Sarcopenic Obesity in Survivors of Childhood Acute Lymphoblastic Leukemia: Prevalence, Risk Factors, and Implications for Cancer Survivors

Overview

Journal Support Care Cancer

Specialties Critical Care
Oncology

Date 2024 Nov 26

PMID 39592473

Authors

Gargi Das

Kritika Setlur

Manisha Jana

Lakshmy Ramakrishnan

Vandana Jain

Jagdish Prasad Meena

Aditya Kumar Gupta

Sadanand Dwivedi

Rachna Seth

Affiliations

Soon will be listed here.

Abstract

Purpose: Sarcopenic obesity, characterized by increased adiposity with low skeletal muscle mass, contributes to frailty and the development of chronic disease. Data on sarcopenic obesity in survivors of childhood acute lymphoblastic leukemia (cALL) is limited.

Methodology: A cross-sectional study on 65 cALL survivors (7-18 years, > 2 years from treatment completion) was conducted on cALL survivors with the primary outcome to determine the prevalence of sarcopenic obesity. Sarcopenic obesity was defined as patients with a positive Fat Mass Index (FMI) z-score with a negative Skeletal Muscle Index (SMI) z-score, measured using a Dual-Energy Xray Absorptiometry (DXA) scan. In addition, we assessed the factors associated with sarcopenic obesity by multivariable regression analysis.

Results: The mean (± SD) age was 12.9 (± 3.2) years, the median (Interquartile Range) time since diagnosis was 6.5 (5.9;8) years, and 66% received cranial radiotherapy. Central obesity, insulin resistance, and metabolic syndrome were seen in 21.5%, 23.1%, and 21% respectively. DXA-derived body composition variables revealed higher fat percentage despite normal body mass index (BMI) and lower muscle mass compared to the general population. Sarcopenic obesity was seen in 21 (34%) of survivors. On multivariable regression analysis, age at diagnosis (OR: 0.95 (95% CI: 0.92-0.98), p = 0.02), central obesity (OR: 18.99 (95% 2.32-155.5), p = 0.006) and insulin resistance (OR: 10.2 (95% CI: 1.75-59.09), p = 0.01) were associated with sarcopenic obesity.

Conclusions: Sarcopenic obesity, an early clinical indicator for metabolic disease despite normal BMI, was significantly worse in children diagnosed with ALL at a younger age and was associated with central obesity and insulin resistance, which may contribute to adverse outcomes later in life.

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