Original Paper
HOR MON E RE SE ARCH I N PÆDIATRIC S
Horm Res Paediatr 2014;82:372–379 DOI: 10.1159/000368798
Received: June 26, 2014 Accepted: September 30, 2014 Published online: October 30, 2014
Longitudinal Changes in Body Mass Index in Children with Craniopharyngioma Muhammad Jaffar Khan a, c Khadija Nuzhat Humayun d Malcolm Donaldson b S. Faisal Ahmed b M. Guftar Shaikh b a
Section of Human Nutrition (University of Glasgow), Glasgow Royal Infirmary, and b Department of Endocrinology, Royal Hospital for Sick Children (Yorkhill), Glasgow, UK; c Khyber Medical University, Peshawar, and d Department of Paediatrics and Child Health, Agha Khan University Hospital, Karachi, Pakistan
Key Words Craniopharyngioma · Body mass index · Obesity · Hypopituitarism · Growth hormone therapy
sociated with the subsequent development of panhypopituitarism. Pediatric craniopharyngioma subjects who have BMI SDS ≥2 at presentation require early and aggressive intervention to help prevent the complications of obesity. © 2014 S. Karger AG, Basel
© 2014 S. Karger AG, Basel 1663–2818/14/0826–0372$39.50/0 E-Mail [email protected] www.karger.com/hrp
Introduction
Craniopharyngioma represents 1.2–4% of all brain tumors and is the leading cause of hypothalamic obesity [1]. Obesity is one of the major causes of morbidity and reduced quality of life in children and adolescents with craniopharyngioma [2], leading to premature cardiovascular diseases, psychosocial problems, and failure to achieve academic potential, especially in children with hypothalamic involvement of the tumor [3]. The hypothalamic obesity seen in craniopharyngioma is related to the disruption of hormonal signals from leptin and insulin [4] to the arcuate nucleus. The neurons of the arcuate nucleus are responsible for secreting pro-opiomelanocortin, agouti-related peptide, and peptide YY [5, 6]. Altered secretion of these hormones results is abnormal appetite and hyperphagia. Data also suggest increased parasympathetic and reduced sympathetic tone [7], nocDr. M. Guftar Shaikh Department of Endocrinology Royal Hospital for Sick Children (Yorkhill) Glasgow G3 8SJ (UK) E-Mail guftar.shaikh @ nhs.net
Downloaded by: Freie Universität Berlin 130.133.8.114 - 5/9/2015 10:49:38 PM
Abstract Objective: We investigated the relationship of body mass index at presentation and pituitary status with long-term changes in BMI over a period of 5 years. Study Design: Craniopharyngioma patients (n = 25) attending a tertiary pediatric endocrine center were divided into three groups based on their BMI at presentation [BMI ≥2 standard deviation scores (SDS), 0–1.99 SDS, and
HOR MON E RE SE ARCH I N PÆDIATRIC S
Horm Res Paediatr 2014;82:372–379 DOI: 10.1159/000368798
Received: June 26, 2014 Accepted: September 30, 2014 Published online: October 30, 2014
Longitudinal Changes in Body Mass Index in Children with Craniopharyngioma Muhammad Jaffar Khan a, c Khadija Nuzhat Humayun d Malcolm Donaldson b S. Faisal Ahmed b M. Guftar Shaikh b a
Section of Human Nutrition (University of Glasgow), Glasgow Royal Infirmary, and b Department of Endocrinology, Royal Hospital for Sick Children (Yorkhill), Glasgow, UK; c Khyber Medical University, Peshawar, and d Department of Paediatrics and Child Health, Agha Khan University Hospital, Karachi, Pakistan
Key Words Craniopharyngioma · Body mass index · Obesity · Hypopituitarism · Growth hormone therapy
sociated with the subsequent development of panhypopituitarism. Pediatric craniopharyngioma subjects who have BMI SDS ≥2 at presentation require early and aggressive intervention to help prevent the complications of obesity. © 2014 S. Karger AG, Basel
© 2014 S. Karger AG, Basel 1663–2818/14/0826–0372$39.50/0 E-Mail [email protected] www.karger.com/hrp
Introduction
Craniopharyngioma represents 1.2–4% of all brain tumors and is the leading cause of hypothalamic obesity [1]. Obesity is one of the major causes of morbidity and reduced quality of life in children and adolescents with craniopharyngioma [2], leading to premature cardiovascular diseases, psychosocial problems, and failure to achieve academic potential, especially in children with hypothalamic involvement of the tumor [3]. The hypothalamic obesity seen in craniopharyngioma is related to the disruption of hormonal signals from leptin and insulin [4] to the arcuate nucleus. The neurons of the arcuate nucleus are responsible for secreting pro-opiomelanocortin, agouti-related peptide, and peptide YY [5, 6]. Altered secretion of these hormones results is abnormal appetite and hyperphagia. Data also suggest increased parasympathetic and reduced sympathetic tone [7], nocDr. M. Guftar Shaikh Department of Endocrinology Royal Hospital for Sick Children (Yorkhill) Glasgow G3 8SJ (UK) E-Mail guftar.shaikh @ nhs.net
Downloaded by: Freie Universität Berlin 130.133.8.114 - 5/9/2015 10:49:38 PM
Abstract Objective: We investigated the relationship of body mass index at presentation and pituitary status with long-term changes in BMI over a period of 5 years. Study Design: Craniopharyngioma patients (n = 25) attending a tertiary pediatric endocrine center were divided into three groups based on their BMI at presentation [BMI ≥2 standard deviation scores (SDS), 0–1.99 SDS, and
