The effect of hypothalamic involvement and growth hormone treatment on cardiovascular risk factors during the transition period in patients with childhood-onset craniopharyngioma

Park, Sang Hee; Lee, Yun Jeong; Cheon, Jung-Eun; Shin, Choong Ho; Jung, Haewoon; Lee, Young Ah

doi:.0.0.0

Ann Pediatr Endocrinol Metab > Accepted Articles

Original article

DOI: https://doi.org/10.6065/apem.2244046.023 [Accepted] Published online June 30, 2022.

The effect of hypothalamic involvement and growth hormone treatment on cardiovascular risk factors during the transition period in patients with childhood-onset craniopharyngioma

Sang Hee Park¹, Yun Jeong Lee¹, Jung-Eun Cheon², Choong Ho Shin¹, Haewoon Jung³

, Young Ah Lee¹

¹Department of Pediatrics, Seoul National University Children
²Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
³Department of Pediatrics, Kyung Hee University Medical Center, Seoul, Korea

Address for correspondence: Haewoon Jung
Email: woonieya@gmail.com

Received: February 22, 2022 Revised: May 12, 2022 Accepted: June 10, 2022

Abstract

Purpose
Hypothalamic damage may increase the risk of adulthood obesity and cardiovascular disease in craniopharyngioma. We evaluated the effects of hypothalamic involvement (HI) and growth hormone (GH) discontinuation on cardiovascular risk factors during the transition period in patients with childhood-onset craniopharyngioma.
Methods
Thirty-three patients (17 males, 16 females) underwent retesting for adult GH deficiency (GHD) in 2005-2020 at Seoul National University Children’s Hospital. Postoperative HI was graded by Puget’s criteria and data regarding GH replacement was collected. At retesting, body mass index (BMI), fasting blood glucose, insulin, high-density lipoprotein cholesterol (HDL-C), triglycerides, and blood pressure were assessed.
Results
The mean age of commencement and discontinuation of GH replacement for childhood GHD was 10.0 ± 3.6 and 15.3 ± 3.1 years, respectively. The mean age at retesting for adult GHD was 17.7 ± 2.5 years. When patients were categorized by post-GH discontinuation duration, those with durations > 6 months (n = 27) showed lower HDL-C levels than those < 6 months (p = 0.037). Patients with extensive HI (n = 16) showed higher BMI z-score than those with none or mild HI (p = 0.020). Both the extent of HI and longer post-GH discontinuation duration were significantly predictive for decreased HDL-C levels (p < 0.05, for both).
Conclusion
The extent of HI and GH discontinuation duration during the transition period can increase cardiovascular risk in patients with childhood-onset craniopharyngioma.

Keywords: Craniopharyngioma, Hypothalamus, Growth hormone, Cardiovascular disease, Dyslipidemias