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Hormonal factors influencing weight and growth pattern in craniopharyngioma
Author(s): Pinto G, Bussieres L, Recasens C, Souberbielle JC, Zerah M, Brauner R
Source: HORMONE RESEARCH    Volume: 53    Issue: 4    Pages: 163-169    Published: 2000  
Times Cited: 20     References: 20     
Abstract: Patients operated on for craniopharyngioma frequently suffer from hyperphagia and are obese, but their statural growth is normal despite growth hormone (GH) deficiency. We have evaluated the hormonal factors influencing changes in weight and growth in 17 children before and 1, 3-6, 12, and/or 24 months after surgical resection of a craniopharyngioma performed at 7.7 +/- (SE) 1 years of age. Of these, 15 patients had a GH deficiency before surgery, and all had complete pituitary deficiency after it. The plasma fasting insulin concentrations before surgery were positively correlated with body mass index (BMI, kg/m(2); p < 0.05), plasma insulin-like growth factors (IGFI, p = 0.03, and IGFII, p = 0.04), and leptin (p = 0.03). They increased significantly 1 month after surgery and continued to increase thereafter, whereas leptin increased significantly only 3-6 months after surgery, paralleling changes in BMI. The plasma fasting insulin concentrations before surgery were also positively correlated with the weight changes (12.3 +/- 2.3 kg, p < 0.01) during the 12 months after surgery, but not with changes in BMI SDS (3.1 +/- 0.5, p = 0.07). Both expressions of weight change were correlated with the concomitant growth rates (4.8 +/- 0.7 cm, p < 0.01). IGFI was above the 10th percentile for children with idiopathic short stature in 10 of 15 patients with craniopharyngioma-induced GH deficiency and IGF-binding protein 3 in 14 of 15 patients. Craniopharyngioma itself modified the control of insulin secretion, and surgery increased the insulin secretion which continued in the same way in a given patient after surgery. The increased insulin secretion in turn increases weight and keeps IGFI nearly normal. This may explain the normal growth rate despite the complete lack of GH. Copyright (C) 2000 S. Karger AG, Basel.
Document Type: Proceedings Paper
Language: English
Reprint Address: Brauner, R (reprint author), Hop Necker Enfants Malad, Serv Endocrinol & Croissance, 149 Rue Sevres, F-75743 Paris 15, France
Addresses:
1. Hop Necker Enfants Malad, Serv Endocrinol & Croissance, F-75743 Paris 15, France
2. Univ Paris 05, Dept Pediat Endocrinol, F-75270 Paris, France
3. Univ Paris 05, Dept Neurosurg, F-75270 Paris 06, France
4. Univ Paris 05, Physiol Lab, F-75270 Paris 06, France
5. Assistance Publ Hop Paris, Hop Albert Chenevier, Dept Psychiat, Paris, France
Publisher: KARGER, ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND
Subject Category: Endocrinology & Metabolism
IDS Number: 365FF
ISSN: 0301-0163
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