{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T13:45:21Z","timestamp":1746107121886},"reference-count":74,"publisher":"Oxford University Press (OUP)","issue":"2","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Childhood acute lymphoblastic leukaemia (ALL) survivors have an increased risk of metabolic and cardiovascular disease. We aimed to assess the presence of non-alcoholic fatty liver disease (NAFLD) in childhood ALL and if it is associated with early cardiovascular dysfunction.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>In total, 53 childhood ALL survivors and 34 controls underwent auxological evaluation, biochemical assay, liver, heart and vascular ultrasound study.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>NAFLD was more frequent in ALL patients than in controls (39.6% vs 11.7%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01). Patients with NAFLD were more obese and insulin resistant than patients without NAFLD. Flow-mediated dilatation and interventricular septum were lower in the ALL group than those in the control group (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001 for both). The patients with NAFLD showed lower left ventricular ejection fraction than those without NAFLD (<jats:italic>P<\/jats:italic>\u2009=\u20090.011). In ALL survivors, BMI-SDS and subcutaneous fat were the strongest predictors of NAFLD, whereas preperitoneal adipose tissue and C-reactive protein were the strongest predictors of left ventricular ejection fraction.<\/jats:p>\n<\/jats:sec>\n<jats:sec><jats:title>Conclusions<\/jats:title>\n<jats:p>Childhood ALL survivors had higher prevalence of NAFLD than healthy controls, which is associated with early left ventricular impairment. In the case of fatty liver, a comprehensive heart evaluation is mandatory. We strongly recommend to prevent visceral adiposity in ALL survivors, to search for metabolic syndrome or its components and to reinforce the need of intervention on diet and lifestyle during the follow-up of these patients.<\/jats:p>\n<\/jats:sec>","DOI":"10.1530\/eje-16-0608","type":"journal-article","created":{"date-parts":[[2016,12,3]],"date-time":"2016-12-03T02:05:32Z","timestamp":1480730732000},"page":"111-121","update-policy":"http:\/\/dx.doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":8,"title":["Non-alcoholic fatty liver disease is associated with early left ventricular dysfunction in childhood acute lymphoblastic leukaemia survivors"],"prefix":"10.1093","volume":"176","author":[{"given":"Maurizio","family":"Delvecchio","sequence":"first","affiliation":[{"name":"1Department of Biomedicine and Human OncologyPediatric Section, University \u2018A. Moro\u2019 of Bari, Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paola","family":"Muggeo","sequence":"additional","affiliation":[{"name":"1Department of Biomedicine and Human OncologyPediatric Section, University \u2018A. Moro\u2019 of Bari, Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariantonietta","family":"Monteduro","sequence":"additional","affiliation":[{"name":"2Department of Diagnostic ImagingUniversity of Bari \u2018A. Moro\u2019, Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Lassandro","sequence":"additional","affiliation":[{"name":"1Department of Biomedicine and Human OncologyPediatric Section, University \u2018A. Moro\u2019 of Bari, Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Novielli","sequence":"additional","affiliation":[{"name":"1Department of Biomedicine and Human OncologyPediatric Section, University \u2018A. Moro\u2019 of Bari, Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Valente","sequence":"additional","affiliation":[{"name":"3Department of Emergency and Organ Transplantation (DETO)Cardiovascular Diseases Section, University \u2018A. Moro\u2019 of Bari, Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuela","family":"Salinaro","sequence":"additional","affiliation":[{"name":"2Department of Diagnostic ImagingUniversity of Bari \u2018A. Moro\u2019, Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annapaola","family":"Zito","sequence":"additional","affiliation":[{"name":"3Department of Emergency and Organ Transplantation (DETO)Cardiovascular Diseases Section, University \u2018A. Moro\u2019 of Bari, Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco Matteo","family":"Ciccone","sequence":"additional","affiliation":[{"name":"3Department of Emergency and Organ Transplantation (DETO)Cardiovascular Diseases Section, University \u2018A. Moro\u2019 of Bari, Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vito Leonardo","family":"Miniello","sequence":"additional","affiliation":[{"name":"1Department of Biomedicine and Human OncologyPediatric Section, University \u2018A. Moro\u2019 of Bari, Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Santoro","sequence":"additional","affiliation":[{"name":"1Department of Biomedicine and Human OncologyPediatric Section, University \u2018A. Moro\u2019 of Bari, Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paola","family":"Giordano","sequence":"additional","affiliation":[{"name":"1Department of Biomedicine and Human OncologyPediatric Section, University \u2018A. Moro\u2019 of Bari, Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Felicia","family":"Faienza","sequence":"additional","affiliation":[{"name":"1Department of Biomedicine and Human OncologyPediatric Section, University \u2018A. Moro\u2019 of Bari, Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","reference":[{"key":"2016120218051922000_176.2.111.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60457-2"},{"key":"2016120218051922000_176.2.111.2","unstructured":"Scottish Intercollegiate Guidelines Network (SIGN). Long term follow up of survivors of childhood cancer (SIGN, Edinburgh, 2013). SIGN publication no. 132."},{"key":"2016120218051922000_176.2.111.3","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.2003.04499.x"},{"key":"2016120218051922000_176.2.111.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa060185"},{"key":"2016120218051922000_176.2.111.5","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2007-10-117150"},{"key":"2016120218051922000_176.2.111.6","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1002\/pbc.21992","article-title":"Progressive neurocognitive impairment in young adult survivors of childhood acute lymphoblastic leukemia","volume":"53","author":"Harila","year":"2009","journal-title":"Pediatric Blood and Cancer"},{"key":"2016120218051922000_176.2.111.7","doi-asserted-by":"publisher","DOI":"10.1186\/1824-7288-38-4"},{"key":"2016120218051922000_176.2.111.8","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1002\/pbc.21780","article-title":"Effect of childhood cancer treatment on fertility markers in adult male long-term survivors","volume":"52","author":"van Casteren","year":"2009","journal-title":"Pediatric Blood and Cancer"},{"key":"2016120218051922000_176.2.111.9","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/jsm052"},{"key":"2016120218051922000_176.2.111.10","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1007\/BF03346571","article-title":"Thyroid function and thyroid autoimmunity in childhood acute lymphoblastic leukemia offtherapy patients treated only with chemotherapy","volume":"33","author":"Delvecchio","year":"2010","journal-title":"Journal of Endocrinological Investigation"},{"key":"2016120218051922000_176.2.111.11","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1097\/00043426-200110000-00007","article-title":"Cardiovascular risk factors in young adult survivors of childhood acute lymphoblastic leukemia","volume":"23","author":"Oeffinger","year":"2001","journal-title":"Journal of Pediatric Hematology\/Oncology"},{"key":"2016120218051922000_176.2.111.12","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22120"},{"key":"2016120218051922000_176.2.111.13","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006-2178"},{"key":"2016120218051922000_176.2.111.14","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.07.8709"},{"key":"2016120218051922000_176.2.111.15","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1097\/MPH.0b013e318059c249","article-title":"Early indicators of dysmetabolic syndrome in young survivors of acute lymphoblastic leukemia in childhood as a target for preventing disease","volume":"29","author":"Trimis","year":"2007","journal-title":"Journal of Pediatric Hematology\/Oncology"},{"key":"2016120218051922000_176.2.111.16","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1007\/s12020-014-0395-7","article-title":"Metabolic syndrome in childhood leukemia survivors: a meta-analysis","volume":"49","author":"Faienza","year":"2015","journal-title":"Endocrine"},{"key":"2016120218051922000_176.2.111.17","doi-asserted-by":"publisher","DOI":"10.1210\/jc.87.7.3019"},{"key":"2016120218051922000_176.2.111.18","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2002.30690"},{"key":"2016120218051922000_176.2.111.19","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)66378-7"},{"key":"2016120218051922000_176.2.111.20","doi-asserted-by":"publisher","DOI":"10.1002\/hep.25762"},{"key":"2016120218051922000_176.2.111.21","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1038\/nrgastro.2013.41","article-title":"Progression of NAFLD to diabetes mellitus, cardiovascular disease or cirrhosis","volume":"10","author":"Anstee","year":"2013","journal-title":"Nature Reviews Gastroenterology and Hepatology"},{"key":"2016120218051922000_176.2.111.22","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2006-1212"},{"key":"2016120218051922000_176.2.111.23","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2000.102940"},{"key":"2016120218051922000_176.2.111.24","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1093\/ajcn\/82.5.1046","article-title":"Relation between elevated serum alanine aminotransferase and metabolic syndrome in Korean adolescents","volume":"82","author":"Park","year":"2005","journal-title":"American Journal of Clinical Nutrition"},{"key":"2016120218051922000_176.2.111.25","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.1023\/A:1018850223495","article-title":"Liver involvement in obese children: ultrasonography and liver enzyme levels at diagnosis and during follow-up in an Italian population","volume":"42","author":"Franzese","year":"1997","journal-title":"Digestive Disease and Science"},{"key":"2016120218051922000_176.2.111.26","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1089\/met.2012.0169","article-title":"Ultrasound evaluation and correlates of fatty liver disease: a population study in a Mediterranean area","volume":"11","author":"Chiloiro","year":"2013","journal-title":"Metabolic Syndrome and Related Disorders"},{"key":"2016120218051922000_176.2.111.27","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2014.09.020"},{"key":"2016120218051922000_176.2.111.28","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2010.02.004"},{"key":"2016120218051922000_176.2.111.29","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23890"},{"key":"2016120218051922000_176.2.111.30","first-page":"E282","article-title":"Liver steatosis coexists with myocardial insulin resistance and coronary dysfunction in patients with type 2 diabetes","volume":"291","author":"Lautamaki","year":"2006","journal-title":"American Journal of Physiology: Endocrinology and Metabolism American Physiological Society"},{"key":"2016120218051922000_176.2.111.31","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21983"},{"key":"2016120218051922000_176.2.111.32","doi-asserted-by":"publisher","DOI":"10.1097\/01.mcg.0000225668.53673.e6"},{"key":"2016120218051922000_176.2.111.33","first-page":"457","article-title":"Impairment of the left ventricular systolic and diastolic function in patients with nonalcoholic fatty liver disease","volume":"17","author":"Fotbolcu","year":"2010","journal-title":"Cardiology Journal"},{"key":"2016120218051922000_176.2.111.34","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-5448.2003.t01-1-00022.x"},{"key":"2016120218051922000_176.2.111.35","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2006.03.021"},{"key":"2016120218051922000_176.2.111.36","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0096(199601)24:1<25::AID-JCU4>3.0.CO;2-N"},{"key":"2016120218051922000_176.2.111.37","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1053\/jlts.2002.36740","article-title":"One hundred consecutive hepatic biopsies in the workup of living donors for right lobe liver transplantation","volume":"8","author":"Ryan","year":"2002","journal-title":"Liver Transplantation"},{"key":"2016120218051922000_176.2.111.38","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1053\/gast.2002.35354","article-title":"The utility of radiological imaging in nonalcoholic fatty liver disease","volume":"12","author":"Saadeh","year":"2002","journal-title":"Gastroenterology"},{"key":"2016120218051922000_176.2.111.39","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2014.10.003"},{"key":"2016120218051922000_176.2.111.40","doi-asserted-by":"publisher","DOI":"10.1093\/ejechocard\/jen204"},{"key":"2016120218051922000_176.2.111.41","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(01)01746-6"},{"key":"2016120218051922000_176.2.111.42","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.74.6.1399"},{"key":"2016120218051922000_176.2.111.43","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1159\/000097034","article-title":"Mannheim carotid intima-media thickness consensus (2004\u20132006). An update on behalf of the Advisory Board of the 3rd and 4th Watching the Risk Symposium, 13th and 15th European Stroke Conferences, Mannheim, Germany, 2004, and Brussels, Belgium, 2006.","volume":"23","author":"Touboul","year":"2007","journal-title":"Cerebrovascular Disease"},{"key":"2016120218051922000_176.2.111.44","doi-asserted-by":"publisher","DOI":"10.1053\/ejvs.2002.1748"},{"key":"2016120218051922000_176.2.111.45","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/j.ijcard.2016.06.180","article-title":"Echocardiography and NAFLD (non-alcoholic fatty liver disease)","volume":"221","author":"Trovato","year":"2016","journal-title":"International Journal of Cardiology"},{"key":"2016120218051922000_176.2.111.46","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2014.11.030"},{"key":"2016120218051922000_176.2.111.47","doi-asserted-by":"crossref","first-page":"e239","DOI":"10.1111\/dme.12234","article-title":"Late effects of childhood cancer treatment: severe hypertriglyceridaemia, central obesity, non alcoholic fatty liver disease and diabetes as complications of childhood total body irradiation","volume":"30","author":"Rajendran","year":"2013","journal-title":"Diabetic Medicine"},{"key":"2016120218051922000_176.2.111.48","doi-asserted-by":"publisher","DOI":"10.1530\/eje.1.01931"},{"key":"2016120218051922000_176.2.111.49","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006-0128"},{"key":"2016120218051922000_176.2.111.50","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02717-3"},{"key":"2016120218051922000_176.2.111.51","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1053\/jhep.2003.50161","article-title":"Nonalcoholic fatty liver, steatohepatitis, and the metabolic syndrome.","volume":"37 38","author":"Marchesini","year":"2003","journal-title":"Hepatology"},{"key":"2016120218051922000_176.2.111.52","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2007-0482"},{"key":"2016120218051922000_176.2.111.53","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.50.8.1844"},{"key":"2016120218051922000_176.2.111.54","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2007.04824.x"},{"key":"2016120218051922000_176.2.111.55","doi-asserted-by":"crossref","first-page":"145754","DOI":"10.1155\/2012\/145754","article-title":"Diagnosis and evaluation of nonalcoholic fatty liver disease","volume":"2012","author":"Obika","year":"2012","journal-title":"Experimental Diabetes Research"},{"key":"2016120218051922000_176.2.111.56","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1097\/MPG.0b013e318252a13f","article-title":"Diagnosis of non-alcoholic fatty liver disease in children and adolescents: position paper of the ESPGHAN Hepatology Committee","volume":"54","author":"Vajro","year":"2012","journal-title":"Journal of Pediatrics Gastroenterology and Nutrition"},{"key":"2016120218051922000_176.2.111.57","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.04.008"},{"key":"2016120218051922000_176.2.111.58","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinimag.2012.07.011"},{"key":"2016120218051922000_176.2.111.59","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1590\/2359-3997000000068","article-title":"PEG-asparaginase induced severe hypertriglyceridemia","volume":"60","author":"Galindo","year":"2016","journal-title":"Archives of Endocrinology and Metabolism"},{"key":"2016120218051922000_176.2.111.60","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2014.109413"},{"key":"2016120218051922000_176.2.111.61","doi-asserted-by":"crossref","first-page":"2685","DOI":"10.1016\/j.ejca.2014.06.023","article-title":"Severe hypertriglyceridaemia during therapy for childhood acute lymphoblastic leukaemia","volume":"50","author":"Bhojwani","year":"2014","journal-title":"European Journal of Cancer"},{"key":"2016120218051922000_176.2.111.62","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2012.02.017"},{"key":"2016120218051922000_176.2.111.63","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2006.08.021"},{"key":"2016120218051922000_176.2.111.64","doi-asserted-by":"crossref","first-page":"1579","DOI":"10.3748\/wjg.v13.i10.1579","article-title":"Nonalcoholic fatty liver disease is a novel predictor of cardiovascular disease","volume":"13","author":"Hamaguchi","year":"2007","journal-title":"World Journal of Gastroenterology"},{"key":"2016120218051922000_176.2.111.65","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23135"},{"key":"2016120218051922000_176.2.111.66","doi-asserted-by":"publisher","DOI":"10.1042\/CS20080253"},{"key":"2016120218051922000_176.2.111.67","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21327"},{"key":"2016120218051922000_176.2.111.68","doi-asserted-by":"publisher","DOI":"10.1016\/j.tips.2015.05.001"},{"key":"2016120218051922000_176.2.111.69","doi-asserted-by":"crossref","first-page":"456","DOI":"10.3390\/ijms17040456","article-title":"Additive effect of non-alcoholic fatty liver disease on metabolic syndrome related endothelial dysfunction in hypertensive patients","volume":"17","author":"Perticone","year":"2016","journal-title":"International Journal of Molecular Sciences"},{"key":"2016120218051922000_176.2.111.70","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1097\/MAJ.0000000000000402","article-title":"Role of the endothelium in the metabolic syndrome: IIB or Not IIB","volume":"349","author":"Shaul","year":"2015","journal-title":"American Journal of the Medical Sciences"},{"key":"2016120218051922000_176.2.111.71","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.amjcard.2003.09.009","article-title":"Comparison of cardiac structure and function in American Indians with and without the metabolic syndrome (the Strong Heart Study)","volume":"93","author":"Chinali","year":"2004","journal-title":"American Journal of Cardiology"},{"key":"2016120218051922000_176.2.111.72","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1038\/sj.jhh.1002222","article-title":"Cardiac structure and function and arterial circulation in hypertensive patients with and without metabolic syndrome","volume":"21","author":"Ferrara","year":"2007","journal-title":"Journal of Human Hypertension"},{"key":"2016120218051922000_176.2.111.73","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr453"},{"key":"2016120218051922000_176.2.111.74","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.10.021"}],"container-title":["European Journal of Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/eje.bioscientifica.com\/view\/journals\/eje\/176\/2\/111.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/eje.bioscientifica.com\/view\/journals\/eje\/176\/2\/111.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T16:34:36Z","timestamp":1676392476000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejendo\/article\/176\/2\/111\/6655121"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,2]]},"references-count":74,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.1530\/eje-16-0608","relation":{},"ISSN":["0804-4643","1479-683X"],"issn-type":[{"value":"0804-4643","type":"print"},{"value":"1479-683X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,2]]}}}