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

Artikel i vetenskaplig tidskrift
Författare 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
Publicerad i Journal of Clinical Endocrinology & Metabolism
Volym 105
Nummer/häfte 4
Sidor 11
ISSN 0021-972X
Publiceringsår 2020
Publicerad vid Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition
Sidor 11
Språk en
Länkar dx.doi.org/10.1210/clinem/dgz279
Ämnesord 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
Ämneskategorier Endokrinologi och diabetes

Sammanfattning

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.

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