ESPE Abstracts

Objective: Craniopharyngiomas, diagnosed and treated during childhood, pose significant challenges due to their location in the sella turcica, adjacent to the pituitary and hypothalamus. Patients often experience endocrine deficiencies which may affect their body composition and metabolic health. We aim ed to explore the body composition components and their interaction with metabolic syndrome components in pediatric patients with craniopharyngioma following neurosurgical treatment.

Methods: This longitudinal single-center retrospective study comprised of pediatric patients who were diagnosed with craniopharyngioma for which they underwent surgery between 2012 and 2024. Included in the analysis were 21 patients (13 boys) who underwent body composition assessment by bioimpedance analysis (BIA). Their latest reported values were compared to those of 63 sex- and age-matched healthy controls. The analysis included anthropometric measurements [height and body mass index (BMI) z-scores], indices of muscle and adiposity and metabolic syndrome components (glucose intolerance, elevated systolic and/or diastolic blood pressure, hypertriglyceridemia and low high-density lipoprotein-cholesterol).

Results: Patients with craniopharyngioma had lower height z-scores (P =0.018) and higher BMI z-scores (P <0.001) as compared to controls. Moreover, 11 children (52.4%) in the craniopharyngioma group were classified with obesity (5 with obesity class 1 and 6 with obesity class 2-3). Patients with craniopharyngioma exhibited higher adiposity compared to controls, with significantly elevated total body fat percentage (FATP) (P <0.001), trunk-to-total body fat ratio (P =0.012), and lower muscle-to-fat ratio (MFR) z-scores (P <0.001). The appendicular skeletal muscle mass (ASMM) z-scores were similar. A sex- and age-adjusted model revealed that the diagnosis of metabolic syndrome components was positively associated with FATP (odds ratio=1.13, confidence interval [1.04, 1.23], P =0.006). Mixed models revealed that over time, patients with craniopharyngioma demonstrated an increase in ASMM z-score (β=0.14, P =0.002) together with a decline in sex- and age-adjusted FATP (β=-0.99, P =0.018).

Conclusion: Despite struggling with obesity and hormonal deficiencies, survivors of craniopharyngioma showed favorable changes in body composition with appropriate medical interventions. The multidisciplinary medical team offering tailored hormone replacement therapy, nutritional consultation and psychosocial guidance may limit metabolic sequalae in this population.