title: Energy expenditure in obesity associated with craniopharyngioma.
abstract: OBJECTIVE
  Obesity is a common yet incompletely understood complication of childhood craniopharyngioma. We hypothesized that craniopharyngioma is associated with specific defects in energy balance compared to obese control children.
  
  
  METHODS
  Eleven craniopharyngioma patients were recruited for a study on body composition and energy balance. Eight subjects were obese. The obese craniopharyngioma patients had a mean age (+/-SD) of 11.2 +/- 1.7 years. The average body mass index z score was 2.33 (+/-0.32). A previously studied group of obese children (BMI z score 2.46 +/- 0.46) served as controls. Resting energy expenditure (REE) was determined by indirect calorimetry and body composition by dual energy X-ray absorptiometry in all children.
  
  
  RESULTS
  Obese craniopharyngioma patient subjects had increased mean (+/-standard error) fat-free mass compared to obese controls (57% +/- 0.88 % vs 50.0% +/- 0.87%, p = 0.02). The obese craniopharyngioma patients had a 17% lower REE compared to values expected from the World Health Organization equation (1,541 +/- 112.6 vs 1,809 +/- 151.8 kcal; p = 0.01). In contrast, the obese control children had measured REE within 1% of predicted (1,647 +/- 33.2 vs. 1,652 +/- 40.2; p = 0.8). In a linear regression model, REE remained significantly lower than predicted after controlling for FFM.
  
  
  CONCLUSIONS
  Lower REE may be a factor contributing to obesity in children with craniopharyngioma. Further study is needed into the mechanisms for reduced energy expenditure in patients with craniopharyngioma.
authors.affiliation: Division of Endocrinology, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. kimr@email.chop.edu
authors.forename: Roy J
authors.initials: RJ
authors.lastname: Kim
authors.forename: Rachana
authors.initials: R
authors.lastname: Shah
authors.forename: Andy M
authors.initials: AM
authors.lastname: Tershakovec
authors.forename: Babette S
authors.initials: BS
authors.lastname: Zemel
authors.forename: Leslie N
authors.initials: LN
authors.lastname: Sutton
authors.forename: Adda
authors.initials: A
authors.lastname: Grimberg
authors.forename: Thomas
authors.initials: T
authors.lastname: Moshang
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D001823:Body Composition / Q000502:physiology; D002153:Calorimetry, Indirect; D002648:Child; D002675:Child, Preschool; D003397:Craniopharyngioma / Q000150:complications* / Q000503:physiopathology* / Q000601:surgery; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D019635:Neurosurgical Procedures; D009765:Obesity / Q000209:etiology* / Q000503:physiopathology*; D010911:Pituitary Neoplasms / Q000150:complications* / Q000503:physiopathology* / Q000601:surgery; D012044:Regression Analysis; D015430:Weight Gain / Q000502:physiology