ESPE Abstracts

Previous studies have found that the incidence of postoperative metabolic diseases (such as obesity, cardiovascular diseases and diabetes) in patients with craniopharyngioma (CP) is high, which seriously affects the long-term quality of life of patients. At present, few data on postoperative glucose and lipid metabolism in patients with CP, and the results of different studies are heterogeneous. The purpose of this study is to monitor the glucose and lipid metabolism indexes after CP in children for a long time, analyze the data characteristics, and explore the related risk factors, so as to provide a basis for the prevention and treatment of postoperative complications related to metabolic disorders in children with CP.

Methods: A total of 44 children with CP who underwent surgical treatment from January 2006 to February 2024 were retrospectively analyzed for their body weight and glucose and lipid metabolism indexes, including fasting insulin, fasting plasma glucose, glycosylated hemoglobin, total cholesterol, triglycerides, high-density lipoprotein and low-density lipoprotein cholesterol. In order to ensure the reliability of the analysis results, on the one hand, the data at the last follow-up of the children were collected to preliminarily describe the abnormal situation of glucose and lipid metabolism; on the other hand, the data before hypoglycemic and lipid-lowering drugs were used to conduct stratified analysis to explore the correlation between the indicators.

Results: The mean follow-up duration was 7.45±4.64 years. The mean age at operation was 8.57±4.25 years, and the mean age at last follow-up was 16.02±5.36 years. At the last follow-up, 40.9% of the children were overweight or obese, 55% had insulin resistance or abnormal glucose metabolism, and 81.8% had dyslipidemia. The data before the use of hypoglycemic and lipid-lowering drugs showed that the incidence of abnormal glucose homeostasis in the overweight/obese group was significantly higher than that in the normal weight group after CP, with insulin resistance as the main manifestation, but the incidence of dyslipidemia was similar between the two groups. Further correlation analysis showed that abnormal glucose homeostasis was associated with abnormal weight before and after operation, but no related factors of dyslipidemia were found.

Conclusion: Abnormal glucose metabolism and dyslipidemia are common in overweight/obese children after CP, among which abnormal glucose metabolism is associated with overweight/obesity. It is suggested that weight control may be an important means to effectively avoid metabolic disorders after CP.