Risk factors for obesity in childhood survivors of suprasellar brain tumours: a retrospective study
Ngee Lek1, Philippa Prentice, Rachel M Williams
1Department of Paediatrics, University of Cambridge, UK.
Insights
Childhood brain tumor survivors, especially girls, face a high risk of obesity post-diagnosis. Early identification of risk factors like female gender and higher baseline BMI is crucial for intervention.
Area of Science:
- Pediatric Endocrinology
- Neuro-oncology
- Pediatric Oncology
Background:
- Childhood brain tumors, particularly suprasellar types, can lead to significant long-term health issues.
- Body Mass Index (BMI) changes and obesity are common concerns in survivors of childhood cancers.
- Understanding post-diagnosis BMI trajectories is vital for managing long-term health in these young patients.
Purpose of the Study:
- To analyze changes in Body Mass Index (BMI) after diagnosis in children treated for suprasellar brain tumors.
- To identify specific risk factors associated with the development of obesity in this survivor population.
Main Methods:
- Retrospective analysis of 46 childhood suprasellar brain tumor survivors (16 boys, 30 girls).
- Median follow-up of 3.93 years post-diagnosis.
- Survival analyses were employed to determine obesity risk factors.
Main Results:
- Obesity prevalence increased from 6% at diagnosis to 43% at last follow-up (p < 0.001).
- Girls showed a significantly greater increase in BMI SDS in the first year post-diagnosis compared to boys (p = 0.01).
- Female gender (HR 5.0) and higher baseline BMI (HR 4.7) were identified as significant risk factors for developing obesity.
Conclusions:
- Childhood suprasellar brain tumor survivors experience a substantial increase in obesity post-diagnosis.
- Female survivors and those with a higher baseline BMI are at increased risk.
- Early prediction and targeted interventions are essential for managing obesity in high-risk survivors.
Aim:
To characterize postdiagnosis changes in body mass index (BMI) among childhood survivors of suprasellar brain tumours, and to determine the risk factors associated with obesity.
Methods:
We conducted a retrospective analysis of 46 children (16 boys and 30 girls) with median (IQR) age of 7.49 (3.47-11.59) years at tumour diagnosis, and followed up for 3.93 (1.68-7.27) years. Survival analyses were used to identify risks of developing obesity.
Results:
There were no sex differences in age at tumour diagnosis, duration of follow-up, tumour types, endocrinopathies, treatment modalities or baseline BMI SDS. In the first year after tumour diagnosis, ΔBMI SDS (median; IQR) was greater in girls (1.32; 0.07-2.08) than in boys (0.48; -0.40 to 0.89) (p = 0.01). At diagnosis, 3/46 children (6%) were obese; this increased to 20/46 (43%) by last follow-up (p < 0.001) and was more common in girls (17/30; 57%) than in boys (3/16; 19%). Female gender (hazard ratio 5.0, 95% CI 1.2-21.7; p = 0.04) and greater than average baseline BMI (hazard ratio 4.7, 95% CI 1.1-20.8; p = 0.02) were risk factors for subsequent obesity.
Conclusion:
Accurate prediction of obesity risk is important and would allow early targeted intervention in high-risk patients.
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