TY - JOUR
T1 - Preoperative BMI Predicts Postoperative Weight Gain in Adult-onset Craniopharyngioma
AU - Duan, Daisy
AU - Wehbeh, Leen
AU - Mukherjee, Debraj
AU - Hamrahian, Amir H.
AU - Rodriguez, Fausto J.
AU - Gujar, Sachin
AU - Khalafallah, Adham M.
AU - Hage, Camille
AU - Caturegli, Patrizio
AU - Gallia, Gary L.
AU - Ahima, Rexford S.
AU - Maruthur, Nisa M.
AU - Salvatori, Roberto
N1 - Publisher Copyright:
© 2021 The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
PY - 2021/4/1
Y1 - 2021/4/1
N2 - Context: Craniopharyngiomas, while benign, have the highest morbidity of all nonmalignant sellar tumors. Studies on weight and metabolic outcomes in adult-onset craniopharyngioma (AOCP) remain sparse. Objective: To examine postsurgical weight and metabolic outcomes in AOCP and to identify any clinical predictors of weight gain. Methods: Retrospective chart review of patients with AOCP who underwent surgery between January 2014 and May 2019 in a single pituitary center. The study included 45 patients with AOCP with a minimum follow-up of 3 months. Median follow-up time was 26 months (interquartile range [IQR] 10-44). Main outcome measures were the changes in weight/body mass index (BMI), metabolic comorbidities, and pituitary deficiencies between preoperative and last follow-up. Results: Both weight and BMI were higher at last follow-up, with a mean increase of 3.4 kg for weight (P =. 015) and 1.15 kg/m2 for BMI (P =. 0095). Median % weight change was 2.7% (IQR -1.1%, 8.8%). Obesity rate increased from 37.8% at baseline to 55.6% at last follow-up. One-third of patients had ~15% median weight gain. The prevalence of metabolic comorbidities at last follow-up was not different from baseline. Pituitary deficiencies increased postoperatively, with 58% of patients having ≥3 hormonal deficiencies. Preoperative BMI was inversely associated with postoperative weight gain, which remained significant after adjusting for age, sex, race, tumor, and treatment characteristics. Patients with ≥3 hormonal deficiencies at last follow-up also had higher postoperative weight gain. Conclusion: In this AOCP cohort, those with a lower BMI at the preoperative visit had higher postoperative weight gain. Our finding may help physicians better counsel patients and provide anticipatory guidance on postoperative expectations and management.
AB - Context: Craniopharyngiomas, while benign, have the highest morbidity of all nonmalignant sellar tumors. Studies on weight and metabolic outcomes in adult-onset craniopharyngioma (AOCP) remain sparse. Objective: To examine postsurgical weight and metabolic outcomes in AOCP and to identify any clinical predictors of weight gain. Methods: Retrospective chart review of patients with AOCP who underwent surgery between January 2014 and May 2019 in a single pituitary center. The study included 45 patients with AOCP with a minimum follow-up of 3 months. Median follow-up time was 26 months (interquartile range [IQR] 10-44). Main outcome measures were the changes in weight/body mass index (BMI), metabolic comorbidities, and pituitary deficiencies between preoperative and last follow-up. Results: Both weight and BMI were higher at last follow-up, with a mean increase of 3.4 kg for weight (P =. 015) and 1.15 kg/m2 for BMI (P =. 0095). Median % weight change was 2.7% (IQR -1.1%, 8.8%). Obesity rate increased from 37.8% at baseline to 55.6% at last follow-up. One-third of patients had ~15% median weight gain. The prevalence of metabolic comorbidities at last follow-up was not different from baseline. Pituitary deficiencies increased postoperatively, with 58% of patients having ≥3 hormonal deficiencies. Preoperative BMI was inversely associated with postoperative weight gain, which remained significant after adjusting for age, sex, race, tumor, and treatment characteristics. Patients with ≥3 hormonal deficiencies at last follow-up also had higher postoperative weight gain. Conclusion: In this AOCP cohort, those with a lower BMI at the preoperative visit had higher postoperative weight gain. Our finding may help physicians better counsel patients and provide anticipatory guidance on postoperative expectations and management.
KW - craniopharyngioma
KW - hypothalamus
KW - obesity
KW - pituitary
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U2 - 10.1210/clinem/dgaa985
DO - 10.1210/clinem/dgaa985
M3 - Review article
C2 - 33417676
AN - SCOPUS:85103607686
SN - 0021-972X
VL - 106
SP - E1603-E1617
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 4
ER -