Ann Pediatr Endocrinol Metab.  2023 Jun;28(2):107-115. 10.6065/apem.2244046.023.

The effect of hypothalamic involvement and growth hormone treatment on cardiovascular risk factors during the transition period in patients with childhood-onset craniopharyngioma

• Park SH
• Lee YJ
• Cheon JE
• Shin CH
• Jung HW
• Lee YA

• KMID: 2543291
• DOI: http://doi.org/10.6065/apem.2244046.023

Abstract

Purpose
Hypothalamic damage may increase the risk of adulthood obesity and cardiovascular disease in patients with craniopharyngioma. We evaluated the effects of hypothalamic involvement (HI) and growth hormone (GH) discontinuation on cardiovascular risk factors during the transition period in patients with childhood-onset craniopharyngioma.
Methods
Thirty-three patients (17 males, 16 females) underwent retesting for adult GH deficiency (GHD) between 2005 and 2020 at Seoul National University Children's Hospital. Postoperative HI was graded by Puget's criteria and data regarding GH replacement were collected. At retesting, body mass index (BMI), fasting blood glucose, insulin, high-density lipoprotein cholesterol (HDL-C), triglycerides, and blood pressure were assessed.
Results
The mean age of commencement and discontinuation of GH replacement for childhood GHD was 10.0±3.6 and 15.3±3.1 years, respectively. The mean age at retesting for adult GHD was 17.7±2.5 years. When patients were categorized by post-GH discontinuation duration, those with durations >6 months (n=27) showed lower HDL-C levels than those with <6 months (P=0.037). Patients with extensive HI (n=16) had higher BMI z-scores than did those with no HI or mild HI (P=0.020). Both the extent of HI and longer post-GH discontinuation duration were significantly predictive for decreased HDL-C levels (P<0.05, for both).
Conclusion
The extent of HI and GH discontinuation duration during the transition period can increase cardiovascular risks in patients with childhood-onset craniopharyngioma.

Keyword

Craniopharyngioma; Hypothalamus; Growth hormone; Cardiovascular disease; Dyslipidemias

Figure

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  Fig. 1. Flow chart of the study participants. GHD, growth hormone deficiency; MRI, magnetic resonance imaging.

Reference

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