[1]申丹丹 贾红蔚 刘铭 何庆 郑方遒.颅咽管瘤术后垂体功能减退患者糖代谢异常危险因素研究[J].国际内分泌代谢杂志,2022,42(04):293-297.[doi:10.3760/cma.j.cn121383-20210104-01006]
　Shen Dandan,Jia Hongwei,Liu Ming,et al.Study on the risk factors of abnormal glucose metabolism in patients with hypopituitarism after craniopharyngioma surgery[J].International Journal of Endocrinology and Metabolism,2022,42(04):293-297.[doi:10.3760/cma.j.cn121383-20210104-01006]
点击复制

颅咽管瘤术后垂体功能减退患者糖代谢异常危险因素研究()
分享到：

《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
42
期数:
2022年04期
页码:
293-297
栏目:
论著
出版日期:
2022-07-20

文章信息/Info

Title:
Study on the risk factors of abnormal glucose metabolism in patients with hypopituitarism after craniopharyngioma surgery
作者:
申丹丹 贾红蔚 刘铭 何庆 郑方遒
天津医科大学总医院内分泌代谢科 300052
Author(s):
Shen Dandan;  Jia Hongwei;  Liu Ming;  He Qing;  Zheng Fangqiu.
Department of Endocrinology and Metabolism, the General Hospital of Tianjin Medical University, Tianjin 300052, China
关键词:
颅咽管瘤;  垂体功能减退;  糖尿病;  糖耐量;  下丘脑性肥胖
Keywords:
Craniopharyngioma;  Hypopituitarism;  Diabetes;  Glucose tolerance;  Hypothalamic obesity
DOI:
10.3760/cma.j.cn121383-20210104-01006
摘要:
目的 研究颅咽管瘤术后垂体功能减退患者糖代谢异常的危险因素。方法 收集2008年3月至2020年7月天津医科大学总医院住院的49例颅咽管瘤术后垂体功能减退患者首次入院资料,根据1999年世界卫生组织(WHO)公布的糖尿病诊断标准,将49例患者分为糖代谢异常组(糖尿病患者和糖耐量减低患者)和糖代谢正常组。收集患者的一般资料、术后并发症、实验室检验结果等进行病例回顾性分析。结果(1)糖代谢异常组 18 例,其中11例为糖尿病,7例为糖耐量异常。(2)糖代谢异常组体重指数(BMI)、合并脂肪肝比例及甘油三酯水平显著高于糖代谢正常组。(3)二元logistic回归分析发现,超重、肥胖是颅咽管瘤术后垂体功能减退患者糖代谢异常的独立危险因素,BMI截断值为27.25 kg/m2。结论 颅咽管瘤术后患者糖代谢异常比例较高,超重肥胖是其独立危险因素。
Abstract:
Objective To study the risk factors of abnormal glucose metabolism in patients with hypopituitarism after craniopharyngioma operation.Methods The first admission data of 49 patients with hypopituitarism after craniopharyngioma were collected from March 2008 to July 2020 in the General Hospital of Tianjin Medical University. According to the diagnostic criteria of diabetes published by the World Health Organization(WHO)in 1999, 49 patients were divided into the group with abnormal glucose metabolism(diabetic patients and patients with impaired glucose tolerance)and the group with normal glucose metabolism. The general information, postoperative complications and laboratory results of these patients were retrospectively analyzed.Results(1)There were 18 cases in the group with abnormal glucose metabolism, among which 11 cases were diagnosed with diabetes, and 7 cases were diagnosed with impaired glucose tolerance.(2)The body mass index(BMI), the percentage of fatty liver and the level of triglyceride of the group with abnormal glucose metabolism were much higher than the control group.(3)Overweight and obesity were independent risk factors for abnormal glucose metabolism in postoperative patients with craniopharyngioma, and the cut-off value of BMI was 27.25 kg/m2.Conclusion The proportion of patients with abnormal glucose metabolism after craniopharyngioma is high and overweight and obesity are independent risk factors for abnormal glucose metabolism in postoperative patients with craniopharyngioma.

参考文献/References:

[1] Müller HL,Merchant TE,Warmuth-Metz M,et al.Craniopharyngioma[J].Nat Rev Dis Primers,2019,5(1):75.DOI:10.1038/s41572-019-0125-9.
[2] Bunin GR,Surawicz TS,Witman PA,et al.The descriptive epidemiology of craniopharyngioma[J].J Neurosurg,1998,89(4):547-551.DOI:10.3171/jns.1998.89.4.0547.
[3] Olsson DS,Andersson E,Bryngelsson IL,et al.Excess mortality and morbidity in patients with craniopharyngioma,especially in patients with childhood onset:a population-based study in Sweden[J].J Clin Endocrinol Metab,2015,100(2):467-74.DOI:10.1210/jc.2014-3525.
[4] Zacharia BE,Bruce SS,Goldstein H,et al.Incidence,treatment and survival of patients with craniopharyngioma in the surveillance,epidemiology and end results program[J].Neuro Oncol,2012,14(8):1070-1078.DOI:10.1093/neuonc/nos142.
[5] Müller HL,Merchant TE,Puget S,et al.New outlook on the diagnosis,treatment and follow-up of childhood-onset craniopharyngioma[J].Nat Rev Endocrinol,2017,13(5):299-312.DOI:10.1038/nrendo.2016.217.
[6] MüLLER HL.Management of endocrine disease:childhood-onset craniopharyngioma:state of the art of care in 2018[J].Eur J Endocrinol,2019,180(4):R159-R174.DOI:10.1530/EJE-18-1021.
[7] Bogusz A,Müller HL.Childhood-onset craniopharyngioma:latest insights into pathology,diagnostics,treatment,and follow-up[J].Expert Rev Neurother,2018,18(10):793-806.DOI:10.1080/14737175.2018.1528874.
[8] 冯英.颅咽管瘤中肥胖的机制与影响[J].国际内分泌代谢杂志,2017,37(5):352-354.DOI:10.3760/cma.j.issn.1673-4157.2017.05.016.
[9] Nielsen EH,Feldt-Rasmussen U,Poulsgaard L,et al.Incidence of craniopharyngioma in Denmark(n=189)and estimated world incidence of craniopharyngioma in children and adults[J].J Neurooncol,2011,104(3):755-763.DOI:10.1007/s11060-011-0540-6.
[10] Crotty TB,Scheithauer BW,Young WF Jr,et al.Papillary craniopharyngioma:a clinicopathological study of 48 cases[J].J Neurosurg,1995,83(2):206-214.DOI:10.3171/jns.1995.83.2.0206.
[11] Erfurth EM.Endocrine aspects and sequel in patients with craniopharyngioma[J].J Pediatr Endocrinol Metab,2015,28(1-2):19-26.DOI:10.1515/jpem-2014-0419.
[12] 唐彩华,周金桥,邓大同.垂体功能减退症合并糖尿病12例报道[J].安徽医药,2014,18(12):2341-2342.DOI:10.3969/j.issn.1009-6469.2014.042.
[13] Tsai WT,Chen YL,Lai SM,et al.Craniopharyngioma or its surgery induces diabetes mellitus. Case report[J].Neuro Endocrinol Lett,2011,32(5):627-630.
[14] 陈敏,陈玉华,任伶俐,等.颅咽管瘤伴糖尿病高血糖高渗状态二例并文献复习[J].中华内分泌代谢杂志,2010,26(11):1006-1008.DOI:10.3760/cma.j.issn.1000-6699.2010.11.026.
[15] 高龙,黄乐,吕玲,等.颅咽管瘤术后儿童高血糖高渗综合征一例[J].中国小儿急救医学,2013,20(5):548-549.DOI:10.3760/cma.j.issn.1673-4912.2013.05.038.
[16] 莫泽纬,陈道雄.颅咽管瘤术后并发下丘脑性肥胖、2型糖尿病1例[J].中国现代医学杂志,2017,27(27):127-128.DOI:10.3969/j.issn.1005-8982.2017.27.025.
[17] Matthews DR,Hosker JP,Rudenski AS,et al.Homeostasis model assessment:insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man[J].Diabetologia,1985,28(7):412-419.DOI:10.1007/BF00280883.
[18] Wijnen M,van den Heuvel-Eibrink MM,Janssen JAMJL,et al.Very long-term sequelae of craniopharyngioma[J].Eur J Endocrinol,2017,176(6):755-767.DOI:10.1530/EJE-17-0044.
[19] Andereggen L,Hess B,Andres R,et al.A ten-year follow-up study of treatment outcome of craniopharyngiomas[J].Swiss Med Wkly,2018,148:w14521.DOI:10.4414/smw.2018.14521.
[20] Abuzzahab MJ,Roth CL,Shoemaker AH.Hypothalamic obesity:rologue and promise[J].Horm Res Paediatr,2019,91(2):128-136.DOI:10.1159/000496564.
[21] Simoneau-Roy J,O'Gorman C,Pencharz P,et al.Insulin sensitivity and secretion in children and adolescents with hypothalamic obesity following treatment for craniopharyngioma?[J].Clin Endocrinol(Oxf),2010,72(3):364-370.DOI:10.1111/j.1365-2265.2009.03639.x.
[22] Lustig RH,Post SR,Srivannaboon K,et al.Risk factors for the development of obesity in children surviving brain tumors[J].J Clin Endocrinol Metab,2003,88(2):611-616.DOI:10.1210/jc.2002-021180.
[23] Roth CL,Eslamy H,Werny D,et al.Semiquantitative analysis of hypothalamic damage on MRI predicts risk for hypothalamic obesity[J].Obesity(Silver Spring),2015,23(6):1226-1233.DOI:10.1002/oby.21067.
[24] Lustig RH,Hinds PS,Ringwald-Smith K,et al.Octreotide therapy of pediatric hypothalamic obesity:a double-blind,placebo-controlled trial[J].J Clin Endocrinol Metab,2003,88(6):2586-2592.DOI:10.1210/jc.2002-030003.
[25] Kalina MA,Wilczek M,Kalina-Faska B,et al.Carbohydrate-lipid profile and use of metformin with micronized fenofibrate in reducing metabolic consequences of craniopharyngioma treatment in children:single institution experience[J].J Pediatr Endocrinol Metab,2015,28(1-2):45-51.DOI:10.1515/jpem-2014-0425.
[26] Zoicas F,Droste M,Mayr B,et al.GLP-1 analogues as a new treatment option for hypothalamic obesity in adults:report of nine cases[J].Eur J Endocrinol,2013,168(5):699-706.DOI:10.1530/EJE-12-0997.
[27] Roth CL,Perez FA,Whitlock KB,et al.A phase 3 randomized clinical trial using a once-weekly glucagon-like peptide-1 receptor agonist in adolescents and young adults with hypothalamic obesity[J].Diabetes Obes Metab,2021,23(2):363-373..DOI:10.1111/dom.14224.
[28] Lomenick JP,Buchowski MS,Shoemaker AH.A 52-week pilot study of the effects of exenatide on body weight in patients with hypothalamic obesity[J].Obesity(Silver Spring),2016,24(6):1222-1225.DOI:10.1002/oby.21493.
[29] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2020年版)[J].中华糖尿病杂志,2021,13(4):315-409.DOI:10.3760/cma.j.cn115791-20210221-00095.

相似文献/References:

[1]吴蔚,杨叶虹,李益明.下丘脑性肥胖临床研究进展[J].国际内分泌代谢杂志,2014,(01):32.[doi:10.3760/cma.j.issn.1673-4157.2014.01.009]
　Wu Wei,Yang Yehong,Li Yiming.Clinical progress in hypothalamic obesity[J].International Journal of Endocrinology and Metabolism,2014,(04):32.[doi:10.3760/cma.j.issn.1673-4157.2014.01.009]
[2]冯英.颅咽管瘤中肥胖的机制与影响[J].国际内分泌代谢杂志,2017,37(05):352.
　Feng Ying..The mechanism and effect of obesity in craniopharyngioma[J].International Journal of Endocrinology and Metabolism,2017,37(04):352.
[3]余红,何庆.欧洲内分泌学会生长激素替代治疗安全性的共识解读——颅咽管瘤术后[J].国际内分泌代谢杂志,2023,43(03):274.[doi:10.3760/cma.j.cn121383-20230504-05006]
　Yu Hong,He Qing..Interpretation of the European Endocrine Society Consensus on the safety of growth hormone replacement therapy-Postoperative craniopharyngioma[J].International Journal of Endocrinology and Metabolism,2023,43(04):274.[doi:10.3760/cma.j.cn121383-20230504-05006]
[4]吴晗 于淼 贾黎静 肖诚.遗传性血色病所致内分泌功能异常的研究进展[J].国际内分泌代谢杂志,2023,43(05):376.[doi:10.3760/cma.j.cn121383-20221211-12028]
　Wu Han,Yu Miao,Jia Lijing,et al.Research advances in endocrinopathies caused by hereditary haemochromatosis[J].International Journal of Endocrinology and Metabolism,2023,43(04):376.[doi:10.3760/cma.j.cn121383-20221211-12028]

备注/Memo

备注/Memo:
通信作者:郑方遒,Email:fqzheng@163.com
更新日期/Last Update: 2022-06-20