Dietary intake and risk of metabolic syndrome in long-term survivors of pediatric allogeneic hema-topoietic stem cell transplantation

Abstract

Metabolic syndrome (MetS) is a late effect of stem cell transplantation and has been ascribed to conditioning including total body irradiation (TBI), but the influence of lifestyle factors has not yet been studied. We explored the dietary intake and MetS in 85 long-term survivors (median age 30 years and median follow-up time 20 years). Results: Overall, the distribution of fatty acid deviated from the recommendations with a higher intake of saturated fat and a lower intake of monounsaturated, polyunsaturated fat, and N-3 fatty acids, but was comparable to that of the background population. The prevalence of MetS was 27%, corresponding to that of the elderly background population. Both in the total cohort and within the subgroup treated with TBI we found a higher fat intake in patients with fulfilling MetS criteria (36.8E% [range: 27.2-51.2E%] versus 32.0E% [range: 24.6-42.1E%], (P = 0.013)). This was confirmed in a multivariate analysis adjusted for TBI, sex and age at follow-up (OR 1.20 (1.06–1.39) P = 0.008). Conclusion: Although comparable with the diet in the background population the intake of fat is a key factor for the occurrence of MetS in young TBI treated survivors. This highlights the importance of a reduced fat intake in survivors conditioned with TBI.