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Anthropometric parameters and their relationship to serum growth hormone-binding protein and leptin levels in
B Argüelles1, V Barrios, M Buño
1Universidad Autónoma, Department of Pediatrics, Division of Pediatric Endocrinology, Hospital Universitario Niño Jesús, E-28009 Madrid, Spain.
Insights
Children with acute lymphoblastic leukemia (ALL) experience compromised linear growth and a tendency towards obesity post-therapy. Leptin levels correlate with nutritional status, while growth hormone-binding protein (GHBP) shows limited correlation.
Area of Science:
- Pediatric Endocrinology
- Pediatric Oncology
- Human Growth and Development
Background:
- Acute lymphoblastic leukemia (ALL) treatment can impact growth and body composition in children.
- Understanding the roles of growth hormone-binding protein (GHBP) and leptin is crucial for monitoring these effects.
Purpose of the Study:
- To investigate auxological parameters in children with ALL.
- To examine the relationship between serum GHBP and leptin levels with anthropometric measurements during and after ALL treatment.
Main Methods:
- Longitudinal study of 26 prepubertal children diagnosed with ALL.
- Measurement of auxological parameters, serum GHBP, and leptin at diagnosis and various time points during and after therapy (up to 36 months).
Main Results:
- Serum GHBP levels decreased during initial therapy, normalizing post-treatment.
- Height standard deviation score (SDS) improved after 24 months; weight and upper arm circumference increased post-chemotherapy.
- Leptin showed a strong positive correlation with nutritional anthropometric parameters, particularly body mass index (BMI).
Conclusions:
- Linear growth is impaired during ALL illness and therapy, potentially due to transient growth hormone insensitivity.
- Children with ALL exhibit a tendency towards obesity after therapy withdrawal.
- Leptin serves as a valuable marker for nutritional status in pediatric ALL patients.
Objective:
The aim of this study was to follow auxological parameters and their relationship to serum growth hormone-binding protein (GHBP) and leptin levels in children with acute lymphoblastic leukemia (ALL).
Design And Methods:
In total, 26 prepubertal children with ALL were studied. We report these data at the time of the clinical diagnosis (n=26) and at 6 (n=21), 12 (n=21), 18 (n=21), 24 (n=20), 30 (n=16) and 36 months (n=16) after beginning treatment.
Results:
Serum GHBP levels decreased during the first 18 months and returned to normal when therapy was withdrawn. Height SDS increased at 24 months after diagnosis. Weight and the upper arm circumference had increased 6 months after chemotherapy withdrawal, whereas tricipital and subscapular skinfolds had increased both at 6 months after diagnosis and 6 months after therapy had stopped. Therefore, the tendency to become overweight is both an early and a late side-effect of anti-leukemia therapy. A significant positive correlation was found between serum leptin levels and every nutritional anthropometric parameter, with body mass index having the best relationship. However, serum GHBP levels were only correlated with BMI at the end of the study. No correlation was found between leptin and GHBP.
Conclusions:
In children with ALL, linear growth is compromised during the acute phase of their illness and therapy; this is probably secondary to a state of partial and transient GH insensitivity. These patients tend to become obese after therapy withdrawal, with leptin being an excellent nutritional marker.
