Endocrine Abstracts

Introduction: Patients with craniopharyngioma (CP) suffer from pituitary deficiencies and hypothalamic damage, resulting in obesity and impaired bone health. Little is known about long-term changes in body composition and bone mineral density (BMD).

Methods: Dutch and Swedish patients were included in this retrospective longitudinal study if they had DXA-scan (body composition/BMD) data available at age of 18 years or older. Linear regression modelswereestimated for change of Z-score of total body, L2-L4 and femur neck. Age- and sex-specific standardized deviation scores (SDS) were calculated. Data is provided as mean ± standard deviation unless stated otherwise.

Results: There were 112 CPincluded [58 (52%) male, 50 (44%) childhood-onset] witha median age at first presentation of 25 years (range 0–73) and median age at last documented visit at the clinic of 49 years (range 16–82). All patients had one DXA-scan available, 86 CP had at least two DXA-scans. The mean time between first and last DXA-scan was 10.8 ± 6.7 years. Hypopituitarism occurred in 96%. Values of body composition measures were high and increased: BMI at first DXA-scan was 30.0 ± 4.8, the mean difference from first to last DXA-scan 1.95 ± 3.39, P<0.001. Fat mass index (FMI) at first DXA-scan was 10.7 ± 3.4, the mean difference to last DXA-scan was 0.86 ± 2.41, P = 0.002; fat free mass index (FFMI) at first DXA-scan was 18.3 ± 3.2; the mean difference to last DXA-scan was 18.3 ± 3.2, 1.15 ± 1.86, P <0.001. However, corresponding SDS did not increase, except for FFMI SDS (from 0.26 ± 1.63 to 1.11 ± 2.14, P<0.001). Fat percentage (SDS) did not change. Predictors in a linear regression model for Δ Z-score models were hydrocortisone dose (total body Δ Z-score: beta −0.07, P = 0.002), medication to improve BMD (L2-L4 Δ Z-score: beta -1.07, P = 0.008), radiotherapy (femur neck Δ Z-score: beta −0.64, P = 0.04); the estimated regression coefficient for growth hormone replacement therapy was not significant but showed a strong trend (femur neck Δ Z-score: beta 0.81, P = 0.06).

Conclusions: Patients withCP remain stable in BMI SDS, fat percentage SDS and FMI SDS and increase in FFMI SDS and BMD Z-scores. Hydrocortisone dose, radiotherapy and medication to improve BMDwere significantly associated to change in BMD (Δ Z-score).Growth hormone replacement therapy showed a trend towards association with Δ Z-score.