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Resting energy expenditure in children at risk of hypothalamic dysfunction

J Van Schaik1,2, M Burghard2,3, M H Lequin2,4

  • 1Division of Pediatric Endocrinology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.

Endocrine Connections
|July 29, 2022
PubMed

Insights

Resting energy expenditure (REE) may decrease in children with hypothalamic dysfunction (HD), particularly those with severe symptoms or posterior hypothalamic damage. Measuring REE can help guide obesity treatment strategies in these children.

Area of Science:

  • Pediatric Endocrinology
  • Neuroendocrinology
  • Metabolic Research

Background:

  • Suprasellar brain damage poses a risk for hypothalamic dysfunction (HD) in children.
  • Hypothalamic dysfunction can lead to decreased resting energy expenditure (REE), but this is not universal.
  • Identifying children with HD who experience reduced REE is crucial for appropriate management.

Purpose of the Study:

  • To determine which children at risk for HD exhibit low REE.
  • To investigate the association between reduced REE and the clinical severity of HD.
  • To explore the relationship between low REE and the extent of radiological hypothalamic damage.

Main Methods:

  • A retrospective cohort study compared measured REE (mREE) to predicted REE (pREE) in children at risk of HD.
  • Low REE was defined as mREE less than 90% of pREE.
  • The mREE/pREE quotient was analyzed against clinical HD scores and radiological hypothalamic damage.

Main Results:

  • Of 67 children studied (mostly with brain tumors), 67.2% had low mREE.
  • Children with severe HD showed significantly lower mREE/pREE quotients than those with mild or moderate HD.
  • Posterior hypothalamic damage correlated with lower mREE/pREE quotients; tumor progression, severe HD, and panhypopituitarism with diabetes insipidus were risk factors for reduced REE.

Conclusions:

  • Reduced REE is associated with the severity of clinical hypothalamic dysfunction in children.
  • REE measurement can differentiate children with mild/moderate HD who might benefit from REE-increasing obesity treatments versus those needing other interventions.
Abstract

Keywords:
hypothalamic obesityposterior hypothalamic damageresting energy expendituresuprasellar tumor

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