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Relative risks of contributing factors to morbidity and mortality in adults with craniopharyngioma on growth hormone replacement

Yuen, Kevin C.J.; Mattsson, Anders F.; Burman, Pia LU ; Erfurth, Eva Marie LU ; Camacho-Hubner, Cecilia; Fox, Janet L.; Verhelst, Johan; Geffner, Mitchell E. and Abs, Roger (2018) In Journal of Clinical Endocrinology and Metabolism 103(2). p.768-777
Abstract

Context: In adults, craniopharyngioma (CP) of either childhood-onset (CO-CP) or adult-onset (AOCP) is associated with increased morbidity and mortality, but data on the relative risks (RRs) of contributing factors are lacking. Objective: To assess the RRs of factors contributing to morbidity and mortality in adults with CO-CP and AO-CP. Methods: Data on 1669 patients with CP from KIMS (Pfizer International Metabolic Database) were analyzed using univariate and multiple Poisson and Cox regression methods. Results:WhenCO-CP andAO-CP groupswere combined, history of stroke and hyperlipidemia increased cardiovascular risk, higher bodymass index (BMI) and radiotherapy increased cerebrovascular risk, and increased waist circumference increased... (More)

Context: In adults, craniopharyngioma (CP) of either childhood-onset (CO-CP) or adult-onset (AOCP) is associated with increased morbidity and mortality, but data on the relative risks (RRs) of contributing factors are lacking. Objective: To assess the RRs of factors contributing to morbidity and mortality in adults with CO-CP and AO-CP. Methods: Data on 1669 patients with CP from KIMS (Pfizer International Metabolic Database) were analyzed using univariate and multiple Poisson and Cox regression methods. Results:WhenCO-CP andAO-CP groupswere combined, history of stroke and hyperlipidemia increased cardiovascular risk, higher bodymass index (BMI) and radiotherapy increased cerebrovascular risk, and increased waist circumference increased the risk of developing diabetes mellitus (DM). Comparedwith patients with CO-CP, patients with AO-CP had a threefold higher risk of tumor recurrence, whereas being female and previous radiotherapy exposure conferred lower risks. Radiotherapy and older age with every 10 years from disease onset conferred a 2.3-To 3.5-fold risk for developing new intracranial tumors, whereas older age, greater and/or increasing BMI, history of stroke, and lower insulinlike growth factor I (IGF-I) standard deviation scoremeasured at last sampling before death were related to increased all-cause mortality. Compared with the general population, adults with CP had 9.3-, 8.1-, and 2.2-fold risks of developing DM, new intracranial tumors, and early death, respectively. Conclusion: Conventional factors that increase the risks of cardio-And cerebrovascular diseases and DM and risks for developing new intracranial tumors contributed to excess morbidity and mortality. In addition, lower serum IGF-I level measured from the last sample before death was inversely associated with mortality risk in patients with CP.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Clinical Endocrinology and Metabolism
volume
103
issue
2
pages
10 pages
publisher
The Endocrine Society
external identifiers
  • scopus:85041918906
ISSN
0021-972X
DOI
10.1210/jc.2017-01542
language
English
LU publication?
yes
id
0bca347f-58e4-4e46-9572-33049ee18a16
date added to LUP
2018-03-06 11:40:54
date last changed
2018-05-29 11:18:37
@article{0bca347f-58e4-4e46-9572-33049ee18a16,
  abstract     = {<p>Context: In adults, craniopharyngioma (CP) of either childhood-onset (CO-CP) or adult-onset (AOCP) is associated with increased morbidity and mortality, but data on the relative risks (RRs) of contributing factors are lacking. Objective: To assess the RRs of factors contributing to morbidity and mortality in adults with CO-CP and AO-CP. Methods: Data on 1669 patients with CP from KIMS (Pfizer International Metabolic Database) were analyzed using univariate and multiple Poisson and Cox regression methods. Results:WhenCO-CP andAO-CP groupswere combined, history of stroke and hyperlipidemia increased cardiovascular risk, higher bodymass index (BMI) and radiotherapy increased cerebrovascular risk, and increased waist circumference increased the risk of developing diabetes mellitus (DM). Comparedwith patients with CO-CP, patients with AO-CP had a threefold higher risk of tumor recurrence, whereas being female and previous radiotherapy exposure conferred lower risks. Radiotherapy and older age with every 10 years from disease onset conferred a 2.3-To 3.5-fold risk for developing new intracranial tumors, whereas older age, greater and/or increasing BMI, history of stroke, and lower insulinlike growth factor I (IGF-I) standard deviation scoremeasured at last sampling before death were related to increased all-cause mortality. Compared with the general population, adults with CP had 9.3-, 8.1-, and 2.2-fold risks of developing DM, new intracranial tumors, and early death, respectively. Conclusion: Conventional factors that increase the risks of cardio-And cerebrovascular diseases and DM and risks for developing new intracranial tumors contributed to excess morbidity and mortality. In addition, lower serum IGF-I level measured from the last sample before death was inversely associated with mortality risk in patients with CP.</p>},
  author       = {Yuen, Kevin C.J. and Mattsson, Anders F. and Burman, Pia and Erfurth, Eva Marie and Camacho-Hubner, Cecilia and Fox, Janet L. and Verhelst, Johan and Geffner, Mitchell E. and Abs, Roger},
  issn         = {0021-972X},
  language     = {eng},
  month        = {02},
  number       = {2},
  pages        = {768--777},
  publisher    = {The Endocrine Society},
  series       = {Journal of Clinical Endocrinology and Metabolism},
  title        = {Relative risks of contributing factors to morbidity and mortality in adults with craniopharyngioma on growth hormone replacement},
  url          = {http://dx.doi.org/10.1210/jc.2017-01542},
  volume       = {103},
  year         = {2018},
}