{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T03:25:49Z","timestamp":1789442749344,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,7,15]],"date-time":"2018-07-15T00:00:00Z","timestamp":1531612800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["P30 CA008748"],"award-info":[{"award-number":["P30 CA008748"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["KL2 TR000458"],"award-info":[{"award-number":["KL2 TR000458"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Childhood cancer survivors exposed to abdominal radiation (abdRT) are at increased risk for both insulin\u2010dependent and non\u2013insulin\u2010dependent diabetes. We sought to clarify the pathophysiology of diabetes after abdRT by performing dynamic studies of insulin and glucose and testing for type 1 diabetes\u2010associated autoantibodies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>Cross\u2010sectional analysis of 2\u2010year childhood cancer survivors treated with abdRT at age \u226421 years who underwent oral glucose tolerance testing and assessment of diabetes\u2010related autoantibodies from December 2014 to September 2016. Prevalence of insulin\/glucose derangements, indices of insulin sensitivity\/secretion (homeostatic model assessment of insulin resistance [HOMA\u2010IR], whole\u2010body insulin sensitivity, insulinogenic index), autoantibody positivity, and treatment\/demographic factors associated with adverse metabolic outcomes were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 40 participants previously exposed to abdRT (57.5% male; median age at cancer diagnosis, 3.3 years [range, 0.5\u201320.1]; median age at study 14.3 years [range, 8.3\u201349.8]; none with obesity), 9 (22.5%) had glucose derangements (<jats:italic>n<\/jats:italic>\u00a0=\u00a04 with impaired fasting glucose [\u2265100 mg\/dL]; <jats:italic>n<\/jats:italic>\u00a0=\u00a04 with impaired glucose tolerance [2\u2010hour glucose 140\u2013199 mg\/dL]; <jats:italic>n<\/jats:italic>\u00a0=\u00a01 with previously unrecognized diabetes [2\u2010hour glucose \u2265200 mg\/dL]). Three of the four individuals with impaired fasting glucose also had insulin resistance, as measured by HOMA\u2010IR; an additional four subjects with normal glucose tolerance were insulin resistant. The subject with diabetes had normal HOMA\u2010IR. No participant had absolute insulinopenia or\u00a0&gt;1 positive diabetes\u2010related autoantibody.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study suggests that radiation\u2010induced damage to the insulin\u2010producing \u03b2\u2010cells is an unlikely explanation for the early derangements in glucose metabolism observed after abdRT. Research into alternative pathways leading to diabetes after abdRT is needed.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.27304","type":"journal-article","created":{"date-parts":[[2018,7,16]],"date-time":"2018-07-16T05:09:03Z","timestamp":1531717743000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Insulin and glucose homeostasis in childhood cancer survivors treated with abdominal radiation: A pilot study"],"prefix":"10.1002","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4668-9176","authenticated-orcid":false,"given":"Danielle Novetsky","family":"Friedman","sequence":"first","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center  New York NY"},{"name":"Weill Cornell Medical College  New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Hilden","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center  New York NY"},{"name":"Weill Cornell Medical College  New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaya S.","family":"Moskowitz","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center  New York NY"},{"name":"Weill Cornell Medical College  New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5234-4134","authenticated-orcid":false,"given":"Suzanne L.","family":"Wolden","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center  New York NY"},{"name":"Weill Cornell Medical College  New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily S.","family":"Tonorezos","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center  New York NY"},{"name":"Weill Cornell Medical College  New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoltan","family":"Antal","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center  New York NY"},{"name":"Weill Cornell Medical College  New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dean","family":"Carlow","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center  New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shakeel","family":"Modak","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center  New York NY"},{"name":"Weill Cornell Medical College  New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nai\u2010Kong","family":"Cheung","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center  New York NY"},{"name":"Weill Cornell Medical College  New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin C.","family":"Oeffinger","sequence":"additional","affiliation":[{"name":"Duke University  Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles A.","family":"Sklar","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center  New York NY"},{"name":"Weill Cornell Medical College  New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,7,15]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21149"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31610-0"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2009.209"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2014.01.014"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.66.6545"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(12)70323-6"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.54.4379"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-006-0528-5"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.22.2.345"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.27.7.1798"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(12)70340-6"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(95)91461-7"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/08916930701619169"},{"key":"e_1_2_9_15_1","unstructured":"Centers for Disease Control and Prevention.National center for health statistics. CDC growth charts. May 30 2000ed. United States."},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.01.026"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.54.suppl_2.S52"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc17-S005"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00280883"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-1921"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.19.7251"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.22.9.1462"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-0646"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2003-031503"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.1994.tb00273.x"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199910143411601"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.59.4648"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.25249"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2016.11.022"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2013.218"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.20331"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.23036"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0000000000000848"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0b013e31827e8fb9"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0052237"}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fpbc.27304","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.27304","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,17]],"date-time":"2023-09-17T08:18:21Z","timestamp":1694938701000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pbc.27304"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,7,15]]},"references-count":34,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2018,11]]}},"alternative-id":["10.1002\/pbc.27304"],"URL":"https:\/\/doi.org\/10.1002\/pbc.27304","archive":["Portico"],"relation":{},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"value":"1545-5009","type":"print"},{"value":"1545-5017","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,7,15]]},"assertion":[{"value":"2018-04-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-06-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-07-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e27304"}}