Sibylle Rovani, Victoria Butler, D. Samara-Boustani, G. Pinto, L. González-Briceño, Adrien Nguyen Quoc, Gaëlle Vermillac, A. Stoupa, A. Besançon, J. Beltrand, C. Thalassinos, I. Flechtner, Yamina Dassa, M. Viaud, Maria Beatriz Arrom-Branas, N. Boddaert, S. Puget, T. Blauwblomme, C. Alapetite, S. Bolle, François Doz, Jacques Grill, Christelle Dufour, Franck Bourdeaut, S. Abbou, L. Guerrini-Rousseau, A. Leruste, K. Beccaria, M. Polak, D. Kariyawasam
{"title":"Long-Term Weight Gain in Children with Craniopharyngioma.","authors":"Sibylle Rovani, Victoria Butler, D. Samara-Boustani, G. Pinto, L. González-Briceño, Adrien Nguyen Quoc, Gaëlle Vermillac, A. Stoupa, A. Besançon, J. Beltrand, C. Thalassinos, I. Flechtner, Yamina Dassa, M. Viaud, Maria Beatriz Arrom-Branas, N. Boddaert, S. Puget, T. Blauwblomme, C. Alapetite, S. Bolle, François Doz, Jacques Grill, Christelle Dufour, Franck Bourdeaut, S. Abbou, L. Guerrini-Rousseau, A. Leruste, K. Beccaria, M. Polak, D. Kariyawasam","doi":"10.1093/ejendo/lvae044","DOIUrl":null,"url":null,"abstract":"OBJECTIVE\nAdamantinomatous craniopharyngioma mainly affects children. Excessive weight gain is a major long-term complication. The primary objective of this study was to assess long-term weight changes in children treated for craniopharyngioma. The secondary objectives were to identify risk factors for excessive weight gain and to look for associations with hypothalamic damage by the tumour or treatment.\n\n\nDESIGN\nSingle-centre retrospective cohort study.\n\n\nMETHOD\nChildren managed for craniopharyngioma at our centre between 1990 and 2019 were included. The body mass index (BMI) standard deviation scores (SDS) at baseline and at last follow-up were compared. Univariate and multivariate analyses were performed in order to identify variables associated with the long-term BMI-SDS variation.\n\n\nRESULTS\nThe 108 patients had a mean follow-up of 10.4 years. The mean BMI-SDS increase over time was 2.11 (p < 0.001) overall, 1.21 (p < 0.001) in the group without hypothalamic involvement by the tumour, and 1.95 (p < 0.001) in the group managed using intended hypothalamus-sparing surgery. Absence of hypothalamic involvement by the tumour or treatment was significantly associated with less weight gain (p = 0.046 and p < 0.01, respectively). After adjustment, factors associated with a BMI-SDS change greater than 2 were female sex (p = 0.023), tumour involving the hypothalamus (p = 0.04), and higher baseline BMI (p < 0.001).\n\n\nCONCLUSION\nClinically significant weight gain occurred in nearly all children treated for craniopharyngioma, including those whose hypothalamus was spared by the tumour and intentionally by treatment. However, hypothalamus integrity was associated with less weight gain. Despite hypothalamus-sparing strategies, hypothalamic obesity remains a major concern, indicating a need for novel treatment approaches.","PeriodicalId":11884,"journal":{"name":"European Journal of Endocrinology","volume":null,"pages":null},"PeriodicalIF":5.3000,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Endocrinology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ejendo/lvae044","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
Abstract
OBJECTIVE
Adamantinomatous craniopharyngioma mainly affects children. Excessive weight gain is a major long-term complication. The primary objective of this study was to assess long-term weight changes in children treated for craniopharyngioma. The secondary objectives were to identify risk factors for excessive weight gain and to look for associations with hypothalamic damage by the tumour or treatment.
DESIGN
Single-centre retrospective cohort study.
METHOD
Children managed for craniopharyngioma at our centre between 1990 and 2019 were included. The body mass index (BMI) standard deviation scores (SDS) at baseline and at last follow-up were compared. Univariate and multivariate analyses were performed in order to identify variables associated with the long-term BMI-SDS variation.
RESULTS
The 108 patients had a mean follow-up of 10.4 years. The mean BMI-SDS increase over time was 2.11 (p < 0.001) overall, 1.21 (p < 0.001) in the group without hypothalamic involvement by the tumour, and 1.95 (p < 0.001) in the group managed using intended hypothalamus-sparing surgery. Absence of hypothalamic involvement by the tumour or treatment was significantly associated with less weight gain (p = 0.046 and p < 0.01, respectively). After adjustment, factors associated with a BMI-SDS change greater than 2 were female sex (p = 0.023), tumour involving the hypothalamus (p = 0.04), and higher baseline BMI (p < 0.001).
CONCLUSION
Clinically significant weight gain occurred in nearly all children treated for craniopharyngioma, including those whose hypothalamus was spared by the tumour and intentionally by treatment. However, hypothalamus integrity was associated with less weight gain. Despite hypothalamus-sparing strategies, hypothalamic obesity remains a major concern, indicating a need for novel treatment approaches.
期刊介绍:
European Journal of Endocrinology is the official journal of the European Society of Endocrinology. Its predecessor journal is Acta Endocrinologica.
The journal publishes high-quality original clinical and translational research papers and reviews in paediatric and adult endocrinology, as well as clinical practice guidelines, position statements and debates. Case reports will only be considered if they represent exceptional insights or advances in clinical endocrinology.
Topics covered include, but are not limited to, Adrenal and Steroid, Bone and Mineral Metabolism, Hormones and Cancer, Pituitary and Hypothalamus, Thyroid and Reproduction. In the field of Diabetes, Obesity and Metabolism we welcome manuscripts addressing endocrine mechanisms of disease and its complications, management of obesity/diabetes in the context of other endocrine conditions, or aspects of complex disease management. Reports may encompass natural history studies, mechanistic studies, or clinical trials.
Equal consideration is given to all manuscripts in English from any country.