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

van Santen, S. S. (author)
Olsson, Daniel S, 1983 (author)
Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
van den Heuvel-Eibrink, M. M. (author)
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Wijnen, M. (author)
Hammarstrand, Casper, 1990 (author)
Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
Janssen, Jamjl (author)
Johansson, G. (author)
van der Lely, A. J. (author)
Neggers, Sjcmm (author)
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 (creator_code:org_t)
2020-03-07
2020
English.
In: Journal of Clinical Endocrinology & Metabolism. - : The Endocrine Society. - 0021-972X .- 1945-7197. ; 105:4
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • 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.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)

Keyword

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

Publication and Content Type

ref (subject category)
art (subject category)

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