{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:18:49Z","timestamp":1791389929022,"version":"4.3.3"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2012,10,5]],"date-time":"2012-10-05T00:00:00Z","timestamp":1349395200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2013,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Children treated for acute lymphoblastic leukemia (ALL) are more likely to become overweight. Prolonged exposure to high\u2010dose glucocorticoids may cause insulin resistance and facilitate development of this phenotype.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>Body mass indices (BMI) and insulin resistance (homeostatic model assessment [HOMA]\u2010IR) were prospectively measured among on\u2010 (n\u2009=\u200931) and off\u2010therapy participants (n\u2009=\u200929). On\u2010therapy participants were assessed prior to and while on glucocorticoids (5 days of prednisone 40\u2009mg\u2009m<jats:sup>\u22122<\/jats:sup> or dexamethasone 6\u2009mg\u2009m<jats:sup>\u22122<\/jats:sup>) given as part of routine maintenance chemotherapy, with a subset (n\u2009=\u200910) receiving an intravenous glucose tolerance test (IVGTT) while on glucocorticoids.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Baseline HOMA\u2010IR values among on\u2010 and off\u2010therapy participants were similar, but among on\u2010therapy participants, HOMA\u2010IR increased significantly with glucocorticoid exposure (median 3.39 vs. 1.26; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01) with 45.2% of participants having values &gt;4.39 (upper 2.5th percentile among normal weight adolescents). Although baseline HOMA\u2010IR was significantly correlated with current BMI (r\u2009=\u20090.48, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01), change in HOMA\u2010IR following steroid exposure was not correlated with any demographic or treatment characteristic including current BMI. Among those with IVGTT data, HOMA estimates in general correlated with values derived from a minimal model analysis (r\u2009\u223c\u20090.7).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>High\u2010dose glucocorticoids given as part of routine chemotherapy were associated with a significantly increased insulin resistant state. Given the amount and duration of glucocorticoids children with ALL experience, these physiologic changes could be an important contributor to the development of therapy\u2010related obesity. Pediatr Blood Cancer 2013; 60: 621\u2013626. \u00a9 2012 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.24364","type":"journal-article","created":{"date-parts":[[2012,10,5]],"date-time":"2012-10-05T17:43:36Z","timestamp":1349459016000},"page":"621-626","source":"Crossref","is-referenced-by-count":34,"title":["Glucocorticoids and insulin resistance in children with acute lymphoblastic leukemia"],"prefix":"10.1002","volume":"60","author":[{"given":"Eric J.","family":"Chow","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Pihoker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra L.","family":"Friedman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie J.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeannine S.","family":"McCune","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Wharton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian L.","family":"Roth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. 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