4.3 Article

Novel clinical algorithm for hypothalamic obesity in youth with brain tumours and factors associated with excess weight gain

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PEDIATRIC OBESITY
卷 17, 期 7, 页码 -

出版社

WILEY
DOI: 10.1111/ijpo.12903

关键词

hypothalamic; obesity; neurooncology; obesity; paediatrics

资金

  1. National Institutes of Health National Institute of Diabetes and Digestive Kidney Diseases [5 T32 DK063687]

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Hypothalamic obesity is common in children with hypothalamic tumors. A clinical algorithm can help in the recognition and management of this condition, but further research is needed to develop effective treatment.
Background A standardized approach for identifying and treating hypothalamic obesity (HO) in children with hypothalamic tumours is lacking. Objectives To describe children with hypothalamic tumours at risk for obesity, assess outcomes of a novel HO clinical algorithm, and identify factors associated with weight gain. Methods Retrospective analysis of youth with hypothalamic and suprasellar tumours, seen at a paediatric tertiary care centre from 2010 to 2020. Results The study cohort (n = 130, 50% female, median age at diagnosis 5 [range 0-17]y) had a median duration of follow up of 5 (0.03-17)y. At last recorded body mass index (BMI) measurement, 34% had obesity, including 17% with severe obesity. Median onset of overweight and obesity after diagnosis was 6.2 (0.3-134) and 8.9 (0.7-65) months, respectively. After algorithm implementation (n = 13), the proportion that had an early dietitian visit (within 6 months) increased from 36% to 54%, (p = 0.498) and weight management referrals increased from 51% to 83% (p = 0.286). Higher BMI z-score at diagnosis was associated with overweight and obesity development (p < 0.001). Conclusion Patients with hypothalamic tumours commonly develop obesity. Use of a clinical algorithm may expedite recognition of HO. Further research is needed to identify predictors of weight gain and to develop effective treatment.

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