Jiska van Schaik1,2, Ichelle M A A van Roessel1, Netteke A Y N Schouten-van Meeteren2, Laura van Iersel1, Sarah C Clement3, Annemieke M Boot4, Hedi L Claahsen-van der Grinten5, Marta Fiocco2,6, Geert O Janssens2,7, Dannis G van Vuurden2, Erna M Michiels2, Sen K S Han2,8, Paul A S P van Trotsenburg9, Peter W P Vandertop10, Leontien C M Kremer2, Hanneke M van Santen1,2. 1. Department of Pediatric Endocrinology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands. 2. Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands. 3. Department of Pediatrics, VU Amsterdam University Medical Centers, Amsterdam, the Netherlands. 4. Department of Pediatric Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. 5. Department of Pediatrics, Amalia Children's Hospital, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands. 6. Institute of Mathematics, Leiden University, Leiden, the Netherlands. 7. Department of Radiation Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands. 8. Department of Neurosurgery, University Medical Center Utrecht, Utrecht, the Netherlands. 9. Department of Pediatric Endocrinology, Emma Children's Hospital, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands. 10. Neurosurgical Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands.
Abstract
PURPOSE: Childhood brain tumor survivors (CBTS) are at risk for developing obesity, which negatively influences cardiometabolic health. The prevalence of obesity in CBTS may have been overestimated in previous cohorts because of inclusion of children with craniopharyngioma. On the contrary, the degree of weight gain may have been underestimated because of exclusion of CBTS who experienced weight gain, but were neither overweight nor obese. Weight gain may be an indicator of underlying hypothalamic-pituitary (HP) dysfunction. We aimed to study prevalence of and risk factors for significant weight gain, overweight, or obesity, and its association with HP dysfunction in a national cohort of noncraniopharyngioma and nonpituitary CBTS. METHODS: Prevalence of and risk factors for significant weight gain (body mass index [BMI] change ≥ +2.0 standard deviation score [SDS]), overweight, or obesity at follow-up, and its association with HP dysfunction were studied in a nationwide cohort of CBTS, diagnosed in a 10-year period (2002-2012), excluding all craniopharyngioma and pituitary tumors. RESULTS: Of 661 CBTS, with a median age at follow-up of 7.3 years, 33.1% had significant weight gain, overweight, or obesity. Of the CBTS between 4 and 20 years of age, 28.7% were overweight or obese, compared with 13.2% of the general population between 4 and 20 years of age. BMI SDS at diagnosis, diagnosis of low-grade glioma, diabetes insipidus, and central precocious puberty were associated with weight gain, overweight, or obesity. The prevalence of HP dysfunction was higher in overweight and obese CTBS compared with normal-weight CBTS. CONCLUSION: Overweight, obesity, and significant weight gain are prevalent in CBTS. An increase in BMI during follow-up may be a reflection of HP dysfunction, necessitating more intense endocrine surveillance.
PURPOSE: Childhood brain tumor survivors (CBTS) are at risk for developing obesity, which negatively influences cardiometabolic health. The prevalence of obesity in CBTS may have been overestimated in previous cohorts because of inclusion of children with craniopharyngioma. On the contrary, the degree of weight gain may have been underestimated because of exclusion of CBTS who experienced weight gain, but were neither overweight nor obese. Weight gain may be an indicator of underlying hypothalamic-pituitary (HP) dysfunction. We aimed to study prevalence of and risk factors for significant weight gain, overweight, or obesity, and its association with HP dysfunction in a national cohort of noncraniopharyngioma and nonpituitary CBTS. METHODS: Prevalence of and risk factors for significant weight gain (body mass index [BMI] change ≥ +2.0 standard deviation score [SDS]), overweight, or obesity at follow-up, and its association with HP dysfunction were studied in a nationwide cohort of CBTS, diagnosed in a 10-year period (2002-2012), excluding all craniopharyngioma and pituitary tumors. RESULTS: Of 661 CBTS, with a median age at follow-up of 7.3 years, 33.1% had significant weight gain, overweight, or obesity. Of the CBTS between 4 and 20 years of age, 28.7% were overweight or obese, compared with 13.2% of the general population between 4 and 20 years of age. BMI SDS at diagnosis, diagnosis of low-grade glioma, diabetes insipidus, and central precocious puberty were associated with weight gain, overweight, or obesity. The prevalence of HP dysfunction was higher in overweight and obese CTBS compared with normal-weight CBTS. CONCLUSION: Overweight, obesity, and significant weight gain are prevalent in CBTS. An increase in BMI during follow-up may be a reflection of HP dysfunction, necessitating more intense endocrine surveillance.
Authors: I M A A van Roessel; J van Schaik; A Y N Schouten-van Meeteren; A M Boot; H L Claahsen-van der Grinten; S C Clement; L van Iersel; K S Han; A S P van Trotsenburg; W P Vandertop; L C M Kremer; H M van Santen Journal: Support Care Cancer Date: 2022-04-13 Impact factor: 3.359
Authors: Ichelle M A A van Roessel; Antoinette Y N Schouten-van Meeteren; Lisethe Meijer; Eelco W Hoving; Boudewijn Bakker; Hanneke M van Santen Journal: Front Endocrinol (Lausanne) Date: 2022-04-06 Impact factor: 6.055