Metabolic syndrome parameters, determinants, and biomarkers in adult survivors of childhood cancer: methodology of the Dutch Childhood Cancer Survivor Study Metabolic Syndrome (Dutch LATER METS Study) (Preprint)

BACKGROUND Potential long-term effects of treatment for childhood cancer include adiposity, insulin resistance, dyslipidemia and hypertension. These risk factors cluster together as metabolic syndrome (MetS) 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 studies in national cohorts on prevalence and determinants of MetS in childhood cancer survivors including biomarkers and genetic predisposition are available. OBJECTIVE Describe the methodology of the Dutch LATER METS study on prevalence and risk factors of metabolic syndrome in adult survivors of childhood cancer, treated between 1963 and 2002. METHODS The current study is a cross-sectional study, based on recruitment of a national cohort of adult long-term survivors, that will assess 1) prevalence as well as disease- and treatment-related and genetic risk factors of MetS and its separate components, compared to available normative data, and 2) diagnostic value of biomarkers. Metabolic syndrome will be classified according to the definitions of the National Cholesterol Education Program (NCEP-ATPIII) as well as the International Diabetes Federation (IDF), and DXA-scans will be performed to assess body composition in more detail. RESULTS Patient accrual started in 2016 and lasted until April 2020. A total of 2380 survivors has participated, in seven pediatric oncology hospitals. From July 2020, biomarker testing, SNP-analysis and data analysis will be performed. CONCLUSIONS The Dutch LATER METS study will provide knowledge on clinical and genetic determinants of MetS, and the diagnostic value of biomarkers, in survivors. The results of this study will be used to optimize surveillance guidelines for MetS in survivors, and improve follow-up of survivors.