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Ross JA, Oeffinger KC, Davies SM, Mertens AC, Langer EK, Kiffmeyer WR, Sklar CA, Stovall M, Yasui Y, Robison LL. Genetic Variation in the Leptin Receptor Gene and Obesity in Survivors of Childhood Acute Lymphoblastic Leukemia: A Report From the Childhood Cancer Survivor Study. J Clin Oncol 2004; 22:3558-62. [PMID: 15337805 DOI: 10.1200/jco.2004.11.152] [Citation(s) in RCA: 104] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
PurposeOverweight (body mass index [BMI] 25 to 29 kg/m2) and obesity (BMI ≥ 30 kg/m2) frequently follow treatment for childhood acute lymphoblastic leukemia (ALL). Recent studies suggest that risk is most apparent in females treated with cranial radiation at a younger age. Because radiation at a young age may affect the hypothalamus causing leptin receptor insensitivity, we hypothesized that a polymorphism in the leptin receptor (LEPR) gene, Gln223Arg, might influence susceptibility to obesity in survivors of childhood ALL.Patients and MethodsWe genotyped 600 non-Hispanic white adult ALL survivors enrolled onto the Childhood Cancer Survivor Study. BMI was compared between those with two copies of the Arg allele to those who had at least one copy of the Gln allele.ResultsFemale survivors with BMI ≥ 25 kg/m2were more likely Arg homozygous than those with BMI less than 25 kg/m2(24% v 12%; P = .007). This difference was not observed in males. Moreover, among females treated with ≥ 20 Gy cranial radiation, Arg/Arg individuals had six times higher odds of having BMI ≥ 25 kg/m2(95% CI, 2.1 to 22.0) than those with a Gln allele (P = .04 for interaction).ConclusionLEPR polymorphism may influence obesity in female survivors of childhood ALL, particularly those exposed to cranial radiation. Because obesity is associated with increased morbidity and mortality in later life, identification of children at high risk might allow for early targeted interventions.
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Affiliation(s)
- Julie A Ross
- Division of Pediatric Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN 55455, USA.
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