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Hypothalamic involvement predicts cardiovascular risk in adults with childhood onset craniopharyngioma on long-term GH therapy.

Holmer, Helene LU ; Ekman, Bertil; Björk, Jonas LU ; Nordström, Carl-Henrik LU ; Popovic, Vera; Siverson, Annbritt and Erfurth, Eva Marie LU (2009) In European Journal of Endocrinology1994-01-01+01:00 161. p.671-679
Abstract
Context: Craniopharyngioma patients without GH therapy are at an increased cardiovascular disease (CVD) risk and particularly concerning women. No previous study on long-term GH therapy in adults with childhood onset (CO) craniopharyngioma was identified. Objective: To investigate CVD risk in adults with CO craniopharyngioma, on complete hormone replacement, including long-term GH therapy, and to investigate the impact of disease-related factors on CVD risk. Design and Participants: In a cross-sectional study of operated CO craniopharyngiomas (1958-2000) from a defined area of Sweden (2.5 million) we enrolled 42 patients (20 women) with a median age 28 (range 17-57) years and assessed CVD risk 20 (4-40) years after first operation.... (More)
Context: Craniopharyngioma patients without GH therapy are at an increased cardiovascular disease (CVD) risk and particularly concerning women. No previous study on long-term GH therapy in adults with childhood onset (CO) craniopharyngioma was identified. Objective: To investigate CVD risk in adults with CO craniopharyngioma, on complete hormone replacement, including long-term GH therapy, and to investigate the impact of disease-related factors on CVD risk. Design and Participants: In a cross-sectional study of operated CO craniopharyngiomas (1958-2000) from a defined area of Sweden (2.5 million) we enrolled 42 patients (20 women) with a median age 28 (range 17-57) years and assessed CVD risk 20 (4-40) years after first operation. Comparisons were made with matched controls and between patients with tumour growth into the third ventricle (TGTV) vs non-TGTV. GH therapy was 10-12 years in women and men. Results: In comparison to controls, both male and female patients had increased BMI, fat mass, insulin and leptin levels. Overall, while not significantly increased in male patients, 55-60% of female patients had a medium-high CVD risk, compared to 10-20% in controls. An increased CVD risk (all P < 0.05) and higher levels of fat mass and insulin were recorded in the TGTV group vs the non-TGTV group. Late puberty induction and lack of androgens were shown in female patients. Conclusions: Adult patients with CO craniopharyngioma, especially those with TGTV, have persistently increased CVD risk. Conventional hormone substitution, including GH, is insufficient to normalize CVD risk, suggesting an important role for irreversible hypothalamic dysfunction. (Less)
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author
organization
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type
Contribution to journal
publication status
published
subject
in
European Journal of Endocrinology1994-01-01+01:00
volume
161
pages
671 - 679
publisher
Society of the European Journal of Endocrinology
external identifiers
  • wos:000272527300003
  • pmid:19667040
  • scopus:70449717048
ISSN
1479-683X
DOI
10.1530/EJE-09-0449
language
English
LU publication?
yes
id
764c8cb8-f1c1-4b42-b811-2825919130ee (old id 1469875)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19667040?dopt=Abstract
date added to LUP
2009-09-02 15:42:48
date last changed
2017-11-19 04:17:51
@article{764c8cb8-f1c1-4b42-b811-2825919130ee,
  abstract     = {Context: Craniopharyngioma patients without GH therapy are at an increased cardiovascular disease (CVD) risk and particularly concerning women. No previous study on long-term GH therapy in adults with childhood onset (CO) craniopharyngioma was identified. Objective: To investigate CVD risk in adults with CO craniopharyngioma, on complete hormone replacement, including long-term GH therapy, and to investigate the impact of disease-related factors on CVD risk. Design and Participants: In a cross-sectional study of operated CO craniopharyngiomas (1958-2000) from a defined area of Sweden (2.5 million) we enrolled 42 patients (20 women) with a median age 28 (range 17-57) years and assessed CVD risk 20 (4-40) years after first operation. Comparisons were made with matched controls and between patients with tumour growth into the third ventricle (TGTV) vs non-TGTV. GH therapy was 10-12 years in women and men. Results: In comparison to controls, both male and female patients had increased BMI, fat mass, insulin and leptin levels. Overall, while not significantly increased in male patients, 55-60% of female patients had a medium-high CVD risk, compared to 10-20% in controls. An increased CVD risk (all P &lt; 0.05) and higher levels of fat mass and insulin were recorded in the TGTV group vs the non-TGTV group. Late puberty induction and lack of androgens were shown in female patients. Conclusions: Adult patients with CO craniopharyngioma, especially those with TGTV, have persistently increased CVD risk. Conventional hormone substitution, including GH, is insufficient to normalize CVD risk, suggesting an important role for irreversible hypothalamic dysfunction.},
  author       = {Holmer, Helene and Ekman, Bertil and Björk, Jonas and Nordström, Carl-Henrik and Popovic, Vera and Siverson, Annbritt and Erfurth, Eva Marie},
  issn         = {1479-683X},
  language     = {eng},
  pages        = {671--679},
  publisher    = {Society of the European Journal of Endocrinology},
  series       = {European Journal of Endocrinology1994-01-01+01:00},
  title        = {Hypothalamic involvement predicts cardiovascular risk in adults with childhood onset craniopharyngioma on long-term GH therapy.},
  url          = {http://dx.doi.org/10.1530/EJE-09-0449},
  volume       = {161},
  year         = {2009},
}