Obesity and metabolic changes are common in young childhood brain tumor survivors

Pietilä, Sari; Mäkipernaa, Anne; Sievänen, Harri; Koivisto, Anna‐Maija; Wigren, Tuija; Lenko, Hanna Liisa

doi:10.1002/pbc.21936

Cited by 85 publications

(77 citation statements)

References 37 publications

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“…Due to the propensity for local recurrence of the tumour, more extensive and/or multiple surgeries and/or radiotherapy is frequently advocated, which often results in hypothalamic-pituitary dysfunction in these patients. Hypothalamic damage has been implicated as the main risk factor for obesity in patients with COCP (7), and the increased cardiovascular risk and poor QoL have been reported to be related to both obesity and GHD (3,8) in these patients. In addition, GHD due to COCP has been reported to increase the risk of metabolic syndrome (9).…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics and effects of GH replacement therapy in adults with childhood-onset craniopharyngioma compared with those in adults with other causes of childhood-onset hypothalamic–pituitary dysfunction

Yuen

Kołtowska-Häggström

Cook³

et al. 2013

European Journal of Endocrinology

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Objective: Adults with childhood-onset (CO) craniopharyngioma (COCP) have poor quality of life (QoL) and clinical outcomes, but few studies have compared these patients with adults with other causes of CO hypothalamic-pituitary dysfunction. In this study, we compared baseline clinical characteristics and patient-reported outcomes before starting GH replacement therapy in adults with GH deficiency (GHD) due to COCP with those of adults either with CO idiopathic/congenital hypopituitarism (COH) or with CO extrasellar (COE) tumours, and evaluated the 1-and 5-year effects of GH replacement therapy. Subjects and methods: Retrospective analysis of the data recorded in KIMS (Pfizer International Metabolic Database) was carried out. Patients with COCP, COH and COE tumours were evaluated at baseline, and after 1 and 5 years of therapy. Results: Compared with COH and COE patients, more COCP patients underwent surgery, had greater abnormalities of body composition and higher prevalence of pituitary hormone deficits (all P!0.001), but comparable fasting glucose, HbA1c, total cholesterol and LDL-cholesterol levels, marital status, parenthood, living arrangements, education, employment and annual sick-leave days. After 1 and 5 years of GH replacement therapy, similar changes were evident with regard to body composition, fasting glucose and HbA1c levels, QoL, and the level of and satisfaction with physical activity across the three groups. Conclusions: Adults with untreated COCP with GHD at baseline demonstrated more co-morbidities including greater abnormalities of body composition, pituitary hormone deficits and visual field defects. Overall, adults with COCP, COH and COE tumours responded comparably to short-and long-term GH replacement therapy, suggesting that patients with GHD due to COCP benefited from GH replacement therapy to a similar degree as those with other causes of CO hypothalamic-pituitary dysfunction did.

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Section: Introductionmentioning

confidence: 99%

Clinical characteristics and effects of GH replacement therapy in adults with childhood-onset craniopharyngioma compared with those in adults with other causes of childhood-onset hypothalamic–pituitary dysfunction

Yuen

Kołtowska-Häggström

Cook³

et al. 2013

European Journal of Endocrinology

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“…Obesity was diagnosed in 35% of patients (21% with the central one). Adiposity was observed more frequently in patients receiving radiotherapy for the whole brain, after damage of hypothalamicpituitary area by neoplastic process, in patients with growth hormone deficiency and with decreased physical activity [8].…”

Section: Discussionmentioning

confidence: 95%

“…An excessive weight gain is the most frequent observed complication [7,8,[9][10][11][12][13][14][15]. Many authors emphasize that the main cause of obesity during or after oncology management is the neoplastic process itself (tumors of h-p area), steroid treatment in brain edema prophylaxis, pituitary insufficiency -particularly growth hormone deficiency, other endocrinopathies, lifestyle changes and accompanying neurological symptoms [18,19].…”

Section: Discussionmentioning

confidence: 99%

“…It reveal that the risk of obesity comparing to healthy adults is similar. On the other hand, Pietilä et al [8] describe significant frequency of obesity and carbohydrate metabolism abnormalities in patients after brain tumors management. Patients in this study underwent treatment for brain tumors of various locations.…”

Section: Discussionmentioning

confidence: 99%

“…It relates mostly to patients treated for hypothalamic-pituitary tumors [8,14,[20][21][22]. As far as some authors are concerned, hypothalamic obesity may develop even some years after hypothalamic tumors management [22], though there are observations that first symptoms may be present shortly after surgery [23].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Evaluation of Carbohydrate and Lipid Metabolism and Risk of Obesity in Children after Brain Tumors Treatment

Okońska¹

2013

J Steroids Horm Sci

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The aim of the study was to assess the carbohydrate and lipid metabolism disturbances as well as weight in children after brain tumors treatment.The study included 33 boys (53.2%) and 29 girls (46.8%) aged 11.6 ± 3.9. 22 patients underwent treatment for tumors of hypothalamic-pituitary(h-p) area: IA-surgery(19/22); IB-surgery and radiotherapy(3/22). 40 patients were treated for tumors outside the h-p area: IIA-with surgery, chemo-and radiotherapy(22/40); IIB-only with surgery(15/40); IIC-patients treated for optic nerve glioma with chemotherapy(3/40).BMI was assessed before and after the treatment. OGTT, HbA1c, lipid profile and WHtR after treatment were assessed. Indices of insulin resistance: HOMA-IR, Quickie, Matsuda and de Fronzo were calculated. 63% overweight/obese patients of IA-group and 27% of IIA-group were observed. Hyperinsulinemia was noted in 44% of IA-group, 20% of IIA-group, and insulin resistance in 38% of IA and 15% of IIA. DM2 was diagnosed in 1 patient of IA-group, IFG in 1 patient of IIB, IGT in 1 patient of IA and 1 patient of IIC. Dyslipidemia was noted in 47% of IA-group, elevated level of LDL-cholesterol in 30% of IIA-group.The excessive weight gain, hyperinsulinemia and dyslipidemia were observed primarily in children treated for hypothalamic-pituitary tumors.

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Early and late renal adverse effects after potentially nephrotoxic treatment for childhood cancer

Knijnenburg

Mulder

Meeteren

et al. 2013

Cochrane Database of Systematic Reviews

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Obesity and metabolic changes are common in young childhood brain tumor survivors

Cited by 85 publications

References 37 publications

Clinical characteristics and effects of GH replacement therapy in adults with childhood-onset craniopharyngioma compared with those in adults with other causes of childhood-onset hypothalamic–pituitary dysfunction

Clinical characteristics and effects of GH replacement therapy in adults with childhood-onset craniopharyngioma compared with those in adults with other causes of childhood-onset hypothalamic–pituitary dysfunction

Evaluation of Carbohydrate and Lipid Metabolism and Risk of Obesity in Children after Brain Tumors Treatment

Early and late renal adverse effects after potentially nephrotoxic treatment for childhood cancer

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