Metabolic Syndrome Parameters, Determinants, and Biomarkers in Adult Survivors of Childhood Cancer: Protocol for the Dutch Childhood Cancer Survivor Study on Metabolic Syndrome (Dutch LATER METS)

Vincent Pluimakers; Marta Fiocco; Jenneke van Atteveld; Monique Hobbelink; Dorine Bresters; Eline Van Dulmen-den Broeder; Margriet Van der Heiden-van der Loo; Geert O Janssens; Leontien Kremer; Jacqueline Loonen; Marloes Louwerens; Helena Van der Pal; Cécile Ronckers; Hanneke Van Santen; Birgitta Versluys; Andrica De Vries; Marry Van den Heuvel-Eibrink; Sebastian Neggers

doi:10.2196/21256

Metabolic Syndrome Parameters, Determinants, and Biomarkers in Adult Survivors of Childhood Cancer: Protocol for the Dutch Childhood Cancer Survivor Study on Metabolic Syndrome (Dutch LATER METS)

JMIR Res Protoc. 2021 Jan 27;10(1):e21256. doi: 10.2196/21256.

Authors

Vincent Pluimakers^#¹, Marta Fiocco^{1

2

3}, Jenneke van Atteveld¹, Monique Hobbelink⁴, Dorine Bresters¹, Eline Van Dulmen-den Broeder^{1

5}, Margriet Van der Heiden-van der Loo⁶, Geert O Janssens^{1

4}, Leontien Kremer^{1

5}, Jacqueline Loonen⁷, Marloes Louwerens², Helena Van der Pal¹, Cécile Ronckers^{1

5

8}, Hanneke Van Santen^{1

9}, Birgitta Versluys^{1

9}, Andrica De Vries^{1

10}, Marry Van den Heuvel-Eibrink¹, Sebastian Neggers^{1

11}

Affiliations

¹ Princess Maxima Center for Pediatric Oncology, Utrecht, Netherlands.
² Department of Internal Medicine, Leiden University Medical Center, Leiden, Netherlands.
³ Mathematical Institute, Leiden University, Leiden, Netherlands.
⁴ Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, Netherlands.
⁵ Department of Pediatric Oncology, Emma Children's Hospital/Amsterdam University Medical Center, Amsterdam, Netherlands.
⁶ Dutch Childhood Oncology Group, Utrecht, Netherlands.
⁷ Department of Hematology, Radboud University Medical Center, Nijmegen, Netherlands.
⁸ Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany.
⁹ Department of Pediatric Oncology and Hematology, Wilhelmina Children's Hospital/University Medical Center Utrecht, Utrecht, Netherlands.
¹⁰ Department of Pediatric Oncology/Hematology, Sophia Children's Hospital/Erasmus Medical Center, Rotterdam, Netherlands.
¹¹ Department of Endocrinology, Erasmus Medical Center, Rotterdam, Netherlands.

^# Contributed equally.

PMID: 32750002
PMCID: PMC7875697
DOI: 10.2196/21256

Abstract

Background: Potential late effects of treatment for childhood cancer include adiposity, insulin resistance, dyslipidemia, and hypertension. These risk factors cluster together as metabolic syndrome and increase the risk for development of diabetes mellitus and cardio- and cerebrovascular disease. Knowledge on risk factors, timely diagnosis, and preventive strategies is of importance to prevent cardio- and cerebrovascular complications and improve quality of life. Currently, no national cohort studies on the prevalence and determinants of metabolic syndrome in childhood cancer survivors, including biomarkers and genetic predisposition, are available.

Objective: The objectives of the Dutch LATER METS study are to assess 1) the prevalence and risk factors of metabolic syndrome and its separate components, and 2) the potential diagnostic and predictive value of additional biomarkers for surveillance of metabolic syndrome in the national cohort of adult long-term survivors of childhood cancer.

Methods: This is a cross-sectional study based on recruitment of all survivors treated in the Netherlands between 1963 and 2002. Metabolic syndrome will be classified according to the definitions of the third Adult Treatment Panel Report of the National Cholesterol Education Program as well as the Joint Interim Statement and compared to reference data. Dual-energy x-ray absorptiometry scans were performed to assess body composition in more detail. The effect of patient characteristics, previous treatment, and genetic variation on the risk of metabolic syndrome will be assessed. The diagnostic and predictive value of novel biomarkers will be tested.

Results: Patient accrual started in 2016 and lasted until April 2020. A total of 2380 survivors from 7 pediatric oncology hospitals have participated. From July 2020, biomarker testing, single nucleotide polymorphism analysis, and data analysis will be performed.

Conclusions: The Dutch LATER METS study will provide knowledge on clinical and genetic determinants of metabolic syndrome and the diagnostic value of biomarkers in childhood cancer survivors. The results of this study will be used to optimize surveillance guidelines for metabolic syndrome in survivors based on enhanced risk stratification and screening strategies. This will improve diagnosis of metabolic syndrome and prevent complications.

International registered report identifier (irrid): DERR1-10.2196/21256.

Keywords: Dutch Childhood Cancer Survivor Study; Dutch LATER METS; childhood cancer survivor; metabolic syndrome; methodology.

©Vincent Pluimakers, Marta Fiocco, Jenneke van Atteveld, Monique Hobbelink, Dorine Bresters, Eline Van Dulmen-den Broeder, Margriet Van der Heiden-van der Loo, Geert O Janssens, Leontien Kremer, Jacqueline Loonen, Marloes Louwerens, Helena Van der Pal, Cécile Ronckers, Hanneke Van Santen, Birgitta Versluys, Andrica De Vries, Marry Van den Heuvel-Eibrink, Sebastian Neggers. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 27.01.2021.