title: Impaired aerobic exercise adaptation in children and adolescents with craniopharyngioma is associated with hypothalamic involvement.
abstract: OBJECTIVE
  Many patients treated for craniopharyngioma (CP) complain of a relative incapacity for physical activity. Whether this is due to an objective decrease in adaptation to exercise is unclear. We assessed exercise tolerance in children with surgically treated CP and appropriate pituitary hormone replacement therapy compared with healthy controls and we examined the potential relationships with hypothalamic involvement, GH replacement, and the catecholamine deficiency frequently observed in these subjects.
  
  
  METHODS
  Seventeen subjects (12 males and five females) with CP and 22 healthy controls (14 males and eight females) aged 15.3±2.5 years (7.3-18 years) underwent a standardized cycle ergometer test. Maximum aerobic capacity was expressed as the ratio of VO(2max) to fat-free mass (VO(2max)/FFM), a measure independent of age and fat mass in children.
  
  
  RESULTS
  VO(2max)/FFM was 20% lower in children with CP compared with controls (P<0.05), even after adjustment for gender. Children with hypothalamic involvement (n=10) had a higher percentage of fat mass (P<0.05) than those without hypothalamic involvement (n=7) and lower VO(2max)/FFM (P<0.05), whereas children without hypothalamic involvement had VO(2max)/FFM close to that of controls (P>0.05). GH treatment was associated with a significant positive effect on aerobic capacity (P<0.05) only in the absence of hypothalamic involvement. No relationship was found between exercise capacity parameters and daily urine epinephrine excretion or epinephrine peak response to insulin-induced hypoglycemia.
  
  
  CONCLUSIONS
  Children with CP have a decrease in aerobic capacity mainly related to hypothalamic involvement. The hypothalamic factors altering aerobic capacity remain to be determined.
authors.affiliation: Department of Pediatric Endocrinology, Angers University Hospital, 4 rue Larrey, 49033 Angers Cedex 01, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Piguel
authors.forename: Pierre
authors.initials: P
authors.lastname: Abraham
authors.forename: Natacha
authors.initials: N
authors.lastname: Bouhours-Nouet
authors.forename: Frédérique
authors.initials: F
authors.lastname: Gatelais
authors.forename: Sylvie
authors.initials: S
authors.lastname: Dufresne
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Rouleau
authors.forename: Régis
authors.initials: R
authors.lastname: Coutant
mesh_terms: D000222:Adaptation, Physiological / Q000502:physiology*; D000293:Adolescent; D002648:Child; D003397:Craniopharyngioma / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology* / Q000503:physiopathology; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D007029:Hypothalamic Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology / Q000556:secondary*; D007031:Hypothalamus / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D010907:Pituitary Hormones / Q000627:therapeutic use; D010911:Pituitary Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology* / Q000503:physiopathology
chemical_list: D010907:Pituitary Hormones