糖皮质激素治疗急性淋巴细胞白血病对血清瘦素及BMI的影响

Mechanism of Glucocorticoids Affecting Obesity in the Treatment of Acute Lymphoblastic Leukemia

目的研究急性淋巴细胞白血病(ALL)治疗过程中糖皮质激素对肥胖的作用从而精确规划化疗方案,减少肥胖并发症的发生。方法 2014年1月-2015年12月于宁夏医科大学总院儿科诊断明确并进行化疗的ALL标危型患儿50例为研究对象,测量身高、体重,计算体质量指数(BMI),采用ELISA法测定瘦素水平,并分析糖皮质激素所导致的瘦素水平变化与肥胖之间的关系。结果诱导阶段及延迟强化阶段化疗后,BMI及瘦素水平升高(P<0.05),瘦素水平与BMI呈正相关;维持阶段二者未见升高(P>0.05)。结论糖皮质激素可使瘦素水平升高,瘦素表达水平与BMI呈正相关,瘦素抵抗导致ALL患儿发生肥胖。

Objective To study the effect and mechanism of glucocorticoids on obesity during the treatment of acute lymphoblastic leukemia(ALL).Methods A total of 50 children diagnosed with ALL and received chemotherapy in the Department of Pediatrics of General Hospital of Ningxia Medical University from January 2014 to December 2015 were included in the study.The height and body weight were measured to calculate body mass index(BMI),leptin levels were measured with ELISA and the correlation between BMI and leptin level was analyzed.Results BMI and leptin level were significantly increased(P<0.05)after induction and delayed intensification chemotherapy,while no increase was seen in the maintenance phase(P>0.05).Leptin level was positively correlated with BMI during induction phase and delayed intensification phase.Conclusion Glucocorticoids increase leptin level and which is positively correlated with BMI.Leptin resistance leads to obesity in ALL children.