Comparison of energy expenditure, body composition, metabolic disorders, and energy intake between obese children with a history of craniopharyngioma and children with multifactorial obesity

Bomer, Ilanit; Sauré, Carola; Caminiti, Carolina; Ramos, Javier González; Zúccaro, Graciela; Brea, Mercedes; Bravo, Mónica; Maza, Carmen

doi:10.1515/jpem-2015-0167

Cited by 23 publications

(33 citation statements)

References 25 publications

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“…A decreased metabolic rate, in terms of both resting and total energy expenditure, is likely to contribute to weight gain in this population. Adults and paediatric patients with childhood-onset craniopharyngioma were found to have a lower resting energy expenditure (REE) compared with controls that were not explained by differences in body composition [ 80 ▪ ]. This energy intake/REE ratio was significantly lower in those with tumours involving the third ventricle [ 81 ].…”

Section: Hypothalamic Obesitymentioning

confidence: 99%

Craniopharyngioma and hypothalamic injury

Müller

2016

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

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Purpose of reviewHypothalamic alterations, pathological or treatment induced, have major impact on prognosis in craniopharyngioma patients mainly because of consequent hypothalamic obesity. Recent insight in molecular genetics, treatment strategies, risk factors and outcomes associated with hypothalamic obesity provide novel therapeutic perspectives. This review includes relevant publications since 2013.Recent findingsRecent findings confirm that alterations in posterior hypothalamic areas because of tumour location and/or treatment-related injuries are associated with severe hypothalamic obesity, reduced overall survival and impaired quality of life in long-term survivors of childhood-onset craniopharyngioma. However, eating disorders are observed because of hypothalamic obesity without clear disease-specific patterns. Treatment options for hypothalamic obesity are very limited. Treatment with invasive, nonreversible bariatric methods such as Roux-en-Y gastric bypass is most efficient in weight reduction, but controversial in the paediatric population because of medical, ethical, and legal considerations. Accordingly, treatment in craniopharyngioma should focus on prevention of (further) hypothalamic injury. Presurgical imaging for grading of hypothalamic involvement should be the basis for hypothalamus-sparing strategies conducted by experienced multidisciplinary teams.SummaryUntil a nonsurgical therapeutic option for hypothalamic obesity for paediatric patients is found, prevention of hypothalamic injury should be the preferred treatment strategy, conducted exclusively by experienced multidisciplinary teams.

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Section: Hypothalamic Obesitymentioning

confidence: 99%

Craniopharyngioma and hypothalamic injury

Müller

2016

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

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“…There is no consensus in relation to such metabolic complication in the literature. In another study conducted by our team 28 that compared obese patients with a history of craniopharyngioma to a group of 43 patients with obesity of multifactorial etiology paired by sex and age found no significant differences in the scale of obesity, centralized fat mass by waist circumference, insulin resistance (52% versus 68%, p= 0.2), dyslipemia (p= 0.68), or hepatic steatosis (p= 0.34) between both groups.…”

Section: Discussionmentioning

confidence: 82%

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

et al. 2017

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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.

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“…En la literatura, no hay consenso con respecto a dicha complicación metabólica. En otro trabajo de nuestro equipo, 28 en el que se compararon pacientes obesos con antecedente de craneofaringioma con un grupo de 43 pacientes obesos multifactoriales apareados por edad y sexo, no se encontraron diferencias significativas en la magnitud de obesidad, centralización por perímetro de cintura, insulinorresistencia (52% vs. 68%; p 0,2), dislipidemia (p 0,68) ni esteatosis hepática (p 0,34) entre ambos grupos.…”

Section: Discussionunclassified

Evaluación nutricional de la población con antecedente de craneofaringioma infantil en el Hospital “Prof. Juan P. Garrahan”

et al. 2017

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RESUMENIntroducción. los craneofaringiomas son malformaciones histológicamente benignas entre el hipotálamo y la hipófisis que pueden afectar la secreción hormonal clave en la regulación endócrina y modulación de la saciedad. Si bien se trata de una enfermedad relativamente benigna, la combinación de obesidad grave de origen hipotalámico y las comorbilidades asociadas a ella disminuyen la calidad de vida. Objetivo. Evaluar el estado nutricional de pacientes operados de craneofaringioma infantil. Población y métodos. Pacientes menores de 21 años al momento del estudio que requirieron cirugía por craneofaringioma en el Hospital de Pediatría Garrahan y que firmaron el consentimiento informado. Se realizó la evaluación antropométrica, composición corporal con impedanciometría, gasto energético con calorimetría indirecta e ingesta energética. Se determinó la resistencia a la insulina y la dislipidemia. Resultados. Se incluyeron 39 pacientes; 41%, normopeso y 59%, obesos. El 68% de los pacientes presentó distribución grasa central; 40%, resistencia a la insulina; y 32%, dislipidemia. No se encontraron diferencias significativas en la presencia de resistencia a la insulina, dislipidemia, gasto energético en reposo ni en la ingesta entre obesos vs. normopeso. El 77% de los pacientes obesos presentó bajo gasto energético independiente del porcentaje de masa magra (62 ± 2,7% vs. 61,2 ± 1,8% de gasto energético en reposo normal vs. bajo; p 0,8). Conclusiones. El 59% de la población estudiada presentó obesidad. No se encontraron diferencias significativas en complicaciones metabólicas entre pacientes obesos y normopeso. Se observó menor gasto energético independiente del porcentaje de masa magra y similar ingesta energética. Palabras clave : craneofaringioma, obesidad, gasto energético, composición corporal, ingestión de energía.

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Comparison of energy expenditure, body composition, metabolic disorders, and energy intake between obese children with a history of craniopharyngioma and children with multifactorial obesity

Abstract: REE was lower in craniopharyngioma patients compared to children with multifactorial obesity regardless of the amount of fat-free mass, suggesting that other factors may be responsible for the lower REE.

Cited by 23 publications

References 25 publications

Craniopharyngioma and hypothalamic injury

Craniopharyngioma and hypothalamic injury

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

Evaluación nutricional de la población con antecedente de craneofaringioma infantil en el Hospital “Prof. Juan P. Garrahan”

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