アイテム詳細

要旨

Introduction: Patients with craniopharyngioma (CP) have disturbances of the hypothalamic-pituitary axis and serious comorbidities such as obesity. We hypothesized that the secretion of hormones regulating the nutritional status is altered in adult patients with CP compared with patients with non-functioning pituitary adenoma (NFPA). Methods: We included 40 CP (50% males, mean age: 49.6 +/- 14.3 years) and 40 NFPA (72.5% males, mean age: 63.4 +/- 9.8 years) patients. We measured glucose, insulin, leptin, total ghrelin, peptide-YY (PYY) and cholecystokinin (CCK) during oral glucose tolerance test (OGTT). Fat mass ( FM) was determined by dual X-ray absorptiometry. Results: Gender distribution was not significantly different, but CP patients were significantly younger (P < 0.001). CP patients had significantly higher BMI and FM than NFPA patients ( BMI 32 +/- 8 vs 28G4 kg/ m(2), P=0.009 and FM 37 +/- 9 vs 33 +/- 9%, PZ0.02). Fasting glucose level ( 84 +/- 12 vs 78 +/- 11 mg/ dl, P=0.03), leptin (27.9 +/- 34.2 vs 11.9 +/- 11.6 upsilon g/ l, P=0.008) and leptin levels corrected for percentage FM (0.66 +/- 0.67 vs 0.32 +/- 0.25 mg/ l%, P=0.005) were significantly higher in CP than in NFPA patients, whereas ghrelin was significantly lower ( 131 +/- 129 vs 191 +/- 119 ng/l, P=0.035). Insulin, PYY and CCK did not differ significantly between groups. After glucose load, leptin decreased significantly in CP patients (P=0.019). In both groups, ghrelin decreased significantly during OGTT ( both P < 0.001). The percentage decline was significantly smaller for CP. PYYand CCK increased equally after glucose in both groups. Conclusion: Our patients with CP have more metabolic complications than our patients with NFPA. The levels of leptin and ghrelin at fasting status and after glucose seem to be altered in CP, whereas changes in insulin, PYY and CCK do not seem to be responsible for the metabolic changes in these patients.