Back to Search
Start Over
Insulin and glucose homeostasis in childhood cancer survivors treated with abdominal radiation: A pilot study
- Source :
- Journal of Clinical Oncology. 34:108-108
- Publication Year :
- 2016
- Publisher :
- American Society of Clinical Oncology (ASCO), 2016.
-
Abstract
- 108 Background: Previous reports have suggested an increased risk of Type I and Type II diabetes mellitus (DM) in childhood cancer survivors exposed to abdominal radiotherapy (RT). The mechanisms leading to DM in this population, however, remain unknown. We sought to clarify the pathophysiology leading to these derangements by performing dynamic testing of glucose and insulin in survivors previously treated with abdominal RT. Methods: Cross-sectional pilot study of 2-year survivors of childhood cancer treated with abdominal RT at Memorial Sloan Kettering between 1975 – 2009. Eligible participants were < 21 years of age at exposure to abdominal RT; those with a known diagnosis of DM or prior exposure to brain or total body RT were excluded. Survivors underwent formal 2-hour glucose tolerance testing; auto-antibodies (insulin auto-antibodies, islet cell autoantibody, glutamic acid decarboxylase) typically present in patients with Type I DM and hemoglobin A1c levels were assessed. Insulin resistance was calculated by the homeostasis model assessment of insulin resistance (HOMA-IR) and Matsuda index. Results: 21 survivors were enrolled (male: 47.6%; median age at RT: 3.3 years; median age at study: 14.4 years [range: 8.3 – 46.9]; median time from abdominal RT: 10.7 years). Primary diagnoses included neuroblastoma (n = 15), rhabdomyosarcoma (n = 3), Wilms (n = 1), Hodgkin lymphoma (n = 1), rhabdoid tumor (n = 1). None of the participants were obese (body mass index [BMI] range: 14.7 – 23.2 kg/m2). Five participants (23.8%, 95% confidence interval: 8% – 47%) had glucose derangements at a median of 8.4 years after RT (one with impaired fasting glucose [fasting glucose ≥ 100 mg/dl) and four with impaired glucose tolerance [2-hour glucose 140-199 mg/dl]). Two additional participants with normal glucose tolerance had impaired insulin sensitivity based on an abnormal Matsuda Index and HOMA-IR. None of the participants had abnormal autoantibodies, insulinopenia, or hemoglobin A1c levels. Conclusions: These findings suggest that nonobese childhood cancer survivors treated with abdominal RT may be at high-risk for subclinical derangements of glucose and insulin. Further study is warranted in larger survivor cohorts. Clinical trial information: NCT02248779.
- Subjects :
- Blood Glucose
Male
Cancer Research
medicine.medical_treatment
Glutamate decarboxylase
Pilot Projects
030204 cardiovascular system & hematology
Gastroenterology
Impaired glucose tolerance
0302 clinical medicine
Cancer Survivors
Abdomen
Homeostasis
Insulin
Glucose homeostasis
Child
education.field_of_study
geography.geographical_feature_category
Hematology
Islet
Pathophysiology
Oncology
Child, Preschool
030220 oncology & carcinogenesis
Homeostatic model assessment
Female
medicine.medical_specialty
Adolescent
Population
Carbohydrate metabolism
Article
Young Adult
03 medical and health sciences
Insulin resistance
Diabetes mellitus
Internal medicine
Glucose Intolerance
Diabetes Mellitus
medicine
Humans
Radiation Injuries
education
geography
Radiotherapy
business.industry
Autoantibody
Infant
Impaired fasting glucose
medicine.disease
Cross-Sectional Studies
Endocrinology
Pediatrics, Perinatology and Child Health
Insulin Resistance
business
Subjects
Details
- ISSN :
- 15277755 and 0732183X
- Volume :
- 34
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Oncology
- Accession number :
- edsair.doi.dedup.....17b49631e1051877fc2947ec8df04201