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 transplantation (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.Patients, height, weight, waist, blood pressure (BP) were measured. Laboratory examination: determination of glucose, magnesium, thyreothropin, Т3, Т4, cortisone, follicle stimulating hormone, lutenizing hormone levels were measured, the lipidogram was made, at girls over 14 estrogens and progesterone levels were determined, at boys over 14 testosterone levels were determined. At 22 (28 %) patients was evaluated 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 hypergondotropic hypogonadism was observed at – у 12 (57 %) patients, the arterial hypertension (BP > 130/85 mm Hg) – at 9 (12 %), hyperglycemia (glucose level > 5.6 mmol/l) – at 10 (13 %) of patients. The dislipidemia and double dislipidemia – at 44 (56 %) и 24 (31 %) of patients 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), hypomagniemia (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 intensiveness), monitoring period after allo-HSCT (1–5 vs older 5 years) on the risk of dislipidemia development is not established.

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