title: Obesity and metabolic changes are common in young childhood brain tumor survivors.
abstract: BACKGROUND
  A population based cross-sectional study was used to examine the prevalence of metabolic syndrome and its components in childhood brain tumor survivors.
  
  
  METHODS
  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 (19%) patients were overweight and four (8%) were obese. According to DXA, 16/46 (35%) patients were obese. Central obesity was found 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 in 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.
authors.affiliation: Department of Pediatrics, Tampere University Hospital, Tampere, Finland. sari.pietila@sci.fi
authors.forename: Sari
authors.initials: S
authors.lastname: Pietilä
authors.forename: Anne
authors.initials: A
authors.lastname: Mäkipernaa
authors.forename: Harri
authors.initials: H
authors.lastname: Sievänen
authors.forename: Anna-Maija
authors.initials: AM
authors.lastname: Koivisto
authors.forename: Tuija
authors.initials: T
authors.lastname: Wigren
authors.forename: Hanna L
authors.initials: HL
authors.lastname: Lenko
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D001932:Brain Neoplasms / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D003430:Cross-Sectional Studies; D005260:Female; D019382:Human Growth Hormone / Q000172:deficiency; D006801:Humans; D008055:Lipids / Q000032:analysis; D008297:Male; D024821:Metabolic Syndrome / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy; D009765:Obesity / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy; D015996:Survival Rate; D055815:Young Adult
chemical_list: D008055:Lipids; D019382:Human Growth Hormone