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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Acute lymphoblastic leukemia (ALL), the most common malignancy in children, constitutes 25% of all pediatric cancer. Childhood cancer patients who are obese at diagnosis represent a particular challenge for the oncologist. Obesity may complicate chemotherapy dose determination, and has been associated with decreased overall and event-free survival in a number of adult cancer patients, and more recently in pediatric patients. The purpose of the present study was to examine whether obesity at diagnosis was associated with decreased overall and event-free survival in a cohort of 322 predominantly Hispanic pediatric patients with B-precursor ALL. Obesity was classified as an age-standardized and sex-standardized body mass index z-score at or above the 95th percentile. Hazard ratios (HRs) for overall and event-free survival were assessed using Cox proportional hazards regression modeling. Obesity at diagnosis was not associated with decreased overall survival (HR = 1.40, 95% confidence interval = 0.69-2.87) or event-free survival (HR = 1.08, 95% confidence interval = 0.65-1.82) in the overall cohort or in either of the 2 age-at-diagnosis (2 to 9 y; 10 to 18 y) subgroups. Our finding of no obesity-related prognostic effect in the overall cohort and in the under 2 to 9-year age-at-diagnosis cohort was consistent with the previous large-scale study of ALL patients; the absence of a prognostic effect in the 10 to 18-year age-at-diagnosis cohort, however, conflicted with previous findings.
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PMID:Obesity and survival in a cohort of predominantly Hispanic children with acute lymphoblastic leukemia. 1700 63

Childhood cancer survivors are at increased risk of many long-term treatment-related sequel such as second cancers, cardiovascular disease, and pulmonary complications. Certain treatments seem to influence the risk of becoming overweight, obese, or underweight, and abnormal body mass index (BMI) is associated with increased morbidity and mortality. Because BMI is modifiable, it is important to identify treatment and patient-related factors contributing to altered BMI. New research areas include exploring how genetic susceptibility through population polymorphism may contribute to BMI. Illuminating potential gene-environment interactions that influence obesity and underweight might be more readily accomplished in a study of high-risk individuals (i.e., childhood cancer survivors) with well-characterized exposures. The new Childhood Cancer Research Network in the Children's Oncology Group, when fully implemented, should make it less difficult in the future to recruit the large numbers of patients needed for such studies.
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PMID:Genetic susceptibility and body mass in childhood cancer survivors. 1717 92

As pediatric cancer survivors age, long-term cardiovascular complications related to chemotherapeutic toxicities, as well as development of premature coronary artery disease (CAD) from radiation and increased prevalence of CAD risk factors such as obesity, are likely to become more prevalent. Despite advances in our understanding of CAD in the general population, a large amount of the variance in development of disease is unexplained. Given the strong heritability of CAD, some of this may be attributable to genetics. Premature CAD in particular segregates in families, and twin studies have shown that the genetic contribution is greater in premature CAD. In this article, we present a brief review of the literature on the genetics of CAD. Over 30 monogenic disorders feature CAD phenotypes. Recently, however, interest has shifted to understanding the genetic variation contributing to common, complex disease, where disease risk is polygenic and characterized by environmental factors, and gene-environment interactions. CAD epitomizes such a disease, and highlights the inherent difficulties in understanding the underlying genetic architecture of such diseases. Long-term cardiovascular complications in patients who survive pediatric cancers result in significant morbidity and mortality in this population. Clinicians need to be aware of screening and treatment strategies for primary and secondary prevention of cardiovascular complications in this group. Further research is necessary to define the epidemiology and risk factors of premature CAD in survivors of pediatric cancers, and to determine whether candidate genes for cardiovascular disease in the general population are also susceptibility genes in this vulnerable population.
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PMID:Gene polymorphisms and susceptibility to coronary artery disease. 1726 94

During the last decade there has been increasing interest in possible long-term benefits of breastfeeding for health and development. Most relevant studies published from the second half of 2001 to 2006 suggest that breastfeeding is likely to protect against later obesity, type 1 diabetes, coeliac disease, inflammatory bowel diseases and childhood cancer. Also, breastfeeding seems to have beneficial effects on later cardiovascular risk factors. A positive association between breastfeeding and cognitive development continues to be the most consistent and important effect, whereas the effect of breastfeeding in the prevention of atopy remains controversial. Possible mechanisms which might mediate the protective effect of breastfeeding are considered. Evidence suggests that breastfeeding can to some degree programme future health, although most studies are observational and cannot prove causation. Promotion of breastfeeding is of great importance and may contribute to the prevention of some major health risks at the population level.
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PMID:[Long-term health effects of breastfeeding]. 1819 30

With recent improvements in the diagnosis and treatment of cancer, the number of childhood cancer survivors (CCSs) has been increasing in Japan. The importance of quality of life during the lifetime of CCSs has now been recognized, and the late effects of cancer treatments are essential and important issues. In this study we analyzed the endocrinological abnormalities of CCSs by retrospectively evaluating 122 outpatients (62 males and 60 females) who had been referred from pediatric oncologists to our follow-up clinic among 151 CCSs attending our hospital more than two years after their cancer treatment. Follow-up duration varied from 2 to 30 (median 8.0) years. Their average age was 17.3 (range 4-36, median 17.0) years, and 38 patients (31.1%) reached adulthood. Endocrinological abnormalities were found in 82 (67%) of 122 survivors. Gonadal dysfunction was observed in 60 patients (49%). Thirty-nine patients (32%) were short or grew at a slower rate. Twenty-six patients (21%) showed thyroid dysfunction. Other abnormalities were as follows: obesity in 20 patients (16%), leanness in 10 (8%), central diabetes insipidus in 11 (9%) and adrenocortical dysfunction in 9 (7%). Low bone mineral density was observed in 41 (42%) of 98 patients evaluated. These endocrinological abnormalities were caused by the combined effects of cancer itself and various treatments (chemotherapy, radiation therapy, surgery, and hematopoietic stem cell transplantation). Lifetime medical surveillance and continuous follow-up are necessary for CCSs, because treatment-related complications may occur during childhood and many years after the therapy as well. Endocrinologists should participate in long-term follow-up of these survivors in collaboration with pediatric oncologists.
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PMID:Endocrinological analysis of 122 Japanese childhood cancer survivors in a single hospital. 1871 93

Along with the growing epidemic of obesity, the risk of atherosclerosis, cardiovascular disease morbidity, and mortality are increasing markedly. Several risk factors for cardiovascular disease, such as visceral obesity, glucose intolerance, arterial hypertension, and dyslipidemia commonly cluster together as a condition currently known as metabolic syndrome. Thus far, insulin resistance, and endothelial dysfunction are the primary events of the metabolic syndrome. Several groups have recommended clinical criteria for the diagnosis of metabolic syndrome in adults. Nonetheless, in what concerns children and adolescents, there are no unified definitions, and modified adult criteria have been suggested by many authors, despite major problems. Some pediatric disease states are at risk for premature cardiovascular disease, with clinical coronary events occurring very early in adult life. Survivors of specific pediatric cancer groups, particularly acute lymphocytic leukemia, central nervous system tumors, sarcomas, lymphomas, testicular cancer, and following bone marrow transplantation, may develop metabolic syndrome traits due to: hormonal deficiencies (growth hormone deficiency, thyroid dysfunction, and gonadal failure), drug or radiotherapy damage, endothelial impairment, physical inactivity, adipose tissue dysfunction, and/or drug-induced magnesium deficiency. In conclusion, some primary and secondary prevention remarks are proposed in order to reduce premature cardiovascular disease risk in this particular group of patients.
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PMID:Detection of metabolic syndrome features among childhood cancer survivors: a target to prevent disease. 1906 99

Adult survivors of childhood cancer, particularly brain tumours and acute lymphoblastic leukaemia demonstrate evidence of increased rates of metabolic complications and cardiovascular disease in later life. Evidence is accumulating that risk factors for these complications include obesity, physical inactivity, lipid abnormalities, insulin resistance and development of the metabolic syndrome. Cranial radiotherapy-induced growth hormone deficiency, other direct adverse effects of radiotherapy and anthracycline-induced left ventricular dysfunction are clearly identified risk factors for developing these complications. Growth hormone replacement, where appropriate, has been of some benefit in reducing the prevalence of metabolic complications in some long-term survivors. In others, it is clear that multidisciplinary interventions will need to be developed which focus on modifying aspects of lifestyle including increasing levels of habitual physical activity, improving diet and prevention of smoking along with the use of lipid-lowering medication.
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PMID:Metabolic disorders. 1929 4

Advances in cancer therapy over the last years have resulted in improved survival rates for pediatric cancer patients. However, new treatments are associated with short and long-term morbidity. The endocrine system is particularly sensitive to cancer therapies. Long-term survivors of childhood cancer are at risk for hypothalamic pituitary dysfunction, gonadal failure or disorders relating to pubertal progress, thyroid disease, obesity, disorders of lipid metabolism and disorders of bone and mineral metabolism. Long-term follow-up is indicated, as these disorders may not become apparent until adulthood.
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PMID:Endocrine consequences of childhood malignancies. 1937 43

As childhood cancer treatment has become more effective, survival rates have improved, and a number of complications have been described while many of these patients reach adulthood. Obesity is a well-recognized late effect, and its metabolic effects may lead to cardiovascular disease. Currently, studies concerning overweight have focused on acute lymphocytic leukemia and brain tumors, since they are at risk for hypothalamic-pituitary axis damage secondary to cancer therapies (cranial irradiation, chemotherapy, and brain surgery) or to primary tumor location. Obesity and cancer have metabolic syndrome features in common. Thus, it remains controversial if overweight is a cause or consequence of cancer, and to date additional mechanisms involving adipose tissue and hypothalamic derangements have been considered, comprising premature adiposity rebound, hyperinsulinemia, leptin regulation, and the role of peroxisome proliferator-activated receptor gamma. Overall, further research is still necessary to better understand the relationship between adipogenesis and hypothalamic control deregulation following cancer therapy.
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PMID:Adiposity in childhood cancer survivors: insights into obesity physiopathology. 1946 12

The number of adult survivors of childhood cancer in the general population has increased. As reports on the prevalence of the metabolic syndrome in adult survivors of childhood cancer are scarce, we reviewed the available literature on the components of the metabolic syndrome in adult survivors of childhood cancer. Although there is a lack of studies estimating the prevalence of metabolic syndrome directly, especially prevalence of insulin resistance, obesity, and dyslipidemia is increased in certain groups. Therefore, adult survivors of childhood cancer are at increased risk of developing cerebrovascular and cardiovascular diseases. Accordingly, it is important to identify the predisposing factors of the metabolic syndrome in cohorts of survivors, to introduce medical interventions, and to subsequently decrease the risk of cerebrovascular and cardiovascular events.
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PMID:The metabolic syndrome in adult survivors of childhood cancer, a review. 2018


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