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Blood Lipid Disorders in Post-Operative Craniopharyngioma Children and Adolescents and the Improvement with
Han-Ze Du1, Kang Chen1, Li-Yuan Zhang1
1Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, People's Republic of China.
Insights
Children with craniopharyngioma (CP) often have abnormal blood lipids. Recombinant human growth hormone (rhGH) replacement therapy significantly improved the lipid profiles in these pediatric patients.
Area of Science:
- Pediatric Endocrinology
- Neuro-oncology
- Metabolic Disorders
Background:
- Craniopharyngioma (CP) survivors frequently experience hypothalamic obesity and dyslipidemia post-surgery.
- Limited research exists on pediatric CP patients' lipid profiles, with conflicting findings.
- The impact of recombinant human growth hormone (rhGH) on lipid metabolism in these patients remains unclear.
Purpose of the Study:
- To compare blood lipid profiles in post-operative pediatric craniopharyngioma patients versus healthy controls.
- To evaluate the effects of rhGH replacement therapy on lipid parameters in these patients.
Main Methods:
- Retrospective analysis of 79 pediatric craniopharyngioma patients.
- Comparison of lipid profiles between 36 patients receiving rhGH and 19 patients not receiving rhGH.
- Analysis of lipid changes in 20 patients before and after at least one year of rhGH therapy.
Main Results:
- Craniopharyngioma patients exhibited significantly higher total cholesterol, triglycerides, and LDL-C, and lower HDL-C compared to controls (p < 0.001).
- Obesity status did not significantly alter the lipid profile in CP patients.
- rhGH replacement led to significant reductions in total cholesterol (0.90 mmol/L) and LDL-C (0.73 mmol/L) from baseline.
- Patients on rhGH therapy showed lower LDL-C compared to those not on therapy, even with higher baseline LDL-C.
Conclusions:
- Pediatric craniopharyngioma patients, regardless of obesity, present with unfavorable lipid profiles.
- rhGH replacement therapy demonstrates a beneficial effect on improving lipid profiles in children and adolescents with craniopharyngioma.
Context:
The high prevalence of hypothalamic obesity (HO) and dyslipidemia in individuals with craniopharyngioma (CP) following surgery is a cause for increasing concern. However, few studies have explored the lipid profile in pediatric CP patients, with inconsistent findings. In addition, the role of recombinant human growth hormone (rhGH) replacement remains unclear in these patients.
Objective:
To compare the blood lipid profile among post-operative craniopharyngioma children and adolescents with that among healthy controls and to reveal the effects of rhGH replacement.
Methods:
Data of 79 post-operative craniopharyngioma children and adolescents in our center were retrospectively collected. Sixty patients underwent rhGH replacement during the follow-ups. We selected 36 patients who received rhGH replacement therapy, while 20 patients received rhGH replacement for at least 1 year and had complete lipid data before and after treatment and compared them with 19 patients who did not receive rhGH replacement therapy.
Results:
Craniopharyngioma patients had higher total cholesterol (TC) (5.17 vs 3.77 mmol/L), triglyceride (TG) (1.51 vs 0.73 mmol/L), and low-density lipoprotein cholesterol (LDL-C) (3.14 vs 2.10 mmol/L), and lower high-density lipoprotein cholesterol (HDL-C) (1.06 vs 1.39 mmol/L) than controls (all p < 0.001). The lipid profile of obese and non-obese patients was not significantly different. After rhGH replacement, TC was 0.90 mmol/L lower (p = 0.002) and LDL-C was 0.73 mmol/L lower (p = 0.010) than baseline. Although the baseline LDL-C was higher, patients with rhGH replacement had lower LDL-C (-0.73 mmol/L adjusted for age and sex, p = 0.045) after the initiation of replacement compared with patients without rhGH replacement.
Conclusion:
The lipid profile of obese and non-obese children and adolescents with craniopharyngioma was unfavorable, and rhGH replacement could improve their lipid profile.
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