The role of leptin, soluble leptin receptor, resistin, and insulin secretory dynamics in the pathogenesis of hypothalamic obesity in children

Güran, Tülay; Turan, Serap; Bereket, Abdullah; Akçay, Teoman; Ünlügüzel, Göksenin; Baş, Firdevs; Günöz, Hülya; Saka, Nurçin; Bundak, Rüveyde; Darendelıler, Feyza; İşgüven, Pınar; Yıldız, Metin; Adal, Erdal; Sarıkaya, Sevil; Baygin, Leyla Akin; Memioğlu, Nihal; Önal, Hasan; Ercan, Oya; Haklar, Goncagül

doi:10.1007/s00431-008-0876-x

Cited by 34 publications

(33 citation statements)

References 29 publications

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“…Two causes could account for this: on the one hand, the higher FM of CP patients and on the other hand, a leptin resistance caused by the damage of the hypothalamus (31).…”

Section: Discussionmentioning

confidence: 99%

Food intake regulating hormones in adult craniopharyngioma patients

Roemmler-Zehrer

Geigenberger

Störmann

et al. 2014

European Journal of Endocrinology

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Introduction: Patients with craniopharyngioma (CP) have disturbances of the hypothalamic-pituitary axis and serious comorbidities such as obesity. We hypothesized that the secretion of hormones regulating the nutritional status is altered in adult patients with CP compared with patients with non-functioning pituitary adenoma (NFPA). Methods: We included 40 CP (50% males, mean age: 49.6G14.3 years) and 40 NFPA (72.5% males, mean age: 63.4G9.8 years) patients. We measured glucose, insulin, leptin, total ghrelin, peptide-YY (PYY) and cholecystokinin (CCK) during oral glucose tolerance test (OGTT). Fat mass (FM) was determined by dual X-ray absorptiometry. Results: Gender distribution was not significantly different, but CP patients were significantly younger (P!0.001). CP patients had significantly higher BMI and FM than NFPA patients (BMI 32G8 vs 28G4 kg/m 2 , PZ0.009 and FM 37G9 vs 33G9%,

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“…Two causes could account for this: on the one hand, the higher FM of CP patients and on the other hand, a leptin resistance caused by the damage of the hypothalamus (31).…”

Section: Discussionmentioning

confidence: 99%

Food intake regulating hormones in adult craniopharyngioma patients

Roemmler-Zehrer

Geigenberger

Störmann

et al. 2014

European Journal of Endocrinology

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“…Guran T et al have shown that leptin levels corrected for body mass index (BMI) are higher in patients with hypothalamic obesity than in simple obesity, indicating that there a disruption of responses to leptin and more severe leptin resistance in hypothalamic obesity [21]. A disturbed feedback mechanism from the hypothalamic leptin receptors to the adipose tissue can be assumed, including a loss of leptin feedback inhibition on neuropeptide Y and Agouti-related peptide which are orexigenic hormones [21].…”

Section: Hyperleptinemiamentioning

confidence: 99%

“…A disturbed feedback mechanism from the hypothalamic leptin receptors to the adipose tissue can be assumed, including a loss of leptin feedback inhibition on neuropeptide Y and Agouti-related peptide which are orexigenic hormones [21].…”

Section: Hyperleptinemiamentioning

confidence: 99%

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Pediatric nonalcoholic fatty liver disease associated with craniopharyngioma: case report and review of the literature

Jemel¹,

Khochtali²,

Sayadi³

et al. 2017

Liver Pancreat Sci

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Nonalcoholic fatty liver disease (NAFLD) is a multicluster disease which ranges from simple steatosis to non-alcoholic steatohepatitis NASH. Recently it becomes the main cause of chronic liver disease in children and has emerged to be predicted by many specific risk factors, such as obesity and sedentary lifestyle, on predisposing genetic settings. The natural history of pediatric NAFLD is lacking, and the etiopathogenesis is not fully understood. It has been reported that children with craniopharyngioma can have features of metabolic syndrome and other comorbidities. We reported the case of a 11-year-old child who was diagnosed with craniopharyngioma. After the surgery of his brain tumor and hormone replacement therapy he was diagnosed as having NAFLD.We will use this case to highlight the main pathophysiologic processes resulting in the development of NAFLD in children following treatment of craniopharyngioma. We try to focus on the endocrine disturbances that can link the two entities.

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“…Some reports have documented alterations in human growth hormone (hGH) and insulin levels at the onset, whereas others have described endocrine disorders of hypothalamic insufficiency resulting from surgery of the tumor. 5 The latest patient admitted to our hospital with this syndrome was diagnosed with a low-grade astrocytoma, which was not resected due to its location. After an initial period of tumor growth, the patient responded well to second-line chemotherapy, with a reduction in tumor size, clinical improvement, and gradual weight recovery.…”

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confidence: 99%

The Role of Leptin in Diencephalic Syndrome

Velasco¹,

Clemente

Lorite

et al. 2014

Pediatrics

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Diencephalic syndrome is a rare condition associated with central nervous system tumors. The most common presentation is secondary failure to thrive with proper caloric intake and no statural impairment. Despite the importance of this syndrome, little is known of its pathophysiology. Some reports have documented changes in human growth hormone and insulin levels at the onset, whereas others have described endocrine disorders of hypothalamic insufficiency resulting from surgery of the tumor. It has been suggested that the hormonal changes described, such as increased human growth hormone and ghrelin or decreased insulin and leptin levels, are related to a patient’s BMI. These findings support the role of these 4 hormones as indicators of the patient’s nutritional status but not as mediators or potential therapeutic targets of the disease. We report the case of an infant who initially presented with tumor progression and, after chemotherapy, progressive weight gain and reduced tumor size. Because he presented no hormonal deficiencies or obesity after therapy, we were able to analyze his hormonal status uninfluenced by effects of metabolic treatment or excess weight. Although ghrelin and leptin levels have been related to nutritional status, our patient’s leptin levels fell when tumor size decreased and weight increased: an extraordinary finding because leptin concentration is expected to increase with weight gain. This paradoxical response suggests that leptin may be dysregulated in diencephalic syndrome or that the diencephalic astrocytoma may have had an effect on leptin secretion.

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The role of leptin, soluble leptin receptor, resistin, and insulin secretory dynamics in the pathogenesis of hypothalamic obesity in children

Abstract: Hypothalamic obesity seems to be related to both dysregulated afferent (leptin) and efferent (insulin) neural outputs through the autonomic nervous system resulting in energy storage as fat.

Cited by 34 publications

References 29 publications

Food intake regulating hormones in adult craniopharyngioma patients

Food intake regulating hormones in adult craniopharyngioma patients

Pediatric nonalcoholic fatty liver disease associated with craniopharyngioma: case report and review of the literature

The Role of Leptin in Diencephalic Syndrome

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