Reduced Energy Expenditure and Impaired Feeding-Related Signals But Not High Energy Intake Reinforces Hypothalamic Obesity in Adults with Childhood Onset Craniopharyngioma

Holmer, Helene; Pozarek, Gabriella; Wirfält, Elisabet; Popović, Vera; Ekman, Bertil; Björk, Jonas; Erfurth, Eva Marie

doi:10.1210/jc.2010-0993

Cited by 113 publications

(132 citation statements)

References 28 publications

Supporting

Mentioning

119

Contrasting

Unclassified

Order By: Relevance

“…The two groups were similar in terms of fat-free mass and tests were conducted under similar conditions; therefore, these could not explain the lower REE in CRHO. These differences between groups are supported by previous studies in which patients with craniopharyngioma were found to have lower REE compared with controls, a finding not explained by differences in body composition (7,36). The decreased habitual daily physical activity may be contributing to lower REE in patients with craniopharyngioma.…”

Section: Discussionsupporting

confidence: 79%

“…One of the most troublesome complications is HO (6). Hyperphagia is described in many cases and contributes to obesity; however, it was found that increased intake is not necessary for the development of HO (7). An imbalance in the activity of the autonomic nervous system (ANS) efferent hypothalamic pathways has been hypothesized as an important contributor to the development of this obesity (1,2).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Autonomic nervous system balance in children and adolescents with craniopharyngioma and hypothalamic obesity

Cohen

Syme

McCrindle

et al. 2013

European Journal of Endocrinology

View full text Add to dashboard Cite

Objective: Dysregulation of the autonomic nervous system is thought to be involved in craniopharyngioma-related hypothalamic obesity (CRHO). Increased parasympathetic activity and decreased sympathetic activity have been suggested. We aimed to study autonomic activity using heart rate variability (HRV) and biochemical measures in youth with CRHO compared with controls and to explore relationships between obesity and autonomic indices. Design: A cross-sectional study of 16 youth with CRHO and 16 controls matched for sex, age, and BMI. Methods: Anthropometrics, fasting blood-work, resting energy expenditure (REE), 24-h HRV, and 24-h urine catecholamines were assessed. Quality of life, sleepiness, and autonomic symptoms were evaluated. Power spectral analysis of the HRV was performed. Results: HRV power spectral analysis parameters of both parasympathetic activity (mean high frequency (HF (ms 2 )) 611G504 vs 459G336, PZ0.325) and sympathetic activity (median low frequency/HF 1.62 (1.37, 2.41) vs 1.89 (1.44, 2.99), PZ0.650) did not differ between the groups. Parasympathetic activity negatively correlated with central adiposity in both groups (rZK0.53, PZ0.034 and rZK0.54, PZ0.029) and sympathetic activity positively correlated with central adiposity in CRHO (rZ0.51, PZ0.043). Youth with CRHO had significantly lower REE; lower health and activity scores in the quality of life questionnaires, and higher sleepiness scores. Conclusions: Autonomic activity was similar in CRHO and control subjects. The degree of central adiposity correlated negatively with parasympathetic activity and positively with sympathetic activity in children with CRHO. These results provide a new perspective regarding autonomic balance in this unique patient population.

show abstract

Section: Discussionsupporting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Autonomic nervous system balance in children and adolescents with craniopharyngioma and hypothalamic obesity

Cohen

Syme

McCrindle

et al. 2013

European Journal of Endocrinology

View full text Add to dashboard Cite

show abstract

“…In addition, 77% of obese patients had a low EER, which is consistent with previous publications. 31 Besides, a low EER persisted regardless of the lean body mass percentage, which supports the fact that there may be other factors that reduce energy expenditure in this group of patients.…”

Section: Discussionsupporting

confidence: 67%

Nutritional assessment of a population with a history of childhood craniopharyngioma seen at Hospital “Prof. Dr. Juan P. Garrahan”

et al. 2017

View full text Add to dashboard Cite

Introduction.Craniopharyngiomas are histologically benign malformations located between the pituitary and hypothalamus that may affect key hormone secretion for endocrine regulation and satiety modulation. Although this is a relatively benign disease, the combination of severe hypothalamic obesity and associated comorbidities results in a reduced quality of life. Objective. To assess the nutritional status of patients after craniopharyngioma surgery. Population and Methods. Patients younger than 21 years old at the time of the study who required craniopharyngioma surgery at Hospital de Pediatría Garrahan and who signed an informed consent. Anthropometric characteristics, body composition by impedance analysis, energy expenditure by indirect calorimetry and energy intake were assessed. Insulin resistance and dyslipemia were estimated. Results. A total of 39 patients were included; 41% had a normal weight and 59% were obese. Overall, 68% of patients had a central fat distribution; 40% had insulin resistance; and 32%, dyslipemia. No significant differences were observed in terms of insulin resistance, dyslipemia, energy expenditure at rest, or energy intake between normal weight and obese patients. Among obese patients, 77% had a low energy expenditure, regardless of their percentage of lean body mass (62 ± 2.7% versus 61.2 ± 1.8% of normal versus low energy expenditure at rest; p = 0.8). Conclusions. A total of 59% of the studied population was obese. No significant differences were observed in terms of metabolic complications between normal weight and obese patients. A lower energy expenditure was observed, regardless of the lean body mass percentage and a similar energy intake.

show abstract

“…In several studies, subjects with CP were less active than healthy subjects and were also more obese (8,32), both factors possibly contributing to the differences in VO 2max . In this study, the children with CP were comparable to the controls for BMI SDS, percent fat mass, FFM, and weekly strenuous sports volume.…”

Section: Discussionmentioning

confidence: 99%

Impaired aerobic exercise adaptation in children and adolescents with craniopharyngioma is associated with hypothalamic involvement

Piguel¹,

Ábrahám²,

Bouhours‐Nouet³

et al. 2012

European Journal of Endocrinology

View full text Add to dashboard Cite

Objective: Many patients treated for craniopharyngioma (CP) complain of a relative incapacity for physical activity. Whether this is due to an objective decrease in adaptation to exercise is unclear.We assessed exercise tolerance in children with surgically treated CP and appropriate pituitary hormone replacement therapy compared with healthy controls and we examined the potential relationships with hypothalamic involvement, GH replacement, and the catecholamine deficiency frequently observed in these subjects. Design and methods: Seventeen subjects (12 males and five females) with CP and 22 healthy controls (14 males and eight females) aged 15.3G2.5 years (7.3-18 years) underwent a standardized cycle ergometer test. Maximum aerobic capacity was expressed as the ratio of VO 2max to fat-free mass (VO 2max /FFM), a measure independent of age and fat mass in children. Results: VO 2max /FFM was 20% lower in children with CP compared with controls (P!0.05), even after adjustment for gender. Children with hypothalamic involvement (nZ10) had a higher percentage of fat mass (P!0.05) than those without hypothalamic involvement (nZ7) and lower VO 2max /FFM (P!0.05), whereas children without hypothalamic involvement had VO 2max /FFM close to that of controls (PO0.05). GH treatment was associated with a significant positive effect on aerobic capacity (P!0.05) only in the absence of hypothalamic involvement. No relationship was found between exercise capacity parameters and daily urine epinephrine excretion or epinephrine peak response to insulin-induced hypoglycemia. Conclusions: Children with CP have a decrease in aerobic capacity mainly related to hypothalamic involvement. The hypothalamic factors altering aerobic capacity remain to be determined.

show abstract

Reduced Energy Expenditure and Impaired Feeding-Related Signals But Not High Energy Intake Reinforces Hypothalamic Obesity in Adults with Childhood Onset Craniopharyngioma

Abstract: The major mechanisms that reinforced obesity were hypothalamic damage causing disrupted or impaired sensitivity to feeding-related signals for leptin, insulin, and ghrelin, and reductions in both BMR and physical activity.

Cited by 113 publications

References 28 publications

Autonomic nervous system balance in children and adolescents with craniopharyngioma and hypothalamic obesity

Autonomic nervous system balance in children and adolescents with craniopharyngioma and hypothalamic obesity

Nutritional assessment of a population with a history of childhood craniopharyngioma seen at Hospital “Prof. Dr. Juan P. Garrahan”

Impaired aerobic exercise adaptation in children and adolescents with craniopharyngioma is associated with hypothalamic involvement

Contact Info

Product

Resources

About