Increased Levels of Adipocyte and Epidermal Fatty Acid-Binding Proteins in Acute Lymphoblastic Leukemia Survivors.

Katarzyna Konończuk,Katarzyna Muszyńska-Rosłan,Eryk Latoch,Beata Żelazowska-Rutkowska,Maryna Krawczuk-Rybak

doi:10.3390/jcm10081567

Katarzyna Konończuk, Katarzyna Muszyńska-Rosłan + Show 3 more

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https://doi.org/10.3390/jcm10081567

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Abstract

Childhood cancer survivors are highly exposed to the development of side effects after many years of cessation of anticancer treatment, including altered lipid metabolism that may result in an increased risk of overweight and metabolic syndrome. Adipocyte (A-FABP) and epidermal (E-FABP) fatty acid-binding proteins are expressed in adipocytes and are assumed to play an important role in the development of lipid disturbances leading to the onset of metabolic syndrome. The aim of this study was to investigate the association between serum A-FABP and E-FABP levels, overweight, and components of the metabolic syndrome in acute lymphoblastic leukemia survivors. Sixty-two acute lymphoblastic leukemia (ALL) survivors (34 females) were included in the study. The mean age at the time of the study was 12.41 ± 4.98 years (range 4.71–23.43). Serum levels of A-FABP and E-FABP were analyzed using a commercially available ELISA kit. The ALL survivors presented statistically higher A-FABP levels in comparison with the healthy controls (25.57 ± 14.46 vs. 15.13 ± 7.61 ng/mL, p < 0.001). The subjects with body mass index (BMI) above the normal range (18 overweight, 10 obese) had a greater level of A-FABP compared to the ALL group with normal BMI (32.02 ± 17.10 vs. 20.33 ± 9.24 ng/mL, p = 0.006). Of all participants, 53.23% had at least one risk factor of metabolic syndrome; in this group, only the A-FABP level showed a statistically significant difference compared to the healthy control group (30.63 ± 15.91 vs. 15.13 ± 7.61 ng/mL, p < 0.001). The subjects with two or more metabolic risk factors (16.13%) presented higher levels of both A-FABP (33.62 ± 17.16 vs. 15.13 ± 7.61 ng/mL, p = 0.001) and E-FABP (13.37 ± 3.62 vs. 10.12 ± 3.21 ng/mL, p = 0.021) compared to the controls. Univariable regression models showed significant associations between BMI and systolic blood pressure with the A-FABP level (coeff. 1.02 and 13.74, respectively; p < 0.05). In contrast, the E-FABP level was only affected by BMI (coeff. 0.48; p < 0.01). The findings reported herein suggest that the increased levels of A-FABP and E-FABP may be involved in the pathogenesis of overweight and the onset of metabolic syndrome in acute lymphoblastic leukemia. However, further longitudinal, prospective studies of fatty acid-binding proteins and their potential role in the pathogenesis of obesity and metabolic syndrome in ALL survivors remain to be performed.

Highlights

Acute lymphoblastic leukemia (ALL) constitutes over 25% of all childhood cancers, which qualifies it to be the most common childhood malignancy
The findings reported suggest that the increased levels of A-Fatty acid-binding proteins (FABPs) and Epidermal FABP (E-FABP) may be involved in the pathogenesis of overweight and the onset of metabolic syndrome in acute lymphoblastic leukemia
Metabolic pathways leading to the development of obesity and its complications have not been fully elucidated in this group of patients

Summary

Introduction

Acute lymphoblastic leukemia (ALL) constitutes over 25% of all childhood cancers, which qualifies it to be the most common childhood malignancy. Due to significant advances in the diagnosis and treatment of ALL in recent years, the improvement in survival rate up to 90% has been reached depending on the risk group [1,2,3]. Many studies indicate that this population is exposed to numerous treatment-related complications in later life [4,5,6]. Over the past two decades, multiple reports have been published that indicate childhood cancer survivors (CCS) are at risk of premature aging and develop many diseases earlier than the general population [7]. The most common complications include diseases of civilization such as obesity, diabetes mellitus, metabolic syndrome, heart diseases, osteoporosis or second cancers [8,9]. Cranial radiation has been noted to play an important role in the development of metabolic syndrome (MetS) and insulin resistance (IR) [10]

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