Craniopharyngioma and Metabolic Syndrome: A 5-Year Follow-Up Single-Center Experience

Patients with craniopharyngioma often have comorbidities, such as obesity and hypopituitarism. These two conditions affect each other and worsen the quality of life of patients, which lead to a higher risk of morbidity and mortality. In addition, abdominal obesity, measured as waist circumference (WC), is together with other parameters [arterial hypertension, hyperglycemia, hypertriglyceridemia, and reduced levels of high-density lipoprotein (HDL) cholesterol], one of the components of metabolic syndrome (MS). Each one of these morbidities occurs in patients with craniopharyngioma more frequently than in the remaining population. On these bases, we evaluated metabolic parameters in patients with craniopharyngioma at the time of diagnosis and after a 5-year follow-up, which compares these data with those of age-, gender-, WC-, and body mass index (BMI)-matched controls. In addition, we evaluated the prevalence of MS according to IDF criteria (MS-IDF) and the prevalence of MS according to ATP III (MS-ATPIII) criteria in patients and controls at baseline and after 5 years. We recruited 20 patients with craniopharyngioma (age 38.5 ± 15 years, 10 M) and 20 age-, gender-, WC- and BMI-matched controls (age 34.16 ± 13.19 years, 10 M). In all patients and controls, we evaluated the following: anthropometric features [height, weight, BMI, WC, hip circumference (HC) and waist-to-hip ratio (WHR)], systolic blood pressure (SBP) and diastolic blood pressure (DBP), lipid profile [total cholesterol (TC), HDL, low-density lipoprotein (LDL) cholesterol, triglycerides (TG)], and blood glucose at baseline and after 5 years. The prevalence of MS, according to IDF and ATPIII criteria, was calculated in the two groups at baseline and after 5 years. According to our results, at baseline, patients with craniopharyngioma had a worse metabolic profile than controls and a higher prevalence of MS. Besides, at a 5-year follow-up, patients still had impaired metabolic characteristics and more frequent MS (according to IDF and ATPIII criteria) when compared to controls. These data confirm that MS in patients with craniopharyngioma is unresponsive to life-changing interventions and to a common pharmacological approach. Other factors may be involved in the evolution of these conditions; so, further studies are needed to establish the correct management of these patients.

[1]  New Perspectives in Health , 2022 .

[2]  Xiaoming Zhu,et al.  Risk Factors for Hypothalamic Obesity in Patients With Adult-Onset Craniopharyngioma: A Consecutive Series of 120 Cases , 2021, Frontiers in Endocrinology.

[3]  F. Esposito,et al.  Biological Rhythm and Chronotype: New Perspectives in Health , 2021, Biomolecules.

[4]  T. Battelino,et al.  Prevalence of Endocrine and Metabolic Comorbidities in a National Cohort of Patients with Craniopharyngioma , 2020, Hormone Research in Paediatrics.

[5]  M. Jensterle,et al.  Advances in the Management of Craniopharyngioma in Children and Adults , 2019, Radiology and oncology.

[6]  B. Lu,et al.  Endocrine and Metabolic Outcomes After Transcranial and Endoscopic Endonasal Approaches for Primary Resection of Craniopharyngiomas. , 2019, World neurosurgery.

[7]  M. Pinheiro,et al.  Childhood Craniopharyngioma: A 22-Year Challenging Follow-Up in a Single Center , 2018, Hormone and Metabolic Research.

[8]  M. Murad,et al.  Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline. , 2016, The Journal of clinical endocrinology and metabolism.

[9]  L. Beilin,et al.  Dual Energy X-Ray Absorptiometry Compared with Anthropometry in Relation to Cardio-Metabolic Risk Factors in a Young Adult Population: Is the ‘Gold Standard’ Tarnished? , 2016, PloS one.

[10]  P. Steinbok Craniopharyngioma in Children: Long-term Outcomes , 2015, Neurologia medico-chirurgica.

[11]  P. Beck‐Peccoz,et al.  Analysis of short- and long-term metabolic effects of growth hormone replacement therapy in adult patients with craniopharyngioma and non-functioning pituitary adenoma , 2015, Journal of Endocrinological Investigation.

[12]  R. Pieters,et al.  Obesity Is Underestimated Using Body Mass Index and Waist-Hip Ratio in Long-Term Adult Survivors of Childhood Cancer , 2012, PloS one.

[13]  R. Lustig Hypothalamic Obesity after Craniopharyngioma: Mechanisms, Diagnosis, and Treatment , 2011, Front. Endocrin..

[14]  L. Iughetti,et al.  Obesity and craniopharyngioma , 2011, Italian journal of pediatrics.

[15]  S. A. Jayakody,et al.  Increased Wingless (Wnt) signaling in pituitary progenitor/stem cells gives rise to pituitary tumors in mice and humans , 2011, Proceedings of the National Academy of Sciences.

[16]  Taninee Sahakitrungruang,et al.  Obesity, metabolic syndrome, and insulin dynamics in children after craniopharyngioma surgery , 2011, European Journal of Pediatrics.

[17]  M. Riva,et al.  Neurosurgical treatment of craniopharyngioma in adults and children: early and long-term results in a large case series. , 2011, Journal of neurosurgery.

[18]  F. Saggioro,et al.  CTNNB1 Gene Mutations, Pituitary Transcription Factors, and MicroRNA Expression Involvement in the Pathogenesis of Adamantinomatous Craniopharyngiomas , 2010, Hormones & cancer.

[19]  B. Zemel,et al.  Energy expenditure in obesity associated with craniopharyngioma , 2010, Child's Nervous System.

[20]  J. Björk,et al.  Hypothalamic involvement predicts cardiovascular risk in adults with childhood onset craniopharyngioma on long-term GH therapy. , 2009, European Journal of Endocrinology.

[21]  B. Scheithauer,et al.  The 2007 WHO Classification of Tumours of the Central Nervous System , 2007, Acta Neuropathologica.

[22]  Udo Hoffmann,et al.  Abdominal Visceral and Subcutaneous Adipose Tissue Compartments: Association With Metabolic Risk Factors in the Framingham Heart Study , 2007, Circulation.

[23]  S. Puget,et al.  Craniopharyngioma , 2007, Orphanet journal of rare diseases.

[24]  I. Lemieux,et al.  Abdominal obesity and metabolic syndrome , 2006, Nature.

[25]  R. Eckel,et al.  Preventing cardiovascular disease and diabetes: a call to action from the American Diabetes Association and the American Heart Association. , 2006, Circulation.

[26]  Paul Zimmet,et al.  The metabolic syndrome—a new worldwide definition , 2005, The Lancet.

[27]  A. Emser,et al.  Longitudinal study on growth and body mass index before and after diagnosis of childhood craniopharyngioma. , 2004, The Journal of clinical endocrinology and metabolism.

[28]  I. Lemieux Energy partitioning in gluteal-femoral fat: does the metabolic fate of triglycerides affect coronary heart disease risk? , 2004, Arteriosclerosis, thrombosis, and vascular biology.

[29]  Claude Lenfant,et al.  Definition of Metabolic Syndrome: Report of the National Heart, Lung, and Blood Institute/American Heart Association Conference on Scientific Issues Related to Definition , 2004, Circulation.

[30]  Claude Lenfant,et al.  Definition of Metabolic Syndrome: Report of the National Heart, Lung, and Blood Institute/American Heart Association Conference on Scientific Issues Related to Definition , 2004, Arteriosclerosis, thrombosis, and vascular biology.

[31]  Douglas C. Miller,et al.  Craniopharyngiomas: a clinicopathological analysis of factors predictive of recurrence and functional outcome. , 1994, Neurosurgery.

[32]  R. Levy,et al.  Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. , 1972, Clinical chemistry.

[33]  J. Crigler,et al.  Management of craniopharyngioma in childhood. , 1969, Journal of neurosurgery.

[34]  Gol'dberg Gm,et al.  Squamous cell nests of the pituitary gland as related to the origin of craniopharyngiomas. A study of their presence in the newborn and infants up to age four. , 1960, Archives of pathology.

[35]  G. Johannsson,et al.  The metabolic syndrome and its components in 178 patients treated for craniopharyngioma after 16 years of follow-up. , 2018, European journal of endocrinology.

[36]  F. Greenway,et al.  An Endocrine Society Clinical Practice Guideline Endocrine and Nutritional Management of the Post-Bariatric Surgery Patient: , 2010 .

[37]  S. Cudlip,et al.  Craniopharyngiomas. , 2006, Endocrine reviews.

[38]  J. Pinkney,et al.  Endocrine and neuroanatomic features associated with weight gain and obesity in adult patients with hypothalamic damage. , 2005, The American journal of medicine.

[39]  C. Cowell,et al.  Features of the metabolic syndrome after childhood craniopharyngioma. , 2004, The Journal of clinical endocrinology and metabolism.

[40]  Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. , 2002, Circulation.

[41]  P. Renshaw,et al.  [Detection, evaluation, and treatment of high blood cholesterol in adults]. , 2001, Revista panamericana de salud publica = Pan American journal of public health.

[42]  R. Barnard,et al.  The classification of tumours of the central nervous system. , 1982, Neuropathology and applied neurobiology.

[43]  I. Hunter Squamous metaplasia of cells of the anterior pituitary gland. , 1955, The Journal of pathology and bacteriology.