In patients with craniopharyngiomas, complex treatments were predictive of postoperative visual dysfunction while diabetes insipidus was associated with greater rates of anterior pituitary hormone dysfunction and an increased weakness for gender-independent weight gain, according to data published in the Journal of Clinical Endocrinology and Metabolism.
Craniopharyngiomas are usually related to significant morbidity due to their location and treatment effects, according to Kevin C. J. Yuen, MD, of the division of endocrinology, diabetes and clinical nutrition in the department of medicine at the Oregon Health and Science University, and colleagues.
“The higher BMIs and fat mass observed in patients with [diabetes insipidus] further reinforces the role of hypothalamic damage as an important causal factor in inducing subsequent obesity in these patients and implies that the presence of [diabetes insipidus] can be used as a clinical surrogate marker for hypothalamic obesity,” researchers wrote.
Their retrospective analysis included 180 adults with childhood-onset craniopharyngioma (COCP) studied according to the primary treatment regimen (ie, one surgery vs. complex treatment regimen of more than one surgery and/or radiotherapy) and the presence of diabetes insipidus.
Many of the patients with COCP underwent transcranial surgery (77%) without receiving radiotherapy (84%), according to data.
More patients who underwent complex treatment regimens developed visual field defects and ophthalmoplegia compared with the primary treatment regimen group (P<.01), researchers wrote.
In addition, those with diabetes insipidus demonstrated greater rates of anterior pituitary hormone deficits, BMI and fat mass (P<.01) compared with patients without diabetes insipidus.
Fasting glucose, HbA1c, lipids and quality of life were comparable among patients in the primary treatment regimen vs. complex treatment regimen, and patients without diabetes insipidus.
However, diabetes insipidus in both groups was associated with a greater rate of anterior pituitary hormone deficits and obesity, despite the type of primary treatment they underwent, according to researchers.
Disclosure: Yuen has received research grants from Eli Lilly, Novo Nordisk, Pfizer and Versartis; served on the advisory boards for Corcept Therapeutics, Novo Nordisk and Pfizer. See the study for a full list of all other researchers’ relevant financial disclosures.