title: Comparison of body composition, basal metabolic rate and metabolic outcomes of adults with Prader Willi syndrome or lesional hypothalamic disease, with primary obesity.
abstract: BACKGROUND
  The care of patients with hypothalamic obesity is challenging.
  
  
  OBJECTIVE
  To compare body composition, basal metabolic rate (BMR) and metabolic outcomes of adults, with lesional or genetic hypothalamic obesity, with obese patients suffering from primary obesity, once matched for body mass index (BMI).
  
  
  METHODS
  Adults with hypothalamic obesity of genetic origin (Prader Willi syndrome (PWS)) or acquired hypothalamic damage (HD), such as craniopharygioma, were compared with obese control candidates awaiting bariatric surgery (C), with a BMI between 35 and 65 kg m(-)(2), and aged between 18 and 50 years.
  
  
  METHODS
  Body composition measured by whole-body dual-energy X-ray absorptiometry scanning, BMR using indirect calorimetry, hormonal and metabolic assessments.
  
  
  RESULTS
  A total of 27 adults with a genetic diagnosis of PWS, 15 obese subjects with HD and 206 obese controls with similar BMI were studied. Compared with the control group, PWS patients had an increased percentage of fat mass (FM), and a decreased percentage of android FM. The BMR of PWS patients was significantly lower than controls and highly correlated with lean body mass in PWS and C patients. Body composition of HD was similar with those of obese patients. A trend toward an increased prevalence of diabetes in HD patients and of cytolysis in PWS was observed in comparison with primary obese patients.
  
  
  CONCLUSIONS
  Genetic and lesional hypothalamic obesities have different consequences for phenotypic features such as body composition or BMR compared with primary obese patients. The mechanisms of adipose tissue development and metabolic complications may be different between genetic and lesional obesities.
authors: 1] Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière, Unit of Therapeutic Research, Department of Internal Medicine, Paris, France [2] INSERM U705, CNRS UMR 8206, Neuropsychopharmacology of Drug Addiction, Faculty of Pharmacy, University Paris Descartes, Paris, France.
authors: C
authors: C
authors: Lloret-Linares
authors: P
authors: P
authors: Faucher
authors: M
authors: M
authors: Coupaye
authors: R
authors: R
authors: Alili
authors: A
authors: A
authors: Green
authors: A
authors: A
authors: Basdevant
authors: K
authors: K
authors: Clément
authors: C
authors: C
authors: Poitou
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D001481:Basal Metabolism; D001823:Body Composition; D050218:Body Fat Distribution; D015992:Body Mass Index; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007027:Hypothalamic Diseases / Q000150:complications / Q000453:epidemiology / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000209:etiology / Q000378:metabolism*; D011218:Prader-Willi Syndrome / Q000150:complications / Q000453:epidemiology / Q000378:metabolism*