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

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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.

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Acknowledgments

We would like to thank the patients and their families for participation in this study. This study was supported by the Ratchadapiseksompotch Fund, Faculty of Medicine, Chulalongkorn University.

Conflict of interest

We have no conflict of interest.

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Authors and Affiliations

  1. Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand

    Taninee Sahakitrungruang, Tippayakarn Klomchan, Vichit Supornsilchai & Suttipong Wacharasindhu

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  1. Taninee Sahakitrungruang
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  2. Tippayakarn Klomchan
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  3. Vichit Supornsilchai
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  4. Suttipong Wacharasindhu
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Correspondence to Taninee Sahakitrungruang.

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Sahakitrungruang, T., Klomchan, T., Supornsilchai, V. et al. Obesity, metabolic syndrome, and insulin dynamics in children after craniopharyngioma surgery. Eur J Pediatr 170, 763–769 (2011). https://doi.org/10.1007/s00431-010-1347-8

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  • DOI: https://doi.org/10.1007/s00431-010-1347-8

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