Abstract

Aim: To investigate the potential association among Craniopharyngioma (CP), chronotypes and metabolic risk profile. Subjects and Methods: The study population included 28 patients (46.4% males; 42.6 ± 15.8 years) and 28 controls, age, gender and BMI matched (46.4% males; 46.5 ± 12.9 years). In this study sample, we evaluated: anthropometric measurements (waist circumference, WC; BMI), plasma glucose, lipid profile, and systolic (SBP) and diastolic (DBP) blood pressure. Morningness-Eveningness was measured with the Horne-Ostberg Morningness-Eveningness Questionnaire (MEQ), which included 19 questions about preferred sleep time and daily performance. Results: in both patients and controls grade I obesity was detected in 15 subjects (53.6%), grade II obesity in 13 subjects (46.4%). In the patient group, the mean score of chronotype was 47.8 ± 12.6. In particular, 9 patients (32.1%) exhibited the morning chronotype, 6 (21.4%) the intermediate chronotype and 13 (46.4.%) the evening chronotype. No significant difference was found in gender and age among the chronotype categories. Patients with the evening chronotype had higher blood pressure values and worse metabolic parameters than those with the morning chronotype. In the control group, the mean score of the chronotype was 57.6 ± 9.5. In particular, 16 (57.1%) subjects exhibited the morning chronotype, 10 (35.7%) the intermediate chronotype and only 2 (7.1.%) the evening chronotype. The prevalence of intermediate and evening chronotypes was higher in females than males (p = 0.021), while males have a higher prevalence of the morning chronotype. Subjects with intermediate and evening chronotypes had worse metabolic parameters than those with the morning chronotype. In patients, the chronotype score was inversely correlated to WC, BMI, SBP, DBP, plasma glucose, total cholesterol, triglycerides, LDL cholesterol and positively correlated with HDL cholesterol. No correlation was found between age and chronotype. In controls, the chronotype score was inversely correlated to WC, BMI, plasma glucose, total cholesterol, LDL cholesterol. No correlation was found among chronotype and age, blood pressure, triglycerides, HDL cholesterol. Considering the whole population of the study (patients and controls), at logistic regression the chronotype score was significantly associated with the presence of CP. Conclusions: for the first time thus far, our study puts the light on the association of the CP with chronotypes and metabolic alterations in this disease, which are the main determinants of the reduced quality of life, higher morbidity and mortality in this setting of patients. This finding suggests that alterations of chronotype might represent an adjunctive risk for CP patients and a possible target for their integrate management.

Highlights

  • Craniopharyngioma (CP) is an uncommon epithelial intracranial tumour that can arise anywhere along the path of the craniopharyngeal duct, the majority arises in the sellar/parasellar region, predominantly in the suprasellar space [1,2]

  • Obesity was present in all the enrolled subjects, but there were no differences in the distribution of grade I or II obesity between patients and controls (p = 0.560)

  • Our results showed that, compared to age and Body mass Index (BMI)-matched controls, patients with CP had a higher prevalence of the evening chronotype, which was associated with a greater impairment of their metabolic profile

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Summary

Introduction

Craniopharyngioma (CP) is an uncommon epithelial intracranial tumour that can arise anywhere along the path of the craniopharyngeal duct, the majority arises in the sellar/parasellar region, predominantly in the suprasellar space [1,2]. Among the particular challenges that CP presents, the risk of obesity due to hypothalamic derangement is one of the most demanding and implies devastating consequences for patients. The increased risk of long-term mortality appears to be associated with hypothalamic dysfunction and related manifestations [7,8]. There is a lot of evidence that tumours with hypothalamic involvement confer a high risk of obesity [9,10] and that the degree of this involvement is correlated with the severity of the postoperative obesity [11,12]. The most compelling challenge is that obesity in patients with CP is mainly unresponsive to lifestyle intervention that has proved to be effective in simple obesity, with increased metabolic morbidities and cardiovascular mortalities [16,17]. Bariatric surgical procedures may play an important role for weight loss in patients with CP, but evidence of its effectiveness and safety is still scanty

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