Original Paper

European Journal of Pediatrics

, Volume 170, Issue 6, pp 763-769

Obesity, metabolic syndrome, and insulin dynamics in children after craniopharyngioma surgery

  • Taninee SahakitrungruangAffiliated withDivision of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University Email author 
  • , Tippayakarn KlomchanAffiliated withDivision of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University
  • , Vichit SupornsilchaiAffiliated withDivision of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University
  • , Suttipong WacharasindhuAffiliated withDivision of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University

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Abstract

Introduction

Children after craniopharyngioma surgery often develop rapid weight gain and hyperphagia. We investigate the metabolic syndrome features, risk factors, and the insulin dynamics in these patients.

Materials and methods

Standard oral glucose tolerance tests (OGTT) were performed in 12 subjects, aged 7.7–18.1 years, after surgical removal of craniopharyngioma and their healthy age-, sex-, body mass index-, and pubertal stage-matched controls. Blood samples were obtained for measurement of levels of plasma glucose, insulin, lipids, liver enzymes, baseline hormonal profiles with calculation of insulin secretion, and insulin sensitivity indices derived from OGTT.

Results and discussion

Nine of 12 subjects were severely obese. All patients exhibited significant weight gain after surgery. The waist to hip ratio was higher in subjects compared to controls (P = 0.023). Subjects had higher fasting triglycerides (P = 0.019) and lower HDL/total cholesterol ratio (P = 0.012). Five of 12 subjects met the criteria for the metabolic syndrome, compared with one of 12 in controls. One patient had prediabetes and another patient had overt type 2 diabetes. Six of 12 subjects had nonalcoholic steatohepatitis. No significant risk factors were found between each group of patients with and without the metabolic syndrome. There were no differences of insulin secretion and insulin sensitivity indices between craniopharyngioma and control subjects.

Conclusion

Children after craniopharyngioma surgery are at risk of rapid weight gain and the development of metabolic syndrome. Further studies to better understand the mechanism are required to design effective treatment and prevention.

Keywords

Childhood Craniopharyngioma Insulin resistance Metabolic syndrome Obesity