Endocrine Abstracts

Introduction: Childhood obesity has become an important health problem nowadays. Intracranial lesions (IC) can affect the hypothalamic - hypophyseal axis depending on the localization of the lesion and lead to hypophyseal hormone deficiencies, especially growth hormone. Although IC lesions are important in the etiology of obesity, There’s limited data in the literature about this subject. Aim of this study is to evaluate the incidence of IC lesions and their role in clinical symptoms and etiology in cases with morbid obesity (MO) in childhood.

Materials and methods: One hundred twenty cases admitted with the complaint of MO in 13 years (2002–2015) were included in this study. Anthropometric evaluation and detailed physical examinations were performed. Biochemical and hormonal parameters (glucose, lipid metabolism, adrenal steroids and diurnal cortisol) were evaluated. Contrast-enhanced dynamic magnetic resonance imaging (CDMRI) technique was used to assess the hypothalamo-hypophyseal field. Height of hypophysis was evaluated according to age and sex.

Results: In our study, 16.6% of the MO patients had an IC lesion. Most of the cases had adenoma of the hypophysis (55% of the cases with IC lesion.) Six of the patients with IC lesion had high prolactin levels. Prolactin levels were increased in the 6 patients but front hypophyseal hormone levels were in between normal range in the rest of the patients. None of the patients had decreased growth velocity.

Conclusion: In this long-term study, the important result is that; IC lesion frequency was significantly higher in children and adolescents with MO than those of the normal population. Moreover, these lesions show no other endocrinological or neurological symptom besides obesity. Furthermore; due to this study; we suggest that cranial imaging with CDMRI in these cases, even if the physical-neurological examination is normal, will contribute greatly to the early diagnosis and treatment of lesions without causing other symptoms.