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Other causes of cardiovascular disease after cancer therapy

Lipid Disorders and Metabolic Syndrome

Metabolic syndrome is a combination of some or all of the following problems:

  • Central obesity
  • Insulin resistance or glucose intolerance
  • Hyperinsulinism
  • Dyslipidemia
  • Hypertension

Associated with an increased risk of cardiovascular disease


Increased risk of metabolic syndrome:

  • After treatment for ALL (especially if this included cranial RT)
  • After treatment for brain tumors (again associated with cranial RT)
  • Female gender
  • Steroid therapy
  • Genetic predisposition


Screening for metabolic syndrome:

  • Periodic determination of the following blood work is recommended
    • serum triglycerides
    • low-density lipoprotein
    • high-density lipoprotein cholesterol
    • serum glucose


Growth hormone deficiency due to RT-induced damage to the hypothalamic-pituitary axis increases the risk of cardiac disease and is associated with:

  • abnormalities of metabolism and body composition
  • abnormal bone mineralization
  • impaired cardiac muscle function
  • central obesity
  • unfavorable lipid profile.



Long-term survivors of BMT (hematopoietic cell transplantation) are at increased risk of developing:

  • insulin resistance
  • type 2 diabetes
  • hypertriglyceridemia
  • Pancreatic dysfunction after BMT may occur in the setting of normal BMI (body mass index).


Long-term survivors of Wilms tumor

  • At increased risk of hypertension because of previous nephrectomy (common).
  • Type 2 diabetes mellitus has also been reported after abdominal RT for Wilms tumor (rare).


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