Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2015) 37 EP660 | DOI: 10.1530/endoabs.37.EP660

ECE2015 Eposter Presentations Pituitary: basic and neuroendocrinology (62 abstracts)

High metabolic risk is associated with small hypothalamic volume in acute lymphoblastic leukemia survivors 34 years after cranial radiotherapy

Cecilia Follin 1 , Sanaz Gabery 2 , Æsa Petrsen 2 , Pia Maly Sundgren 1 , Isabella Björkman-Burtcher 1 , Peter Mannfolk 1 , Jimmy Lätt 1 & Eva Marie Erfurth 1


1Institution of Clinical Sciences, Lund University, Lund, Sweden; 2Institution of Translational Neuroendocrinology, Lund, Sweden.


Background: Metabolic complications (obesity, lipid abnormalities, and insulin resistance) are prevalent in acute lymphoblastic leukemia (ALL) survivors treated with cranial radiotherapy (CRT). The hypothalamus (HT) is a complex area involved in endocrine function and metabolic control. In ALL survivors, assessment of the volume of the HT in relation to metabolic parameters including ghrelin, a peptide stimulating food intake, has not been performed previously.

Method: Thirty-four (21 women) ALL survivors, on complete hormone supplementation, were investigated 34 years after ALL diagnosis. Their median age was 38 (27–46) years and they had been treated with a CRT dose of 24 Gy. Comparison was made with 31 matched controls. Assessments of BMI (kg/m2), waist (cm), fat mass (DEXA/kg), fat free mass (kg), plasma (p)-glucose (mmol/l), p-insulin (mIE/l), HOMA-index, s-leptin (μg/l), and s-ghrelin (ng/l) was performed. Magnetic resonance imaging (MRI) was performed to conduct volumetric analysis of the HT.

Results: S-leptin levels (r=−0.4, P=0.04) and fat mass (r=−0.4, P=0.01) were negatively correlated with the HT volume among the 34 ALL survivors, but not among the matched controls (P>0.3). There was a trend of a smaller HT volume among the ALL women compared to gender matched controls (846 mm3 vs 869 mm3, P=0.06). Significantly higher BMI (27.9 kg/m2 vs 22.6 kg/m2), waist (89 cm vs 79 cm), fat mass (29.9 kg vs 22.4 kg), p-insulin (10 mIE/l vs 6 mIE/l), HOMA-index (0.15 vs 0.07), leptin/kg fat mass (1.09 vs 0.6), and s-ghrelin (1560 ng/l vs 993 ng/l) and significantly lower fat free mass (35.4 kg vs 41.6 kg) were recorded among the female ALL survivors compared to matched controls (all P<0.01).

Conclusion: ALL women treated with CRT are at high risk of metabolic abnormalities in association with a smaller HT volume 34 years after ALL diagnosis. These findings suggest a hypothalamic effect of the metabolic complications.

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