Dyslipidemia and metabolic syndrome in children and teenagers after the allogeneic hematopoietic stem cell transplantation
The research comprised 78 patients: girls - 36 (46 %), boys - 42 (54 %). At the moment of the allogeneic hematopoietic stem cell transplan- tation (аllо-HSCT) their age was 1-18 years (median - 9 years); the age at the moment of examination was 2.5-21 years (median - 11 years); the monitoring after allo-HSCT was 1-11 years (median - 3.5 years); the monitoring period of less than 5 years was at 50 (64 %), more than 5 years - at 28 (36 %) of patients. atients P , height, weight, waist, blood pressure (BP) were measured. Laboratory examination: determination of glucose, magnesium, thyreo- thropin, Т, Т, cortisone, follicle stimulating hormone, lutenizing hormone levels were measured, the lipidogram was made, at girls over 3 4 14 estrogens and progesterone levels were determined, at boys over 14 testosterone levels were determined. At 22 (28 %) patients was evalu- ated the activity of renine-angiotensine-aldosterone system (determination of renine and aldosterone concentration). Endocrinologic complications after allo-HSCT were observed at 68 (87 %) of patients. The deterioration of the thyroid gland function was diagnosed at 34 (44 %) of the children and teenagers, the secondary adrenal insufficiency was observed at 7 (9 %) of patients, the hypergon- dotropic hypogonadism was observed at - у 12 (57 %) patients, the arterial hypertension (BP > 130/85 mm Hg) - at 9 (12 %), hyperglyce- mia (glucose level > 5.6 mmol/l) - at 10 (13 %) of patients. The dislipidemia and double dislipidemia - at 44 (56 %) и 24 (31 %) of pa- tients accordingly, hypertriglyceridemia - at 30 (68 %), hypercholesterinemia - at 22 (50 %), the decrease of high density lipoproteins - at 20 (45 %), the increase of the very low density lipoproteins , level - at 4 (9 %) of patients. Obesity - at 11 (14 %) of patients; among them I degree - at 10 (91 %), II degree - at 1 (9 %). The average age of patients with obesity at the moment of examination - 10.5 years. The metabolic syndrome was diagnosed at 3 (4 %) patients. Was revealed the authentic link between the dislipidemia and the chronic reaction of “graft versus host disease” (р = 0.001), hypomagnie- mia (р = 0.003), deterioration of the thyroid gland function (р = 0.007). The influence of the age at the moment of allo-HSCT (1-10 vs older10 years), sex, diagnosis (oncologic vs non-oncologic), conditioning mode (myeloablative vs conditioning mode with increased inten- siveness), monitoring period after allo-HSCT (1-5 vs older 5 years) on the risk of dislipidemia development is not established.