Obesity and Metabolic Changes Are Common in Young Childhood Brain Tumor Survivors

Background. A population based cross-sectional Study was used to examine the prevalence of metabolic syndrome and its components in childhood brain tumor Survivors. Procedure. Fifty-two Survivors were examined at a mean age of 14.4 years (range 3.8-28.7). Lipid and glucose metabolism, thyroid function, and plasma uric acid were evaluated. Fat mass and fat percentage were assessed by dual-energy X-ray absorptiometry (DXA). Metabolic syndrome was defined on International Diabetes Federation criteria. Results. Ten (9%) patients were overweight and four (8%) were obese. According to DXA, 16/46 (35%) patients were obese. Central obesity was round in 11 (21%) patients. Cranial irradiation, hypothalamic/hypophyseal damage, growth hormone (GH) deficiency and impaired mobility were associated with overweight/obesity and central obesity. Thirteen (25%) subjects had hypercholesterolemia, 14 (27%) had raised low-density lipoprotein cholesterol (LDL-C), 12 (23%) had raised blood pressure, four (8%) had metabolic syndrome, two (4%) had hyperinsulinemia and five (10%) had hyperuricemia. Cranial irradiation was associated with hypercholesterolemia (P=0.019), raised LDL-C (P=0.028). raised blood pressure (P=0.040), and metabolic syndrome (P=0.018). Impaired mobility was associated with hypercholesterolemia (P=0.034). Hypothalamic/hypophyseal damage was associated with metabolic syndrome (P = 0.003) and hyperuricemia (P=0.011) as was GH deficiency (P=0.034 and P=0.008). GH Supplementation alleviated adverse metabolic outcomes among brain tumor Survivors with GH deficiency. Conclusions. Obesity/overweight, dyslipidemia, hypertension, metabolic syndrome, and hyperuricemia were common ill Young childhood brain tumor survivors. Cranial irradiation, hypothalamic/hypophyseal damage, growth hormone deficiency, and/or impaired mobility were associated with higher risk for obesity and metabolic changes among these patients. Pediatr Blood Cancer 2009;52:853-859. (C) 2009 Wiley-Liss, Inc.