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Hypothalamic involvement predicts cardiovascular risk in adults with childhood onset craniopharyngioma on long-term GH therapy.
Centralsjukhuset, Kristianstad.
Linköping University, Department of Medicine and Health Sciences. Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Internal Medicine . Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
Lund University Hospital.
Lund University Hospital.
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2009 (English)In: European Journal of Endocrinology, ISSN 0804-4643, Vol. 16, 671-679 p.Article in journal (Refereed) Published
Abstract [en]

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 of 28 years (range 17–57) and assessed CVD risk of 20 (4–40) years after first operation. Comparisons were made with matched controls and between patients with tumor growth into the third ventricle (TGTV) versus non-TGTV. GH therapy was 10–12 years in women and men.

Results: In comparison with controls, both male and female patients had increased body mass index, 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 with 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 versus 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.

Place, publisher, year, edition, pages
2009. Vol. 16, 671-679 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-52312DOI: 10.1530/EJE-09-0449OAI: diva2:281308
Available from: 2009-12-15 Created: 2009-12-15 Last updated: 2010-01-14

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Ekman, Bertil
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Department of Medicine and Health SciencesFaculty of Health SciencesInternal Medicine Department of Endocrinology and Gastroenterology UHL
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