Serum Adipokines as Biomarkers for Surveillance of Metabolic Syndrome in Childhood Acute Lymphoblastic Leukemia/Lymphoma Survivors in Low Middle Income Countries

Abstract

Abstract Background Serum adipokines (leptin and adiponectin) are dysregulated prior to the onset of metabolic syndrome and hence may be useful biomarkers for screening of therapy related cardiometabolic late effects in childhood Acute Lymphoblastic Leukemia/Lymphoma (cALL) survivors. We conducted a study to compare serum levels of adipokines in cALL survivors and controls, and evaluated their role in prediction of metabolic syndrome in our cohort of survivors. Methods In a cross sectional study, we compared serum adipokine levels between 40 cALL survivors (aged 10–18 years, at least 2 years from treatment completion) with similar controls. A multivariable logistic regression analysis was done to assess association of metabolic syndrome in cALL survivors with independent variables including adipokines, demographic and treatment details, other metabolic parameters and Dual Energy Xray Absorptiometry scan derived variables. Results Compared to controls, cALL survivors had higher prevalence of metabolic syndrome (8/40 vs 2/40, p = 0.042) and central obesity (11/40 vs 4/40, p = 0.042). Median serum Leptin (7.39 vs 4.23ng/mL, p = 0.207) levels and derived Leptin-Adiponectin ratio (1.44 vs 0.80, p = 0.598), were higher but not statistically different in our survivors compared to controls; Adiponectin levels were similar (6.07 vs 5.01µg/ml, p = 0.283). In our cohort of cALL survivors, overweight/obesity [OR 21.9, p = 0.020] or higher Leptin levels [OR 1.11, p = 0.047)], were independently associated with metabolic syndrome. Conclusions Serum Leptin, independently predictive of metabolic syndrome in our cohort of cALL survivors, maybe tested in larger studies to assess its utility in surveillance. This may help initiate early preventive measures and in turn improve the quality of life of our survivors.