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Hypothalamic involvement and insufficient sex steroid supplementation are associated with low bone mineral density in women with childhood onset craniopharyngioma.

Holmer, Helene; Popovic-Brkic, Vera; Ekman, Bertil; Follin, Cecilia LU ; Siversson, Ann-Britt and Erfurth, Eva Marie LU (2011) In European Journal of Endocrinology 165. p.25-31
Abstract
Context: Data on bone mineral density (BMD) are lacking in adults with childhood onset (CO)-craniopharyngioma (CP) with hypothalamic damage from the tumour. In patients with CO GH deficiency BMD increases during GH treatment. Objective: The aims were to evaluate BMD in adults with CO-CPs on complete hormone replacement, including long-term GH and to evaluate the impact of hypothalamic damage on these measures. Design and Participants: BMD (DXA-dual-energy x-ray absorptiometry), markers of bone turn over, physical activity and calcium intake were assessed in 39 CO-CP adults (20 women), median age 28 (17-57) years, in comparison with matched population controls. Results: Late puberty induction was recorded in both genders, but reduced... (More)
Context: Data on bone mineral density (BMD) are lacking in adults with childhood onset (CO)-craniopharyngioma (CP) with hypothalamic damage from the tumour. In patients with CO GH deficiency BMD increases during GH treatment. Objective: The aims were to evaluate BMD in adults with CO-CPs on complete hormone replacement, including long-term GH and to evaluate the impact of hypothalamic damage on these measures. Design and Participants: BMD (DXA-dual-energy x-ray absorptiometry), markers of bone turn over, physical activity and calcium intake were assessed in 39 CO-CP adults (20 women), median age 28 (17-57) years, in comparison with matched population controls. Results: Late puberty induction was recorded in both genders, but reduced androgen levels in females only. Only CP-women had lower BMD (P=0.03) at L2-L4, and reduced Z-scores at femoral neck (P=0.004) and L2-L4 (P=0.004). Both genders had increased serum leptin levels (P=0.001), which correlated significantly negatively with BMD at L2-L4 (P=0.003; r = -0.5) and 45% of CP-women had Z-score levels ≤ -2.0 SDS. Furthermore, 75% of those with a Z-score ≤ -2.0 SDS had hypothalamic involvement by the tumour. Calcium intake (P=0.008) and physical activity (P=0.007) levels were reduced in CP men only. Levels of ostecalcin and crossLaps were increased in CP men only. Conclusions: Despite continuous GH therapy low BMD was recorded in CO-CP females. Insufficient estrogen and androgen supplementation during adolescence was the main cause, but hypothalamic involvement with consequent leptin resistance, was also strongly associated with low BMD in both genders. (Less)
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organization
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type
Contribution to journal
publication status
published
subject
in
European Journal of Endocrinology
volume
165
pages
25 - 31
publisher
Society of the European Journal of Endocrinology
external identifiers
  • wos:000291790800004
  • pmid:21502326
  • scopus:79959463647
ISSN
1479-683X
DOI
10.1530/EJE-11-0229
language
English
LU publication?
yes
id
c8f24af7-602c-470a-aaaf-042258bece38 (old id 1936949)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21502326?dopt=Abstract
date added to LUP
2011-05-02 14:59:30
date last changed
2017-11-19 04:17:09
@article{c8f24af7-602c-470a-aaaf-042258bece38,
  abstract     = {Context: Data on bone mineral density (BMD) are lacking in adults with childhood onset (CO)-craniopharyngioma (CP) with hypothalamic damage from the tumour. In patients with CO GH deficiency BMD increases during GH treatment. Objective: The aims were to evaluate BMD in adults with CO-CPs on complete hormone replacement, including long-term GH and to evaluate the impact of hypothalamic damage on these measures. Design and Participants: BMD (DXA-dual-energy x-ray absorptiometry), markers of bone turn over, physical activity and calcium intake were assessed in 39 CO-CP adults (20 women), median age 28 (17-57) years, in comparison with matched population controls. Results: Late puberty induction was recorded in both genders, but reduced androgen levels in females only. Only CP-women had lower BMD (P=0.03) at L2-L4, and reduced Z-scores at femoral neck (P=0.004) and L2-L4 (P=0.004). Both genders had increased serum leptin levels (P=0.001), which correlated significantly negatively with BMD at L2-L4 (P=0.003; r = -0.5) and 45% of CP-women had Z-score levels ≤ -2.0 SDS. Furthermore, 75% of those with a Z-score ≤ -2.0 SDS had hypothalamic involvement by the tumour. Calcium intake (P=0.008) and physical activity (P=0.007) levels were reduced in CP men only. Levels of ostecalcin and crossLaps were increased in CP men only. Conclusions: Despite continuous GH therapy low BMD was recorded in CO-CP females. Insufficient estrogen and androgen supplementation during adolescence was the main cause, but hypothalamic involvement with consequent leptin resistance, was also strongly associated with low BMD in both genders.},
  author       = {Holmer, Helene and Popovic-Brkic, Vera and Ekman, Bertil and Follin, Cecilia and Siversson, Ann-Britt and Erfurth, Eva Marie},
  issn         = {1479-683X},
  language     = {eng},
  pages        = {25--31},
  publisher    = {Society of the European Journal of Endocrinology},
  series       = {European Journal of Endocrinology},
  title        = {Hypothalamic involvement and insufficient sex steroid supplementation are associated with low bone mineral density in women with childhood onset craniopharyngioma.},
  url          = {http://dx.doi.org/10.1530/EJE-11-0229},
  volume       = {165},
  year         = {2011},
}