Publication:
Risk factors for the development of obesity in children surviving brain tumors

dc.contributor.authorRobert H. Lustigen_US
dc.contributor.authorSusan R. Posten_US
dc.contributor.authorKleebsabai Srivannaboonen_US
dc.contributor.authorSusan R. Roseen_US
dc.contributor.authorRobert K. Danishen_US
dc.contributor.authorGeorge A. Burghenen_US
dc.contributor.authorXiaoping Xiongen_US
dc.contributor.authorShengjie Wuen_US
dc.contributor.authorThomas E. Merchanten_US
dc.contributor.otherSt. Jude Children Research Hospitalen_US
dc.contributor.otherChicago Medical Schoolen_US
dc.contributor.otherCincinnati Children's Hospital Medical Centeren_US
dc.contributor.otherUniversity of California, San Franciscoen_US
dc.contributor.otherMahidol Universityen_US
dc.date.accessioned2018-07-24T03:20:58Z
dc.date.available2018-07-24T03:20:58Z
dc.date.issued2003-02-01en_US
dc.description.abstractHypothalamic obesity, a syndrome of intractable weight gain due to hypothalamic damage, is an uncommon but devastating complication for children surviving brain tumors. We undertook a retrospective evaluation of the body mass index (BMI) curves for the St. Jude Children's Research Hospital brain tumor population diagnosed between 1965 and 1995 after completion of therapy to determine risk factors for the development of obesity. Inclusion criteria were: diagnosis less than 14 yr of age, no spinal cord involvement, ambulatory, no supraphysiologic hydrocortisone therapy (>12 mg/m2·d), treatment and follow-up at St. Jude Children's Research Hospital, and disease-free survival greater than 5 yr (n = 148). Risk factors examined were age at diagnosis, tumor location, histology, extent of surgery, hydrocephalus requiring ventriculoperitoneal shunting, initial high-dose glucocorticoids, cranial radiation therapy, radiation dosimetry to the hypothalamus, intrathecal chemotherapy, and presence of endocrinopathy. Analyses were performed both between groups within a risk factor and against BMI changes for age in normal children older than 5.5 yr (the age of adiposity rebound). Risk factors were: age at diagnosis (P = 0.04), radiation dosimetry to the hypothalamus (51-72 Gy, P = 0.002 even after hypothalamic and thalamic tumor exclusion), and presence of any endocrinopathy (P = 0.03). In addition, risk factors when compared with BMI slope for the general American pediatric population included: tumor location (hypothalamic, P = 0.001), tumor histology (craniopharyngioma, P = 0.009; pilocytic astrocytoma, P = 0.043; medulloblastoma, P = 0.039); and extent of surgery (biopsy, P = 0.03; subtotal resection, P = 0.018). These results verify hypothalamic damage, either due to tumor, surgery, or radiation, as the primary cause of obesity in survivors of childhood brain tumors. In particular, hypothalamic radiation doses of more than 51 Gy are permissive. These results reiterate the importance of the hypothalamus in energy balance, provide risk assessment criteria for preventative measures before the development of obesity in at-risk patients, and suggest therapeutic strategies to reduce the future development of obesity.en_US
dc.identifier.citationJournal of Clinical Endocrinology and Metabolism. Vol.88, No.2 (2003), 611-616en_US
dc.identifier.doi10.1210/jc.2002-021180en_US
dc.identifier.issn0021972Xen_US
dc.identifier.other2-s2.0-0037329043en_US
dc.identifier.urihttps://repository.li.mahidol.ac.th/handle/20.500.14594/20769
dc.rightsMahidol Universityen_US
dc.rights.holderSCOPUSen_US
dc.source.urihttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=0037329043&origin=inwarden_US
dc.subjectBiochemistry, Genetics and Molecular Biologyen_US
dc.titleRisk factors for the development of obesity in children surviving brain tumorsen_US
dc.typeArticleen_US
dspace.entity.typePublication
mu.datasource.scopushttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=0037329043&origin=inwarden_US

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