Risk Factors for Obesity in Children with Hypothalamic Masses

Kalaycı Fulya Mete; Kızılay Deniz Özalp; Eda Ataseven; Mehmet Kantar; Uluç Özkızıltan; Elif Bolat; Damla Gökşen; Şükran Darcan; Samim Özen

Aim: Physical damage to hypothalamus, can lead to autonomic dysregulation, temperature imbalance, increased appetite, and obesity. We aim ed to determine the risk factors for the development of hypothalamic obesity.

Methods: The cases were evaluated based on location, size of the mass, treatment modality (surgery or radiotherapy), pathology result, presence of hydrocephalus, family history of consanguinity and obesity, concomitant endocrine pathologies, and comorbidities.

Results: Thirty-four cases, comprising seven optic gliomas, eight pilocytic astrocytomas, seven craniopharyngiomas, two pituitary adenomas, one chiasmatic glioma, one ependymoma, one meningioma, one glial tumor, two germinomas, one hypothalamic astrocytoma, one pineal tumor, one choroid plexus papilloma, and one histiocytosis were evaluated. 15 patients developed obesity after a hypothalamic mass follow-up and referral to pediatric endocrinology. 3 patients had radiotherapy 14 surgery and 11surgery+radiotherapy. 6 patients had follow up data. Mean age was 6.56±4.59 years at diagnosis and 18.52±7.17 years at last follow-up. Mean follow-up period was 5.92 ± 4.37 years. In those who developed obesity, weight gain was observed at 7.35±9.11 months. No significant correlation was found between obesity risk and factors as the localization of the mass, history of radiotherapy, pre- and postoperative mass size, pathological outcome, hydrocephalus, family history of obesity, and consanguinity. Obesity developed in patients who underwent surgery (56%) compared to 44% in those who did not (P = 0.03) (Table 1). Obesity developed more frequently when adrenal insufficiency (P = 0.02) and hypogonadism (P = 0.002) were present.

**Table 1:** Characteristics of patients with and without presenting obesity.
		Obesity(+) (n = 15)	Obesity (-) (n = 19)	P
AT DIAGNOSIS
Age, year		7.78±4.83	4.82±3.63	0.023
Height SDS		-0.93±1.62	0.86±1.09	0.042
BMI SDS		0.60±2.24	0.27±0.71	0.095
Treatment (n, %)	Surgery -	1 (12,5%)	8 (87,5%)
Treatment (n, %)	Surgery +	14 (56%)	11 (44%)	0.032
AVERAGE OF 5.92± 4.37 YEARS OF FOLLOW-UP
Age, year		21.73±5.59	15.99±7.4	0.014
BMI SDS		2.57±1.13	0.29±1.05	0.00
Height SDS		-2.16±2.24	-0.08±0.71	0.07
Adrenal insufficiency		9 (69.2%)	4 (30.8%)	0.02
Growth hormone deficiency		7 (63.6%)	4 (36.4%)	0.113
Hypogonadism		8 (88.9%)	1 (11.1%)	0.002
Dyslipidemia		10 (66.7%)	5 (33.3%)	0.019
Insulin resistance		9 (75%)	3 (25%)	0.010
BMI: body mass index, SDS: standard deviation score

Conclusion: Obesity was higher in those who underwent surgery, as well as in those with hypogonadism and adrenal insufficiency.

ESPE Abstracts

P2-112