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Tumors of the Central Nervous System, Volume 12 pp 73–89Cite as

Hyperinsulinemia Tends to Induce Growth Without Growth Hormone in Children with Brain Tumors After Neurosurgery

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Part of the book series: Tumors of the Central Nervous System ((TCNS,volume 12))

Abstract

Hypothalamo-pituitary dysfunction is commonly seen in children with brain tumors after neurosurgery, resulting in endocrine disorders, including growth hormone deficiency (GHD). GHD causes growth failure, and thus the majority of the patients need GH replacement therapy. Despite GHD, some patients grow normally or excessively, which has been recognized as growth without GH (GWGH). Since hyperinsulinemia is highly associated with the patients with GWGH, it has been considered to play an important role for promoting linear growth. However, the causes of hyperinsulinemia associated with GWGH and the mechanisms of GWGH remain elusive. The data to date collectively suggest that the location of brain tumors and/or the mode of surgery, insulin resistance associated with obesity, insulin-like growth factor (IGF)-I, IGF binding protein (IGFBP)-1 and −3, leptin and prolactin (PRL) may contribute to the regulation of insulin secretion in patients with GWGH. Besides its metabolic effects, insulin exerts the diverse effects as a growth factor, including proliferation and differentiation of osteoblasts, leading to acceleration of linear growth. Interaction between insulin- and IGF-I-induced signaling pathways and of insulin with other hormonal factors such as leptin or PRL may play a crucial role for promoting linear growth in patients with GWGH. Despite normal or excessive linear growth, patients with GWGH still have metabolic abnormalities and retarded bone maturation. It remains elusive whether GH replacement therapy solves these problems and enables the patients to reach normal height in adulthood. Better understanding for the mechanisms of GWGH is essential to improve the quality of life of patients with GWGH. Because of a lack of accumulating data, further studies would be necessary to clarify the clinical characteristics and the mechanisms of GWGH in more detail in the future.

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Acknowledgements

The authors are grateful to Drs. T. Kamijo and H. Mizuno for their helpful suggestions.

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Authors and Affiliations

  1. Department of Pediatrics, Public Central Hospital of Matto Ishikawa, 3-8 Kuramitsu, Hakusan, Ishikawa, 924-8588, Japan

    Norishi Ueda

  2. Department of Pediatrics, Neonatology and Congenital Disorders, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizho-ku, Nagoya, 467-8602, Aichi, Japan

    Hideyuki Iwayama

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  1. Norishi Ueda
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  2. Hideyuki Iwayama
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Correspondence to Norishi Ueda .

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Editors and Affiliations

  1. Department of Biological Sciences, Kean University, Room 213, Library Building, Union, New Jersey, USA

    M.A. Hayat

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Ueda, N., Iwayama, H. (2014). Hyperinsulinemia Tends to Induce Growth Without Growth Hormone in Children with Brain Tumors After Neurosurgery. In: Hayat, M. (eds) Tumors of the Central Nervous System, Volume 12. Tumors of the Central Nervous System, vol 12. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7217-5_7

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  • DOI: https://doi.org/10.1007/978-94-007-7217-5_7

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