颅内生殖细胞肿瘤患者超重/肥胖和血脂异常的高发率。

High prevalence of overweight/obesity and dyslipidemia in patients with intracranial germ cell tumors.

机构信息

Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Shuaifuyuan 1, Dongcheng District, Beijing, 100730, China.

Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

Pituitary. 2022 Dec;25(6):938-947. doi: 10.1007/s11102-022-01274-4. Epub 2022 Sep 10.

DOI:10.1007/s11102-022-01274-4

PMID:36088446

Abstract

PURPOSE

To evaluate the prevalence of overweight/obesity and dyslipidemia in patients with intracranial germ cell tumor (iGCT), and to explore the risk factors of it.

METHODS

iGCT patients visiting Peking Union Medical College Hospital between Jan 2008 to Oct 2020 were included. The prevalence of overweight/obesity and dyslipidemia was calculated. Mixed-effects models were used to evaluate the relationship between BMI z-scores, concentration of lipid profiles and potential risk factors.

RESULTS

One hundred and six patients were included. The median follow-up time was 27 (IQR 5-59) months. The number of patients diagnosed with overweight/obesity and dyslipidemia were 49 (46.2%) and 86 (81.1%) during visits. Higher BMI z-scores were associated with treatment (mean difference (MD) 0.51, 95%CI 0.31-0.72), surgical biopsies (MD 0.71, 95%CI 0.16-1.25), adrenal insufficiency (MD 0.37, 95%CI 0.07-0.68), hypothyroidism (MD 0.35, 95%CI 0.06-0.63), glucocorticoid supplementation (MD 0.64, 95%CI 0.40-0.87), and thyroxine supplementation (MD 0.48, 95%CI 0.24-0.72). Hypothalamus involvement was associated with increased TC (MD 0.52, 95%CI 0.06-0.98), TG (MD 0.36, 95%CI 0.01-0.72), LDL-C (MD 0.60, 95%CI 0.20-0.98), and decreased HDL-C (MD - 0.23, 95%CI - 0.44 to - 0.02). Higher TC (MD 0.53, 95%CI 0.26-0.80) and LDL-C (MD 0.39, 95%CI 0.17-0.62) were observed in patients after treatment. Glucocorticoid supplementation was associated with increased TC (MD 0.70, 95%CI 0.38-1.03), LDL-C (MD 0.51, 95%CI 0.24-0.78), and HDL-C (MD 0.25, 95%CI 0.09-0.40), while sex hormone supplementation was associated with decreased TC (MD - 0.74, 95%CI - 1.2 to - 0.29) and TG (MD - 0.47, 95%CI - 0.86 to - 0.08).

CONCLUSION

Overweight/obesity and dyslipidemia were high prevalent in iGCT patients and should be screened during follow-ups.

摘要

目的

评估颅内生殖细胞瘤（iGCT）患者超重/肥胖和血脂异常的患病率，并探讨其危险因素。

方法

纳入 2008 年 1 月至 2020 年 10 月期间在北京协和医院就诊的 iGCT 患者。计算超重/肥胖和血脂异常的患病率。采用混合效应模型评估 BMI z 评分、血脂谱浓度与潜在危险因素之间的关系。

结果

共纳入 106 例患者，中位随访时间为 27（IQR 5-59）个月。就诊时诊断为超重/肥胖和血脂异常的患者分别为 49 例（46.2%）和 86 例（81.1%）。较高的 BMI z 评分与治疗（平均差值（MD）0.51，95%CI 0.31-0.72）、手术活检（MD 0.71，95%CI 0.16-1.25）、肾上腺功能不全（MD 0.37，95%CI 0.07-0.68）、甲状腺功能减退（MD 0.35，95%CI 0.06-0.63）、糖皮质激素补充（MD 0.64，95%CI 0.40-0.87）和甲状腺素补充（MD 0.48，95%CI 0.24-0.72）有关。下丘脑受累与 TC（MD 0.52，95%CI 0.06-0.98）、TG（MD 0.36，95%CI 0.01-0.72）、LDL-C（MD 0.60，95%CI 0.20-0.98）升高和 HDL-C（MD-0.23，95%CI-0.44 至-0.02）降低有关。治疗后 TC（MD 0.53，95%CI 0.26-0.80）和 LDL-C（MD 0.39，95%CI 0.17-0.62）升高。糖皮质激素补充与 TC（MD 0.70，95%CI 0.38-1.03）、LDL-C（MD 0.51，95%CI 0.24-0.78）和 HDL-C（MD 0.25，95%CI 0.09-0.40）升高有关，而性激素补充与 TC（MD-0.74，95%CI-1.2 至-0.29）和 TG（MD-0.47，95%CI-0.86 至-0.08）降低有关。