Endocrine Abstracts

Effects of Bariatric Surgery in Patients with Craniopharyngioma

Objectives: The prime objective of this study is the identification of the limiting factors of metabolic surgeries on weight reduction in patients with craniopharyngioma (CP) and consecutive hypothalamic obesity (HO).

Patients: As of now, 37 patients were included, of which5 patients presented with HO and earlier bariatric surgery (mean BMI 50.44 kg/m²), 5 patients presented with HO without bariatric intervention (mean BMI 43.95 kg/m²), 9 underwent bariatric surgery as a treatment of alimentary obesity in the past (mean BMI 40.09 kg/m²), 7 patients were alimentary obese with a mean BMI of 47.33 kg/m² and no previous bariatric surgery and 6 participants were healthy controls (mean BMI 24.02 kg/m²).

Methods: For evaluation of eating behavior and quality of life standardized questionnaires and nutrition reports and for the subjective preference for sweet foods a taste-reward-test were used. A modified oral glucose tolerance test was performed to analyze the gastrointestinal hormone status after a defined test meal. Blood was taken right before and 15, 30, 45, 60, 120 min after meal ingestion.

Results: The BMI of patients with HO and bariatric surgery was significantly higher than that of patients with alimentary obesity and bariatric surgery (P < = 0.05). Surprisingly, patients with HO that underwent bariatric surgery had still significantly (P < = 0.05 bzw. 0.01) higher GLP-1 levels than patients of all other groups (at 15 and 30 min after meal ingestion), especially than patients with alimentary obesity and bariatric surgery. There was no statistically significant difference found for PYY.

Conclusion: Patients with HO after bariatric surgery have significantly higher levels of GLP-1 at certain time points after a defined meal, although this doesn’t account for PYY. We conclude, that firstly the effects of bariatric surgery are annihilated through the hypothalamic damage and secondly GLP-1 agonists are no valid treatment for most of these patients. Measuring GLP-1 might at least be useful before starting such a treatment.