Leptin Increase During Dexamethasone and Its Association With Hunger and Fat in Pediatric Acute Lymphoblastic Leukemia
© The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society..
CONTEXT: During treatment, children with acute lymphoblastic leukemia (ALL) receive high doses dexamethasone, which induce acute side effects.
OBJECTIVE: To determine the influence of a 5-day dexamethasone course on changes in leptin, fat mass, BMI, hunger, sleep, and fatigue and to explore associations between these changes.
METHODS: Pediatric ALL patients were included during maintenance treatment. Data were collected before (T1) and after (T2) a 5-day dexamethasone course (6 mg/m2/day). At both time points, BMI, fat mass (bioelectrical impedance analysis), and leptin were assessed, as well as parent-reported questionnaires regarding hunger, fatigue, and sleep problems. Changes between T1 and T2 were assessed using paired tests. Correlation coefficients were calculated to assess associations between these changes (Delta scores: T2-T1). Univariable regression models were estimated to study associations between covariates and elevated leptin.
RESULTS: We included 105 children, with median age 5.4 years (range, 3.0-18.8). Leptin and fat mass, as well as hunger scores, fatigue, and sleep deteriorated after 5 days of dexamethasone (P < .001), in contrast to BMI (P = .12). No correlations between delta leptin and delta fat mass, BMI, hunger, fatigue, or sleep were found. Elevated leptin on T1 was associated with older age (odds ratio [OR] 1.51; 95% CI, 1.28-1.77), higher fat mass (OR 1.19; 95% CI, 1.07-1.33), and earlier maintenance week (OR 0.96; 95% CI, 0.92-0.99).
CONCLUSION: Five days of high-dose dexamethasone treatment led to direct and significant changes in leptin, hunger scores, and fat mass. Since children with ALL are at increased risk for metabolic adverse events, understanding underlying mechanisms is important, and a dexamethasone-induced state of acute leptin resistance might play a role.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:109 |
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| Enthalten in: |
The Journal of clinical endocrinology and metabolism - 109(2024), 3 vom: 20. Feb., Seite 631-640 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
van Hulst, Annelienke M [VerfasserIn] |
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| Links: |
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| Themen: |
7S5I7G3JQL |
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| Anmerkungen: |
Date Completed 21.02.2024 Date Revised 21.02.2024 published: Print Citation Status MEDLINE |
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| doi: |
10.1210/clinem/dgad621 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM363711139 |
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| 100 | 1 | |a van Hulst, Annelienke M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Leptin Increase During Dexamethasone and Its Association With Hunger and Fat in Pediatric Acute Lymphoblastic Leukemia |
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| 500 | |a Date Revised 21.02.2024 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. | ||
| 520 | |a CONTEXT: During treatment, children with acute lymphoblastic leukemia (ALL) receive high doses dexamethasone, which induce acute side effects | ||
| 520 | |a OBJECTIVE: To determine the influence of a 5-day dexamethasone course on changes in leptin, fat mass, BMI, hunger, sleep, and fatigue and to explore associations between these changes | ||
| 520 | |a METHODS: Pediatric ALL patients were included during maintenance treatment. Data were collected before (T1) and after (T2) a 5-day dexamethasone course (6 mg/m2/day). At both time points, BMI, fat mass (bioelectrical impedance analysis), and leptin were assessed, as well as parent-reported questionnaires regarding hunger, fatigue, and sleep problems. Changes between T1 and T2 were assessed using paired tests. Correlation coefficients were calculated to assess associations between these changes (Delta scores: T2-T1). Univariable regression models were estimated to study associations between covariates and elevated leptin | ||
| 520 | |a RESULTS: We included 105 children, with median age 5.4 years (range, 3.0-18.8). Leptin and fat mass, as well as hunger scores, fatigue, and sleep deteriorated after 5 days of dexamethasone (P < .001), in contrast to BMI (P = .12). No correlations between delta leptin and delta fat mass, BMI, hunger, fatigue, or sleep were found. Elevated leptin on T1 was associated with older age (odds ratio [OR] 1.51; 95% CI, 1.28-1.77), higher fat mass (OR 1.19; 95% CI, 1.07-1.33), and earlier maintenance week (OR 0.96; 95% CI, 0.92-0.99) | ||
| 520 | |a CONCLUSION: Five days of high-dose dexamethasone treatment led to direct and significant changes in leptin, hunger scores, and fat mass. Since children with ALL are at increased risk for metabolic adverse events, understanding underlying mechanisms is important, and a dexamethasone-induced state of acute leptin resistance might play a role | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a acute lymphoblastic leukemia | |
| 650 | 4 | |a dexamethasone | |
| 650 | 4 | |a fat mass | |
| 650 | 4 | |a hunger score | |
| 650 | 4 | |a leptin | |
| 650 | 7 | |a Leptin |2 NLM | |
| 650 | 7 | |a Dexamethasone |2 NLM | |
| 650 | 7 | |a 7S5I7G3JQL |2 NLM | |
| 700 | 1 | |a Verwaaijen, Emma J |e verfasserin |4 aut | |
| 700 | 1 | |a van den Berg, Sjoerd A A |e verfasserin |4 aut | |
| 700 | 1 | |a van Litsenburg, Raphaële R L |e verfasserin |4 aut | |
| 700 | 1 | |a Grootenhuis, Martha A |e verfasserin |4 aut | |
| 700 | 1 | |a Fiocco, Marta |e verfasserin |4 aut | |
| 700 | 1 | |a Neggers, Sebastian J C M M |e verfasserin |4 aut | |
| 700 | 1 | |a van den Heuvel-Eibrink, Marry M |e verfasserin |4 aut | |
| 700 | 1 | |a van den Akker, Erica L T |e verfasserin |4 aut | |
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