Metabolic Syndrome in Childhood Cancer Survivors

儿童癌症幸存者的代谢综合征

基本信息

批准号：
7780049
负责人：
Julia Steinberger
金额：
$ 49.82万
依托单位：
UNIVERSITY OF MINNESOTA
依托单位国家：
美国
项目类别：
财政年份：
2006
资助国家：
美国
起止时间：
2006-04-01 至 2012-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7780049
关键词：
Abdomen Acute Lymphocytic Leukemia Address Adolescent Adult Adverse effects Age Antineoplastic Agents Blood Pressure Blood Vessels C-reactive protein Cancer Survivor Cardiovascular Diseases Cardiovascular Physiology Cardiovascular system Carotid Arteries Central obesity Child Cholesterol Clinical Clinical Research Complex Cranial Irradiation Data Demographic Aging Development Diabetes Mellitus Diagnosis Diet Dietary Assessment Dietary Fiber Dietary Practices Disease Doctor of Philosophy Dose Dyslipidemias Endocrine Epidemiologic Studies Exposure to Fasting Fatty acid glycerol esters Fiber Food Frequencies Funding Future Gender General Population Glucose Health behavior Heart Hematologic Neoplasms Hematopoietic Stem Cell Transplantation Hormonal Hormones Hour Hyperinsulinism Hypertension Impairment Individual Inflammation Mediators Insulin Insulin Resistance Intake Interleukin-6 Intervention Intervention Trial Length Leptin Life Lipids Literature Long-Term Effects Long-Term Survivors Malignant Childhood Neoplasm Malignant Neoplasms Malignant neoplasm of testis Measurement Measures Meat Mediating Mediator of activation protein Metabolic syndrome Minnesota National Health and Nutrition Examination Survey Non-Insulin-Dependent Diabetes Mellitus Nutrient Obesity Pathogenesis Pathway interactions Physical activity Play Population Population Control Prevalence Preventive Intervention Principal Investigator Radiation Regimen Reporting Research Research Personnel Risk Risk Factors Role Sampling Schedule Serum Siblings Slice Somatotropin Steroids Survivors Syndrome Therapeutic Thick Treatment Protocols Tumor Necrosis Factor-alpha Tumor Necrosis Factors Universities Vasodilation Visceral X-Ray Computed Tomography adipokines adiponectin brachial artery cancer therapy cardiovascular disorder prevention cardiovascular risk factor chemotherapeutic agent chemotherapy childhood cancer survivor design follow-up genetic analysis growth hormone deficiency high risk hypothalamic pituitary axis insight intima media lifestyle factors low density lipoprotein triglyceride mortality premature programs research clinical testing saturated fat sex tv watching

项目摘要

As many individuals once treated for childhood cancer progress into adulthood, clinical and epidemiologic research is now focusing on an array of long-term effects from cancer treatment to characterize and understand the "consequences of cure". There is evidence to indicate that childhood cancer survivors (CCS) are at increased risk for the metabolic syndrome (MS). The syndrome is composed of obesity, insulin resistance, dyslipidemia and hypertension, and is a predictor of type 2 diabetes and cardiovascular disease. In healthy populations obesity has a central role in the development of the MS, however, it is conceivable that in CCS additional mechanisms other than obesity (e.g. endocrine abnormalities, exposure to radiation and antineoplastic agents) may play a critical role in the development of MS. The major objective of this proposal is to evaluate the relation between insulin resistance (by euglycemic insulin clamp), growth hormone deficiency and other mediators of insulin resistance, with the development of MS and cardiovascular risk early in life, before the relations between the components become complex and disease develops. We propose to study a sample of children and adolescents age 9-18 years, who survived childhood cancer for >5 years after diagnosis, and their healthy siblings, who will participate in a 2 day clinical evaluation. Specific aims are: 1) to determine the prevalence of MS in CCS and compare to healthy controls similar in age and gender distribution, 2) to assess the association of insulin resistance with other components of MS and with early signs of cardiovascular changes, and 3) to assess the relation between obesity and insulin resistance with growth hormone secretion,^adipokines and inflammatory mediators; 4) to evaluate health behaviors related to prevention of cardiovascular disease, diabetes, and obesity. This proposal addresses the need for clinical research focused on newly identified adverse effects of childhood cancer and its treatment, particularly for preventable/modifiable conditions, and will provide new data on potential etiologic factors and avenues for intervention.

由于许多人曾经接受过儿童癌症的治疗，因此临床和流行病学研究的进展，现在关注从癌症治疗中的一系列长期影响，以表征和理解“治愈的后果”。有证据表明，儿童癌症幸存者（CC）的代谢综合征（MS）的风险增加。该综合征由肥胖，胰岛素抵抗，血脂异常和高血压组成，是2型糖尿病和心血管疾病的预测指标。在健康人群中，肥胖在MS的发展中具有核心作用，但是，可以想象，在CCS中，肥胖以外的其他机制（例如内分泌异常，暴露于辐射和抗肿瘤剂）可能在MS发育中起关键作用。该提案的主要目的是评估胰岛素抵抗（通过葡萄糖胰岛素夹），生长激素缺乏症和其他胰岛素抵抗性介体之间的关系，以及在成分之间的关系早期生命的早期，MS和心血管风险的发展就变得复杂，并且疾病变得复杂。我们建议研究9-18岁儿童和青少年的样本，他们在诊断后的儿童癌症中生存了5年，以及他们的健康兄弟姐妹，他们将参加为期2天的临床评估。具体目的是：1）确定MS在CC中的普遍性并与年龄和性别分布相似的健康控制率相比，2）评估胰岛素抵抗与其他MS的其他成分的关联以及心血管变化的早期迹象，以及3）以评估肥胖和胰岛素抵抗与生长荷尔蒙分泌者之间的关系^） 4）评估与预防心血管疾病，糖尿病和肥胖有关的健康行为。该提案解决了针对新确定的儿童癌症及其治疗的新发现的临床研究的需求，特别是对于可预防/可修改的条件，并将提供有关潜在病因学因素和干预途径的新数据。