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Development and validation of a predictive model for hypothalamic obesity following craniopharyngioma resection
Qianshuai Li1, Linlin Zhao1, Fengjuan Huang1
1Department of Endocrinology and Metabolic Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China.
Objective:
To analyze the risk factors for hypothalamic obesity (HO) after craniopharyngioma surgery, construct a predictive model and verify its efficacy.
Methods:
A retrospective analysis was conducted on 136 patients diagnosed with craniopharyngioma at The First Affiliated Hospital of Zhengzhou University between September 2018 and February 2024. Clinical and follow-up data were collected and split into training and validation cohorts (7: 3) randomly and divided into HO and non-HO groups post-surgery. Logistic regression was used to analyse risk factors for postoperative HO, and a prediction model was constructed and its efficacy was verified.
Results:
In the training cohort, the preoperative body mass index (BMI), preoperative serum sodium, preoperative uric acid levels, postoperative calcium levels, the probability of intraoperative blood loss ≥ 100 ml and preoperative hypothalamic injury and T-type tumors were higher in HO group. Small tumors (< 5 cm³) were less frequent in HO group (all P < 0.05). Logistic regression analysis showed that preoperative high BMI and intraoperative blood loss ≥ 100 ml were independent risk factors for postoperative HO, while older age at onset and smaller tumor size were protective factors (all P < 0.05). The model developed from the training cohort showed that the area under the receiver operating characteristic curve (AUC) was 0.865(95%CI of 0.793 ~ 0.937), with a sensitivity of 79.5% and a specificity of 80.8%, the validation cohort had an AUC of 0.864(95%CI:0.744-0.983), with a sensitivity of 90.9% and a specificity of 72.2%. The calibration curve and Hosmer-Lemeshow test demonstrated that the predicted value of the model was in agreement with the observed values in both the training and verification cohorts (P > 0.05).
Conclusion:
Preoperative high BMI and intraoperative blood loss ≥ 100 ml are independent risk factors for HO after craniopharyngioma surgery. A predictive model based on preoperative BMI, age at onset, intraoperative blood loss, and tumor size shows potential for predicting the risk of postoperative HO, aiding in early identification for high-risk patients.
Clinical Trial Number:
Not applicable.
