0.001) in patients compared with controls. BMI, fat mass and leptin concentrations but not lean mass were significantly different between the three GH status groups (P < 0.01, P < 0.01, P = 0.004, and P = 0.67 respectively). When leptin concentrations were expressed per unit of fat mass, they were increased in the patients compared with the controls (P = 0.03) with significant differences between the GH status groups (P = 0.004), being significantly higher in the severe GH deficient group.
CONCLUSIONS
Young adults who receive cranial irradiation in childhood are prone to GH deficiency and hyperleptinaemia. The pathophysiological significance of the hyperleptinaemia remains to be established but it has occurred either as a consequence of radiation induced hypothalamic damage or GH deficiency.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Analysis of Variance</subject><subject>Biological and medical sciences</subject><subject>Body Composition</subject><subject>Case-Control Studies</subject><subject>Child</subject><subject>Endocrinopathies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Growth Hormone - deficiency</subject><subject>Humans</subject><subject>Hypothalamus - radiation effects</subject><subject>Hypothalamus. Hypophysis. Epiphysis (diseases)</subject><subject>Leptin</subject><subject>Linear Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Non tumoral diseases. Target tissue resistance. Benign neoplasms</subject><subject>Obesity - blood</subject><subject>Obesity - etiology</subject><subject>Pituitary Irradiation - adverse effects</subject><subject>Precursor Cell Lymphoblastic Leukemia-Lymphoma - radiotherapy</subject><subject>Proteins - analysis</subject><subject>Statistics, Nonparametric</subject><issn>0300-0664</issn><issn>1365-2265</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkV2L1DAUhoMo7rj6FySIt635aL5EEBnWHWUZQRTBm5Bp0p2MnWY2aZ3plX_d1A6rl14lnDzveeEJABCjEqOKv9qVmHJWEMJZiZVSJUKckPL0ACzuHx6CBaIIFYjz6gI8SWmHEGISicfgAiOqOGViAX6txoOLrTv0vjNu7w30HRzD0N1CY4e2T7AJbRuOPg_qaDpvWuhjNNab3oduouutb-02BPsa3sZw7LdwG-I-dA5a1_jau64eYYhwLsmJ5Lrke__T9-Pbp-BRY9rknp3PS_D1_dWX5aq4-XT9YfnupqgrJkkhSVVRVBGLcWOEskyyhghiuDKES9xQRitmVB5RgjCXCG82UjlqMRPM1oxeghfz3kMMd4NLvd6FIXa5UmMlhUCUowzJGapjSCm6Rh-i35s4aoz0JF7v9ORXT371JF7_Ea9POfr8vH_Y7J39JzibzsDLM2BSbdomu6x9-ssJRPLfZOzNjB1968b_7tfLq3W-5Hgxx33q3ek-buIPzQUVTH9bX-tVtZbq--ePekl_A1pgrkQ</recordid><startdate>199902</startdate><enddate>199902</enddate><creator>BRENNAN, B. M. D</creator><creator>RAHIM, A</creator><creator>BLUM, W. F</creator><creator>ADAMS, J. A</creator><creator>EDEN, O. B</creator><creator>SHALET, S. M</creator><general>Blackwell Science Ltd</general><general>Blackwell</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><scope>NAPCQ</scope></search><sort><creationdate>199902</creationdate><title>Hyperleptinaemia in young adults following cranial irradiation in childhood: growth hormone deficiency or leptin insensitivity?</title><author>BRENNAN, B. M. D ; RAHIM, A ; BLUM, W. F ; ADAMS, J. A ; EDEN, O. B ; SHALET, S. M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4582-82443042d11fa79d585f272a69a2681f35345a927232016801bb89e3d1575dc53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Analysis of Variance</topic><topic>Biological and medical sciences</topic><topic>Body Composition</topic><topic>Case-Control Studies</topic><topic>Child</topic><topic>Endocrinopathies</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Growth Hormone - deficiency</topic><topic>Humans</topic><topic>Hypothalamus - radiation effects</topic><topic>Hypothalamus. Hypophysis. Epiphysis (diseases)</topic><topic>Leptin</topic><topic>Linear Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Non tumoral diseases. Target tissue resistance. Benign neoplasms</topic><topic>Obesity - blood</topic><topic>Obesity - etiology</topic><topic>Pituitary Irradiation - adverse effects</topic><topic>Precursor Cell Lymphoblastic Leukemia-Lymphoma - radiotherapy</topic><topic>Proteins - analysis</topic><topic>Statistics, Nonparametric</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>BRENNAN, B. M. D</creatorcontrib><creatorcontrib>RAHIM, A</creatorcontrib><creatorcontrib>BLUM, W. F</creatorcontrib><creatorcontrib>ADAMS, J. A</creatorcontrib><creatorcontrib>EDEN, O. B</creatorcontrib><creatorcontrib>SHALET, S. M</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><jtitle>Clinical endocrinology (Oxford)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>BRENNAN, B. M. D</au><au>RAHIM, A</au><au>BLUM, W. F</au><au>ADAMS, J. A</au><au>EDEN, O. B</au><au>SHALET, S. M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hyperleptinaemia in young adults following cranial irradiation in childhood: growth hormone deficiency or leptin insensitivity?</atitle><jtitle>Clinical endocrinology (Oxford)</jtitle><addtitle>Clinical Endocrinology</addtitle><date>1999-02</date><risdate>1999</risdate><volume>50</volume><issue>2</issue><spage>163</spage><epage>169</epage><pages>163-169</pages><issn>0300-0664</issn><eissn>1365-2265</eissn><coden>CLECAP</coden><abstract>OBJECTIVE
In order to explore the mechanism of obesity in long‐term survivors of childhood leukaemia, fat mass, lean body mass and serum leptin were assessed in a cohort of 32 (17 males) adults who had received cranial irradiation (XRT) in childhood as part of their treatment for acute lymphoblastic leukaemia (ALL), and compared with 35 age and body mass index (BMI) matched young adults (18 male).
DESIGN
Thirty‐one patients and 18 controls had fat mass and lean body mass assessed by dual x‐ray absorptiometry (DEXA), using a lunar DPX‐L scanner. Serum leptin concentrations were also measured in 27 patients and all controls. Growth hormone status had previously been determined using an insulin tolerance test and arginine stimulation test. Nine patients were classified as severe growth hormone (GH) deficient (group 1), 12 patients as GH insufficient (group 2) and 11 patients as normal (group 3).
RESULTS
BMI and absolute fat mass were not significantly different between the patients and controls regardless of their gender (P = 0.1 and P = 0.14 respectively). In contrast, absolute lean mass was significantly reduced (P < 0.01) and leptin concentrations were significantly increased (P < 0.001) in patients compared with controls. BMI, fat mass and leptin concentrations but not lean mass were significantly different between the three GH status groups (P < 0.01, P < 0.01, P = 0.004, and P = 0.67 respectively). When leptin concentrations were expressed per unit of fat mass, they were increased in the patients compared with the controls (P = 0.03) with significant differences between the GH status groups (P = 0.004), being significantly higher in the severe GH deficient group.
CONCLUSIONS
Young adults who receive cranial irradiation in childhood are prone to GH deficiency and hyperleptinaemia. The pathophysiological significance of the hyperleptinaemia remains to be established but it has occurred either as a consequence of radiation induced hypothalamic damage or GH deficiency.</abstract><cop>Oxford BSL</cop><pub>Blackwell Science Ltd</pub><pmid>10396357</pmid><doi>10.1046/j.1365-2265.1999.00622.x</doi><tpages>7</tpages></addata></record> |
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| subjects | Adolescent Adult Analysis of Variance Biological and medical sciences Body Composition Case-Control Studies Child Endocrinopathies Female Follow-Up Studies Growth Hormone - deficiency Humans Hypothalamus - radiation effects Hypothalamus. Hypophysis. Epiphysis (diseases) Leptin Linear Models Male Medical sciences Non tumoral diseases. Target tissue resistance. Benign neoplasms Obesity - blood Obesity - etiology Pituitary Irradiation - adverse effects Precursor Cell Lymphoblastic Leukemia-Lymphoma - radiotherapy Proteins - analysis Statistics, Nonparametric |
| title | Hyperleptinaemia in young adults following cranial irradiation in childhood: growth hormone deficiency or leptin insensitivity? |
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