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Licensed Unlicensed Requires Authentication Published by De Gruyter July 23, 2015

Comparison of energy expenditure, body composition, metabolic disorders, and energy intake between obese children with a history of craniopharyngioma and children with multifactorial obesity

  • Ilanit Bomer , Carola Saure EMAIL logo , Carolina Caminiti , Javier Gonzales Ramos , Graciela Zuccaro , Mercedes Brea , Mónica Bravo and Carmen Maza

Abstract

Craniopharyngioma is a histologically benign brain malformation with a fundamental role in satiety modulation, causing obesity in up to 52% of patients.

Aim: To evaluate cardiovascular risk factors, body composition, resting energy expenditure (REE), and energy intake in craniopharyngioma patients and to compare the data with those from children with multifactorial obesity.

Population: All obese children and adolescents who underwent craniopharyngioma resection and a control group of children with multifactorial obesity in follow-up between May 2012 and April 2013.

Materials and methods: Anthropometric measurements, bioelectrical impedance, indirect calorimetry, energy intake, homeostatic model assessment insulin resistance (HOMA-IR), and dyslipidemia were evaluated.

Results: Twenty-three patients with craniopharyngioma and 43 controls were included. Children with craniopharyngioma-related obesity had a lower fat-free mass percentage (62.4 vs. 67.5; p=0.01) and a higher fat mass percentage (37.5 vs. 32.5; p=0.01) compared to those with multifactorial obesity. A positive association was found between %REE and %fat-free mass in subjects with multifactorial obesity (68±1% in normal REE vs. 62.6±1% in low REE; p=0.04), but not in craniopharyngioma patients (62±2.7 in normal REE vs. 61.2±1.8% in low REE; p=0.8). No differences were found in metabolic involvement or energy intake.

Conclusions: REE was lower in craniopharyngioma patients compared to children with multifactorial obesity regardless of the amount of fat-free mass, suggesting that other factors may be responsible for the lower REE.


Corresponding author: Carola Saure, Department of Clinical Nutrition, Hospital J.P. Garrahan, Combate de los Pozos 1881, Ciudad Autónoma de Buenos Aires, CP 1245, Argentina, E-mail:

References

1. Bunin GR, Surawicz TS, Witman PA, Preston-Martin S, Davis F, et al. The descriptive epidemiology of craniopharyngioma. J Neurosurg 1998;89:547–51.10.3171/jns.1998.89.4.0547Search in Google Scholar PubMed

2. Müller-Scholden J, Lehrnbecher T, Müller HL, Bensch J, Hengen RH, et al. Radical surgery in a neonate with craniopharyngioma. Report of a case. Pediatr Neurosurg 2000;33:265–9.10.1159/000055967Search in Google Scholar PubMed

3. Einhaus SL, Sanford RA. Craniopharyngiomas. In: Albright AL, Pollack IF, Adelson PD, editors. Principles and practice of pediatric neurosurgery. New York: Thieme, 1999:545–62.Search in Google Scholar

4. Sandford RA. Craniopharyngioma: results of survey of the American Society of Pediatric Neurosurgery. Pediatr Neurosurg 1994;21:39–43.10.1159/000120860Search in Google Scholar PubMed

5. Muller HL, Bueb K, Bartels U, Roth C, Harz K, et al. Obesity after childhood craniopharyngioma: German multicenter study on pre-operative risk factors and quality of life. Klin Padiatr 2001;213:244–9.10.1055/s-2001-16855Search in Google Scholar PubMed

6. Gleeson H, Amin R, Maghnie M. ‘Do no harm’: management of craniopharyngioma. Eur J Endocrinol 2008;159:S95–9.10.1530/EJE-08-0400Search in Google Scholar PubMed

7. Muller HL, Emser A, Faldum A, Bruhnken G, Etavard-Gorris N, et al. Longitudinal study on growth and body mass index before and after diagnosis of childhood craniopharyngioma. J Clin Endocrinol Metab 2004;89:3298–305.10.1210/jc.2003-031751Search in Google Scholar PubMed

8. Trivin C, Busiah K, Mahlarui N, Recansens C, Souberbielle JC, et al. Childhood craniopharyngioma: greater hypothalamic involvement before surgery is associated with higher homeostasis model insulin resistance index. BMC Pediatr 2009;9:24.10.1186/1471-2431-9-24Search in Google Scholar PubMed PubMed Central

9. WHO weight childgrowth charts/SAP weight Percentiles. Available at http://www.who.int/childgrowth/software/en/, http://www.sap.org.ar/prof-percentilos.php.Search in Google Scholar

10. WHO height childgrowth charts/SAP height Percentiles. Available at http://www.who.int/childgrowth/software/en/, http://www.sap.org.ar/prof-percentilos.php.Search in Google Scholar

11. Freedman DS, Serdula MK, Srinivasan SR, Berenson GS. Relation of circumferences and skinfold thicknesses to lipid and insulin concentrations in children and adolescents. The Bogalusa Heart Study. Am J Clin Nutr 1999;69:308–17.10.1093/ajcn/69.2.308Search in Google Scholar PubMed

12. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation and treatment of high blood pressure in children and adolescents. Pediatrics 2004;114:555.10.1542/peds.114.2.S2.555Search in Google Scholar

13. Bravo M, Collado L, Dardanelli E, Araujo M, Lipsich J, et al. Medicion ecografica del espesor medio-intimal carotideo en pacientes pediatricos con obesidad, hipercolesterolemia familiar y diabetes tipo 1. Rev Arg Radiol 2012;76:55–60.Search in Google Scholar

14. Haffner S, Miettinen H, Stern M. The homeostasis model in the San Antonio Heart Study. Diabetes Care 1997;20:1087–92.10.2337/diacare.20.7.1087Search in Google Scholar PubMed

15. Allard P, Elvin EE, Parais G, Hanley JA, O’Loughlin J, et al. Distribution of fasting plasma insulin, free fatty acids and glucose concentration and of homeostasis model assessment of insulin resistance in a representative sample of Quebec children and adolescents. Clin Chem 2003;49:644–9.10.1373/49.4.644Search in Google Scholar PubMed

16. Uwaifo GI, Fallon EM, Chin J, Elberg J, Parikh SJ, et al. Indices of insulin action, disposal, and secretion derived from fasting samples and clamps in normal glucose-tolerant black and white children. Diabetes Care 2002;25:2081–7.10.2337/diacare.25.11.2081Search in Google Scholar PubMed

17. Matthews DR, Hosker JP, Rudensky AS, Naylor BA, Treacher DF, et al. Homeostasis model assessment: insulin resistance and beta cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412–9.10.1007/BF00280883Search in Google Scholar PubMed

18. Houtkooper LB, Going SB, Lobman TG, Roche AF, Van Loan M. Bioelectrical impedance estimation of fat-free body mass in children and youth: a cross validation study. J Appl Physiol 1992;72:366–73.10.1152/jappl.1992.72.1.366Search in Google Scholar PubMed

19. Buscemi S, Verga S, Caimi G, Cerasola G. A low resting metabolic rate is associated with metabolic syndrome. Clin Nutr 2007;26:806–9.10.1016/j.clnu.2007.08.010Search in Google Scholar PubMed

20. Ravusin E, Llioja S, Knowler WC, Christin L, Freymond D, et al. Reduced rate of energy expenditure as a risk factor for body weight gain. N Engl J Med 1988;318:467–72.10.1056/NEJM198802253180802Search in Google Scholar PubMed

21. Roth C. Hypothalamic obesity in patients with craniopharyngioma: profound changes of several weight regulatory circuits. Front Endocrinol 2011;2:49.10.3389/fendo.2011.00049Search in Google Scholar PubMed PubMed Central

22. Muller H, Gebhardt U, Faldum A, Warmuth-Metz M, Pietsch T, et al. Xanthogranuloma, Rathke’s cyst, and childhood craniopharyngioma: results of prospective multinational studies of children and adolescents with rare sellar malformations. J Clin Endocrinol Metab 2012;97:3935–43.10.1210/jc.2012-2069Search in Google Scholar PubMed

23. Kahn MS, Humayun KN, Donaldson M, Ahmed SF, Shaikh MG. Longituinal changes in boy mass index in children with craniopharyngioma. Horm Res Paediatr 2014;82:372–9.10.1159/000368798Search in Google Scholar PubMed

24. Hoffmann A, Postma FP, Stekenburg AS, Gebhardt U, Muller HL. Eating behavior, weight problems and eating disorders in 101 long-term survivors of childhood-onset craniopharyngioma. J Pediatr Endocrinol Metab 2015;28:35–43.10.1515/jpem-2014-0415Search in Google Scholar PubMed

25. Kalina MA, Wilczek M, Kalina-Faska B, Skala-Zamorowska E, Mandera M, et al. Carbohydrate lipid profile and use of metformin with micronized fenofibrate in reducing metabolic consequences of craniopharyngoma treatment in children: single institution experience. J Pediatr Endocrinol Metab 2015;28:45–51.Search in Google Scholar

26. Adachi M, Tsuchiga T, Muroya K, Asakura Y, Sekodo K, et al. Prevalence of obesity, hyperlipemia and insulin resistance in children with suprasellar brain tumors. Clin Pediatr Endocrinol 2007;16:1–9.10.1297/cpe.16.1Search in Google Scholar PubMed PubMed Central

27. Srinivasan S, Ogle GD, Garnett SP, Briody JN, Lee JW, et al. Features of the metabolic syndrome after childhood craniopharyngioma. J Clin Endocrinol Metab 2004;89:81–6.10.1210/jc.2003-030442Search in Google Scholar PubMed

28. Sahakitrungruang T, Klomchan T, Supoonseilchai V, Wachavasndhu S. Obesity, metabolic syndrome and insulin dynamics in children after craniopharyngioma surgery. Eur J Pediatr 2011;170:763–9.10.1007/s00431-010-1347-8Search in Google Scholar PubMed

29. Roth C, Gebhardt U, Muller H. Appetite-regulating hormone changes in patients with craniopharyngioma. Obesity 2011;19:36–42.10.1038/oby.2010.80Search in Google Scholar PubMed

30. Simoneau-Roy J, O’Gorman C, Pencharz P, Adeli K, Daneman D, et al. Insulin sensitivity and secretion in children and adolescents with hypothalamic obesity following treatment for craniopharyngioma. Clin Endocrinol (Oxf) 2010;72: 364–70.10.1111/j.1365-2265.2009.03639.xSearch in Google Scholar PubMed

31. Holmer H, Pozarek G, Wirfalt E, Popovic V, Ekman B, et al. Reduced energy expenditure and impaired feeding-related signals but not high energy intake reinforces hypothalamic obesity in adults with childhood onset craniopharyngioma. J Clin Endocrinol Metab 2010;95:5395–402.10.1210/jc.2010-0993Search in Google Scholar PubMed

32. Kim R, Shah R, Tershakovec A, Zemel B, Sutton L, et al. Energy expenditure in obesity associated with craniopharyngioma. Childs Nerv Syst 2010;26:913–7.10.1007/s00381-009-1078-1Search in Google Scholar PubMed PubMed Central

33. Harz KJ, Muller H, Waldeck E, Pudel V, Roth C. Obesity in patients with craniopharyngioma: assessment of food intake and movement counts indicating physical activity. J Clin Endocrinol Metab 2003;88:5227–31.10.1210/jc.2002-021797Search in Google Scholar PubMed

Received: 2015-4-23
Accepted: 2015-6-15
Published Online: 2015-7-23
Published in Print: 2015-11-1

©2015 by De Gruyter

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