Premature ovarian failure after childhood cancer and risk of metabolic syndrome: a cross-sectional analysis

• Published in: European journal of endocrinology Vol. 185; no. 1; pp. 67 - 75
• Main Authors: Netterlid, Axel, Mörse, Helena, Giwercman, Aleksander, Henic, Emir, Åkesson, Kristina E, Erfurth, Eva-Marie, Elfving, Maria
• Format: Journal Article
• Language: English
• Published: England Bioscientifica Ltd 21.05.2021; Oxford University Press
• Subjects: Absorptiometry, Photon; Adipose Tissue; Adult; Anti-Mullerian Hormone - blood; Antineoplastic Agents - therapeutic use; Antineoplastic Agents, Alkylating - therapeutic use; Blood Glucose - metabolism; Body Composition; Body fat; Cancer; Cancer and Oncology; Cancer och onkologi; Cancer Survivors; Cardiovascular diseases; Case-Control Studies; Children; Cholesterol - blood; Cholesterol, HDL - blood; Cholesterol, LDL - blood; Clinical Medicine; Clinical Study; Cross-sectional studies; Dual energy X-ray absorptiometry; Female; Females; Glycated Hemoglobin A - metabolism; Humans; Hypothalamus; Insulin; Insulin - blood; Klinisk medicin; Medical and Health Sciences; Medicin och hälsovetenskap; Metabolic syndrome; Metabolic Syndrome - epidemiology; Metabolic Syndrome - metabolism; Middle Aged; Neoplasms - therapy; Ovarian cancer; Ovaries; Pituitary; Primary Ovarian Insufficiency - epidemiology; Primary Ovarian Insufficiency - metabolism; Radiotherapy - methods; Reproductive status; Risk Factors; Triglycerides - blood; Young Adult
• ISSN: 0804-4643; 1479-683X; 1479-683X
• DOI: 10.1530/EJE-20-1275

Objective Female childhood cancer survivors (CCS) are at risk of several late effects, such as metabolic syndrome (MetS) and premature ovarian insufficiency (POI). The objective is to study if POI is associated with risk of MetS and increased cardiovascular risk in CSS. Design A cross-sectional study with a median time since the cancer diagnosis of 25 (12–41) years. Patients and controls were recruited from the South Medical Region of Sweden. Methods The study included 167 female CCS, median age 34 (19–57) years, diagnosed with childhood cancer at median age 8.4 (0.1–17.9) years together with 164 controls, matched for age, sex, ethnicity, residence, and smoking habits. All subjects were examined with fasting glucose, insulin, HbA1c, and lipid profile. Fat mass was calculated with dual-energy X-ray absorptiometry (DXA), and questionnaires for medication were obtained. Detailed information of cancer treatment was available. Results POI was present in 13% (22/167) among CCS (hypothalamic/pituitary cause excluded) and in none among controls. MetS was present in 14% (24/167) among all CCS (P  = 0.001), in 23% (5/22) of those with POI (P  < 0.001), compared with 4% (6/164) among controls. OR for MetS in all CCS compared with controls was 4.4 (95% CI: 1.8, 11.1) (P  = 0.002) and among CCS with POI the OR was 7.7 (CI: 2.1, 28.1) (P  = 0.002). Conclusion The prevalence of MetS was higher in females treated for childhood cancer compared with controls, and the presence of POI significantly increased the risk of developing MetS.