Aghi Manish K, Eskandar Emad N, Carter Bob S, Curry William T, Barker Fred G
Neurosurgical Service, Massachusetts General Hospital, Department of Neurosurgery, Harvard Medical School, Boston, Massachusetts, USA.
Neurosurgery. 2007 Oct;61(4):754-60; discussion 760-1. doi: 10.1227/01.NEU.0000298903.63635.E3.
The female preponderance of meningiomas may reflect hormonal influences on meningioma growth. We hypothesized that because obesity affects male steroid hormone synthesis, male patients with meningiomas might exhibit a high obesity rate, which, in turn, might increase their frequency of postoperative complications.
We retrospectively reviewed male patients who underwent craniotomy for benign meningiomas at our institution between 2001 and 2005 (n = 32) and used male patients undergoing craniotomy for aneurysms (n = 32) or glioblastomas (n = 32) from 2001 to 2005 as control subjects. Body mass index (BMI) greater than 30 kg/m was considered obese.
Male patients with meningiomas had a higher average BMI (30.2 kg/m) than male patients with aneurysms (BMI = 27.5 kg/m) or gliomas (BMI = 25.9 kg/m) (P = 0.04). The obesity rate in men with meningiomas (47%) exceeded that in men with aneurysms (19%) or gliomas (3%) (P = 0.2). The median age-normalized BMI percentile was greater in men with meningiomas (67 th percentile) than in men with aneurysms (49th percentile) or gliomas (52 nd percentile) (P = 0.02). Deep vein thrombosis/pulmonary embolus was more common in men with meningiomas (19%) than in men with aneurysms (0%) or gliomas (3%) (P = 0.002). Wound infections were more common in men with meningiomas (6%) than in men with aneurysms (3%) or gliomas (0%) (P = 0.2). The 53% of obese patients with meningiomas who were readmitted with postoperative complications exceeded the 18% of nonobese patients with meningiomas who were readmitted (P = 0.03); complications included deep vein thrombosis and pulmonary embolus (27 and 12%, respectively, in obese and nonobese patients with meningiomas) and postoperative fever (53 and 35%, respectively, in obese and nonobese patients with meningiomas).
We found that many men with meningiomas are obese, suggesting a hormonal influence on meningiomas in men as well as women. Our results also underscore the high risk of postoperative complications in obese male patients with meningiomas.
脑膜瘤在女性中更为常见,这可能反映了激素对脑膜瘤生长的影响。我们推测,由于肥胖会影响男性甾体激素的合成,患有脑膜瘤的男性患者可能具有较高的肥胖率,而这反过来可能会增加他们术后并发症的发生率。
我们回顾性分析了2001年至2005年间在我院接受开颅手术治疗良性脑膜瘤的男性患者(n = 32),并将2001年至2005年间接受开颅手术治疗动脉瘤(n = 32)或胶质母细胞瘤(n = 32)的男性患者作为对照。体重指数(BMI)大于30 kg/m²被视为肥胖。
患有脑膜瘤的男性患者的平均BMI(30.2 kg/m²)高于患有动脉瘤的男性患者(BMI = 27.5 kg/m²)或患有胶质瘤的男性患者(BMI = 25.9 kg/m²)(P = 0.04)。患有脑膜瘤的男性患者的肥胖率(47%)超过了患有动脉瘤的男性患者(19%)或患有胶质瘤的男性患者(3%)(P = 0.02)。患有脑膜瘤的男性患者的年龄标准化BMI百分位数中位数(第67百分位数)高于患有动脉瘤的男性患者(第49百分位数)或患有胶质瘤的男性患者(第52百分位数)(P = 0.02)。脑膜瘤男性患者发生深静脉血栓形成/肺栓塞(19%)比动脉瘤男性患者(0%)或胶质瘤男性患者(3%)更常见(P = 0.002)。伤口感染在脑膜瘤男性患者(6%)中比动脉瘤男性患者(3%)或胶质瘤男性患者(0%)更常见(P = 0.2)。因术后并发症再次入院的肥胖脑膜瘤患者(53%)超过了非肥胖脑膜瘤患者(18%)(P = 0.03);并发症包括深静脉血栓形成和肺栓塞(肥胖和非肥胖脑膜瘤患者分别为27%和12%)以及术后发热(肥胖和非肥胖脑膜瘤患者分别为53%和35%)。
我们发现许多患有脑膜瘤的男性肥胖患者,这表明激素对男性和女性的脑膜瘤均有影响。我们的结果还强调了肥胖男性脑膜瘤患者术后并发症的高风险。