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Fractures, Bone Mineral Density, and Final Height in Craniopharyngioma Patients with a Follow-up of 16 Years

Journal article
Authors S. S. van Santen
Daniel S Olsson
M. M. van den Heuvel-Eibrink
M. Wijnen
Casper Hammarstrand
Jamjl Janssen
G. Johansson
A. J. van der Lely
Sjcmm Neggers
Published in Journal of Clinical Endocrinology & Metabolism
Volume 105
Issue 4
Pages 11
ISSN 0021-972X
Publication year 2020
Published at Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
Pages 11
Language en
Keywords craniopharyngioma, bone health, fractures, bone mineral density, final, height, growth-hormone deficiency, childhood-onset craniopharyngioma, replacement therapy, endocrine sequelae, body-composition, children, osteoporosis, risk, weight, women, Endocrinology & Metabolism
Subject categories Endocrinology and Diabetes


Context: Pituitary hormonal deficiencies in patients with craniopharyngioma may impair their bone health. Objective: To investigate bone health in patients with craniopharyngioma. Design: Retrospective cross-sectional study. Setting: Dutch and Swedish referral centers. 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). Main outcome measures: Fractures, 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. Results: Fractures 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. Conclusions: Men 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.

Page Manager: Webmaster|Last update: 9/11/2012

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