Bretault Marion, Laroche Suzanne, Lacorte Jean-Marc, Barsamian Charles, Polak Michel, Raffin-Sanson Marie-Laure, Touraine Philippe, Bouillot Jean-Luc, Czernichow Sebastien, Carette Claire
Department of Nutrition, Ambroise Paré Hospital, AP-HP, Université de Versailles Saint-Quentin en Yvelines, Boulogne-Billancourt, 92100, France.
Department of Oncology and Endocrine Biochemistry, Pitié-Salpétrière Hospital, AP-HP, Paris, France.
Obes Surg. 2016 May;26(5):1133-7. doi: 10.1007/s11695-015-1977-z.
Craniopharyngiomas are rare cerebral tumors associated with severe obesity after hypothalamic surgery. A meta-analysis showed significant weight loss at 1 year after bariatric surgery in these patients even though more modest than in common causes of obesity. We hypothesized that this discrepancy could be partly explained by differences in GLP-1 secretion after surgery since patients with craniopharyngioma present a significantly higher degree of insulin resistance and hyperinsulinism than common obese control. We report three cases of bariatric surgery in patients presenting with hypothalamique obesity related to craniopharyngiomas. At 18 months, the mean weight loss was 20 kg with expected insulin resistance decrease. Before surgery, standardized test meal shows abolition of postprandial GLP-1 secretion in all patients with a progressive restoration in the patients with gastric bypass (GBP) surgery.
颅咽管瘤是一种罕见的脑肿瘤，与下丘脑手术后的严重肥胖有关。一项荟萃分析显示，这些患者在接受减肥手术后1年体重显著减轻，尽管比常见肥胖原因导致的体重减轻幅度小。我们推测，这种差异部分可以通过手术后胰高血糖素样肽-1（GLP-1）分泌的差异来解释，因为颅咽管瘤患者比普通肥胖对照组存在显著更高程度的胰岛素抵抗和高胰岛素血症。我们报告了3例因颅咽管瘤导致下丘脑性肥胖患者接受减肥手术的病例。在18个月时，平均体重减轻20千克，胰岛素抵抗如预期般降低。手术前，标准化测试餐显示所有患者餐后GLP-1分泌均消失，而接受胃旁路（GBP）手术的患者其分泌逐渐恢复。
