Inflammation mediates link between endotoxemia and cardiometabolic outcomes in cALL survivors

Inflammatory biomarkers are linked to obesity, dyslipidaemia, and insulin resistance among adolescent and young adult survivors of childhood acute lymphoblastic leukaemia (cALL), a recent study has found.

In addition, lipopolysaccharide binding protein (LBP), an indicator of endotoxemia, seems to be directionally associated with inflammation and cardiometabolic outcomes.

Researchers conducted a cross-sectional assessment of 246 cALL survivors (mean age, 22.1±6.3 years), from whom samples of overnight fasting peripheral blood were collected. Appropriate commercial assays were used to measure biomarkers of endotoxemia, endothelial function, inflammation, and oxidative stress.

In terms of outcomes, 41.5 percent of the survivors had dyslipidaemia, making it the most common cardiometabolic complication. It was followed by obesity (32.5 percent), insulin resistance (17.1 percent), and pre-hypertension or hypertension (12.2 percent).

Adjusted logistic regression found that the endotoxemia marker LBP was a significant risk factor for obesity (odds ratio [OR], 2.03, 95 percent confidence interval [CI], 1.13–3.65; p=0.019) and dyslipidaemia. Structural equation models further found that the impact of endotoxemia on cardiometabolic outcomes was mediated by inflammation.

“These results are in agreement with the hypothesis that, in cALL survivors, endotoxemia triggers a pro-inflammatory state that is associated with the development of cardiometabolic complications,” the researchers said.

They found several other interactions between biomarkers and cardiometabolic outcomes. Adiponectin, for instance, was significantly protective against obesity, insulin resistance, dyslipidaemia, and metabolic syndrome. Tumour necrosis factor-alpha and plasminogen activator inhibitor-1, on the other hand, exacerbated the likelihood of obesity.