Cardiometabolic Profile after Pediatric Cancer Treatment: Insight into HDL Composition and Nutritional Intake

Abstract

Few studies have investigated the impact of pediatric cancer treatment on cardiometabolic health, although chemotherapy in children can cause rapid weight gain, transient hypertension, elevated blood glucose and hyperlipidemia. Besides, we have previously shown that young survivors of childhood leukemia are at increased risk of having the metabolic syndrome, dyslipidemia, hypertension and altered high‐density lipoprotein (HDL) composition. This study aims to examine the cardiometabolic profile of children after cancer treatment in relation to their diet, as well as HDL2 and HDL3 composition.MethodsPatients were recruited at Sainte‐Justine University Health Center in Montreal as part of the VIE Program (Valorization, Implication, Education). Fasting blood samples were collected and we assessed participants' anthropometric, metabolic, and biochemical profiles. Three day food records were used to evaluate dietary intake. HDL2 and HDL3 fractions were isolated from plasma by ultracentrifugation, and total protein and lipids were measured by colorimetric reactions.ResultsTo date, 63 patients (44.4% boys) were recruited. Mean age was 11.7 ± 5.6 years and 46.0% were treated for acute lymphoblastic leukemia. The time elapsed since the last treatment was 17.0 ± 9.7 months. We found that 25.4% of participants (n=16/63) had hypertension, 22.2% (n=14/63) were obese and 8.9% (n=5/56) were insulin resistant. One third of patients had dyslipidemia (n=21/63), a risk that was increased by age (OR: 1.31, 95%CI: 1.16–1.50, P<0.01). Patients over 10 years old had insufficient intakes of several nutrients (vitamins A and E, folate, magnesium, zinc). Compared to healthy children, the proportion of esterified cholesterol in HDL2 was lower (18.6 ± 1.2% vs. 11.9 ± 1.4%, P<0.01), but protein content was higher (41.1 ± 1.6% vs. 48.8 ± 1.0, P<0.01). The proportion of esterified cholesterol was also lower in HDL3 fractions of patients treated for cancer (12.6 ± 1.3% vs. 10.1 ± 0.7%, P<0.01).ConclusionThese results indicate cardiometabolic disturbances and anomalies in HDL composition in children shortly after cancer treatment. They emphasize the need for nutritional interventions in this high‐risk population.Support or Funding InformationThis work is funded by The Foundation Centre de cancérologie Charles‐Bruneau and The Joy of Eating Better Foundation and the CHU Sainte‐Justine Foundation.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.