Horm Metab Res 2020; 52(07): 500-508
DOI: 10.1055/a-1169-0307
Endocrine Care

Autonomic Dysfunction is Associated with Increased Cardiometabolic Risk in Patients with Childhood-Onset Craniopharyngioma

Hae Woon Jung
1  Department of Pediatrics, Kyung Hee University Medical Center, Seoul, Korea
,
Hwa Young Kim
2  Department of Pediatrics, Kangwon National University School of Medicine, Chuncheon, Korea
,
Ji Young Kim
3  Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
,
Jung-Eun Cheon
4  Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
,
In-One Kim
4  Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
,
Seung-Ki Kim
5  Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea
,
Choong Ho Shin
3  Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
,
Sei Won Yang
3  Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
,
Young Ah Lee
3  Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
› Author Affiliations

Abstract

Patients with craniopharyngioma are susceptible to autonomic dysfunction as a result of hypothalamic damage. We evaluated indices of heart rate variability (HRV) in patients with childhood-onset craniopharyngioma to investigate autonomic function and its relationship with components of the metabolic syndrome (MetS). This cross-sectional, case-only study included 53 patients (10–30 years of age). We measured the standard deviation of all normal R-R intervals (SDNN) and total power indicating overall HRV, the root-mean square of the difference of successive R-R intervals (RMSSD) and high frequency indicating parasympathetic modulation, and low frequency. These indices were compared according to the presence of the MetS. During the mean 10.8 years of follow-up, 25% of patients were diagnosed with the MetS. Patients with the MetS showed significantly lower levels of SDNN (29.0 vs. 40.6 ms), total power (416.1 vs. 1129.6 ms2), RMSSD (20.1 vs. 34.5 ms), high frequency (94.7 vs. 338.5 ms2), and low frequency (94.5 vs. 289.4 ms2) than those without (p <0.05, for all). Individual components of the MetS including insulin resistance, serum triglycerides levels, and systolic blood pressure were inversely associated with SDNN, total power, RMSSD and high frequency. Higher overall variability and parasympathetic modulation were related to decreased odds ratios for having the MetS (OR 0.91, p=0.029 for SDNN; OR 0.91, p=0.032 for total power). In conclusion, autonomic dysfunction, as evidenced by reduced HRV indices, is associated with increased cardiometabolic risk in patients with childhood-onset craniopharyngioma.



Publication History

Received: 03 July 2019

Accepted: 27 April 2020

Publication Date:
08 June 2020 (online)

© Georg Thieme Verlag KG
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