Журнал исследований костей
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ISSN: 2572-4916
ISSN: 2572-4916
Адриана А. Сивьеро-Миахон*, Патрисия Д. Кавальканти, Тоста-Эрнандес, Насла Саба да Силва, Андреа Каппеллано, Марсело де Медейруш Пиньейру, Анджела М. Спинола-Кастро
Background: Bone mass may be compromised in childhood-onset craniopharyngioma patients due to different factors. The aim of this study was to evaluate the effect of adiposity, hypogonadism and growth hormone on bone mass in craniopharyngioma patients.
Methods: A cross-sectional study of 46 patients, aged between 6.6 and 32.1 years, 7.5 years from diagnosis, 63% male, 39.1% underwent surgery followed by cranial radiotherapy, assessed according to body fat, lumbar spine and total body bone mineral density through dual energy X-ray absorptiometry, computed tomography scan-derived abdominal adipose tissue, and adipokines by univariate and multivariate regression analyses.
Results: Craniopharyngioma patients presented with decreased lumbar spine and total body bone mass related to therapy (cranial radiotherapy and combinations), but no fractures so far. The body mass index Z score at assessment had a positive mechanical effect on total body bone mass. The replacement of sex steroids at or above 3 years increased bone mass at the total body site. The presence of diabetes insipidus and initiating growth hormone at or above 11.8 years of age had a negative impact on lumbar spine bone mass. Regarding cutoffs, 21.7% of patients presented with decreased lumbar spine bone mass and 10.9% at the total body site, but no differences were observed in spite of growth hormone, sex steroid or sex.
Conclusion: Hypothalamic obesity, therapy, and hormone deficiencies may determine bone mass among craniopharyngioma patients. All these factors might be monitored during follow-up, as they could possibly explain linking mechanisms between bone, metabolism and cancer.