Abstract
ContextPituitary hormonal deficiencies in patients with craniopharyngioma may impair their bone health.ObjectiveTo investigate bone health in patients with craniopharyngioma.DesignRetrospective cross-sectional study.SettingDutch and Swedish referral centers.PatientsPatients with craniopharyngioma (n = 177) with available data on bone health after a median follow-up of 16 years (range, 1-62) were included (106 [60%] Dutch, 93 [53%] male, 84 [48%] childhood-onset disease).Main outcome measuresFractures, dual X-ray absorptiometry-derived bone mineral density (BMD), and final height were evaluated. Low BMD was defined as T- or Z-score ≤-1 and very low BMD as ≤-2.5 or ≤-2.0, respectively.ResultsFractures occurred in 31 patients (18%) and were more frequent in men than in women (26% vs. 8%, P = .002). Mean BMD was normal (Z-score total body 0.1 [range, -4.1 to 3.5]) but T- or Z-score ≤-1 occurred in 47 (50%) patients and T-score ≤-2.5 or Z-score ≤-2.0 in 22 (24%) patients. Men received less often treatment for low BMD than women (7% vs. 18%, P = .02). Female sex (OR 0.3, P = .004) and surgery (odds ratio [OR], 0.2; P = .01) were both independent protective factors for fractures, whereas antiepileptic medication was a risk factor (OR, 3.6; P = .03), whereas T-score ≤-2.5 or Z-score ≤-2.0 was not (OR, 2.1; P = .21). Mean final height was normal and did not differ between men and women, or adulthood and childhood-onset patients.ConclusionsMen with craniopharyngioma are at higher risk than women for fractures. In patients with craniopharyngioma, a very low BMD (T-score ≤-2.5 or Z-score ≤-2.0) seems not to be a good predictor for fracture risk.
Highlights
Craniopharyngioma patients (CP) require extensive long-term follow-up because the survival rate is relatively high and the patients often suffer from multiple comorbidities [1, 3]
Several comorbidities could give CP an increased risk of fractures, osteoporosis, and reduced growth: CP are at risk of pituitary insufficiency and/or possibly nonphysiological replacement therapy [3,4,5,6,7,8,9], visual deficiency [10], late puberty induction, hypothalamic damage, and limited physical activity [11,12,13,14]
Osteoporosis is a systemic disease characterized by 3 elements: loss of bone mass, deterioration of the microarchitecture of the bone, and an increased fracture risk [18]
Summary
Patients: Patients with craniopharyngioma (n = 177) with available data on bone health after a median follow-up of 16 years (range, 1-62) were included (106 [60%] Dutch, 93 [53%] male, 84 [48%] childhood-onset disease). In this retrospective cross-sectional study, CO and AO CP treated at the Erasmus University Medical Center (Rotterdam, the Netherlands)/Sophia Children’s Hospital (Rotterdam, the Netherlands), and Sahlgrenska University Hospital (Gothenburg, Sweden) were included. Data on fractures were acquired as described previously [10]; data on fractures were included from 1987 until April 2019. The research proposal was accepted by the Ethical Review Board of the Erasmus Medical Center and the Regional Ethical Review Board of the doi:10.1210/clinem/dgz279
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
