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颅咽管瘤与代谢综合征:一项单中心5年随访经验

Craniopharyngioma and Metabolic Syndrome: A 5-Year Follow-Up Single-Center Experience.

作者信息

Scarano Elisabetta, Solari Domenico, Riccio Enrico, Arianna Rossana, Somma Teresa, Cavallo Luigi Maria, Romano Fiammetta, Colao Annamaria, Di Somma Carolina

机构信息

Endocrinology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.

Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy.

出版信息

Front Neurol. 2022 Mar 9;13:783737. doi: 10.3389/fneur.2022.783737. eCollection 2022.

Abstract

Patients with craniopharyngioma often have comorbidities, such as obesity and hypopituitarism. These two conditions affect each other and worsen the quality of life of patients, which lead to a higher risk of morbidity and mortality. In addition, abdominal obesity, measured as waist circumference (WC), is together with other parameters [arterial hypertension, hyperglycemia, hypertriglyceridemia, and reduced levels of high-density lipoprotein (HDL) cholesterol], one of the components of metabolic syndrome (MS). Each one of these morbidities occurs in patients with craniopharyngioma more frequently than in the remaining population. On these bases, we evaluated metabolic parameters in patients with craniopharyngioma at the time of diagnosis and after a 5-year follow-up, which compares these data with those of age-, gender-, WC-, and body mass index (BMI)-matched controls. In addition, we evaluated the prevalence of MS according to IDF criteria (MS-IDF) and the prevalence of MS according to ATP III (MS-ATPIII) criteria in patients and controls at baseline and after 5 years. We recruited 20 patients with craniopharyngioma (age 38.5 ± 15 years, 10 M) and 20 age-, gender-, WC- and BMI-matched controls (age 34.16 ± 13.19 years, 10 M). In all patients and controls, we evaluated the following: anthropometric features [height, weight, BMI, WC, hip circumference (HC) and waist-to-hip ratio (WHR)], systolic blood pressure (SBP) and diastolic blood pressure (DBP), lipid profile [total cholesterol (TC), HDL, low-density lipoprotein (LDL) cholesterol, triglycerides (TG)], and blood glucose at baseline and after 5 years. The prevalence of MS, according to IDF and ATPIII criteria, was calculated in the two groups at baseline and after 5 years. According to our results, at baseline, patients with craniopharyngioma had a worse metabolic profile than controls and a higher prevalence of MS. Besides, at a 5-year follow-up, patients still had impaired metabolic characteristics and more frequent MS (according to IDF and ATPIII criteria) when compared to controls. These data confirm that MS in patients with craniopharyngioma is unresponsive to life-changing interventions and to a common pharmacological approach. Other factors may be involved in the evolution of these conditions; so, further studies are needed to establish the correct management of these patients.

摘要

颅咽管瘤患者常伴有多种合并症,如肥胖和垂体功能减退。这两种情况相互影响,恶化患者的生活质量,导致更高的发病和死亡风险。此外,以腰围(WC)衡量的腹型肥胖与其他参数[动脉高血压、高血糖、高甘油三酯血症和高密度脂蛋白(HDL)胆固醇水平降低]一起,是代谢综合征(MS)的组成部分之一。这些合并症在颅咽管瘤患者中出现的频率均高于其他人群。基于这些情况,我们评估了颅咽管瘤患者诊断时及5年随访后的代谢参数,并将这些数据与年龄、性别、WC和体重指数(BMI)匹配的对照组进行比较。此外,我们还评估了患者和对照组在基线时以及5年后根据国际糖尿病联盟(IDF)标准(MS-IDF)的MS患病率和根据美国国家胆固醇教育计划成人治疗小组第三次报告(ATP III)标准(MS-ATPIII)的MS患病率。我们招募了20例颅咽管瘤患者(年龄38.5±15岁,男性10例)和20例年龄、性别、WC和BMI匹配的对照组(年龄34.16±13.19岁,男性10例)。对所有患者和对照组,我们评估了以下指标:人体测量学特征[身高、体重、BMI、WC、臀围(HC)和腰臀比(WHR)]、收缩压(SBP)和舒张压(DBP)、血脂谱[总胆固醇(TC)、HDL、低密度脂蛋白(LDL)胆固醇、甘油三酯(TG)]以及基线时和5年后的血糖。计算了两组在基线时和5年后根据IDF和ATPIII标准的MS患病率。根据我们的结果,在基线时,颅咽管瘤患者的代谢状况比对照组差,MS患病率更高。此外,在5年随访时,与对照组相比,患者的代谢特征仍然受损,MS(根据IDF和ATPIII标准)更频繁。这些数据证实,颅咽管瘤患者的MS对改变生活方式的干预措施和常见的药物治疗方法无反应。可能有其他因素参与了这些情况的发展;因此,需要进一步研究以确定对这些患者的正确管理方法。

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Craniopharyngioma in Children: Long-term Outcomes.儿童颅咽管瘤:长期预后
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