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Factors Affecting the Increments of Body Mass Index in Adult Survivors of Childhood Brain Tumors

Korean Journal of Pediatrics 2004;47(9):970-977.
Published online September 15, 2004.
Factors Affecting the Increments of Body Mass Index in Adult Survivors of Childhood Brain Tumors
Jae Ho Yoo1, Sung Yeon Ahn2, Choong Ho Shin3, Sei Won Yang3
1Department of Pediatrics, College of Medicine, Dong-A University, Busanl, Korea
2Department of Pediatrics, College of Medicine, Kangwon National University, Chunchon, Korea
3Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea
뇌종양으로 치료받은 환아에서 성인 시기의 신체질량지수 증가에 영향을 미치는 인자
류재호1, 안성연2, 신충호3, 양세원3
1동아대학교 의과대학 소아과학교실
2강원대학교 의과대학 소아과학교실
3서울대학교 의과대학 소아과학교실
Correspondence: 
Jae Ho Yoo, Email: sa1029@empal.com
Abstract
Purpose
: The purpose of this study was to evaluate the factors affecting the increments of body mass index(BMI) in adult survivors from childhood brain tumors.
Methods
: We retrospectively reviewed medical records of 63 patients who were diagnosed with brain tumors and treated at Seoul National University Children's Hospital between 1982 and 2000. We evaluated the factors affecting adult BMI(aBMI) at attainment of final adult height(FAH). Observed factors were as follows : characteristics of tumors, modes of treatment for tumors, existence of growth hormone deficiency(GHD) and growth hormone(GH) replacements, cumulative BMI changes according to GH replacements.
Results
: aBMI in patients with GHD was greater than that in patients without GHD(23.5?.9 kg/ m2 vs 20.4?.8 kg/m2, P=0.012). Among patients with GHD, GH replacement didn't make any difference in aBMI between treated and untreated patients. Cumulative BMI changes from diagnosis of tumor to attainment of FAH( BMI) were positively correlated with cumulative BMI changes before and during GH replacement(r=0.740, P<0.001 and r=0.574, P<0.001, respectively). When analyzed by multiple stepwise linear regression, the strongest related factor for increment of BMI was the increment of cumulative BMI changes before GH replacements. BMI increments velocity(cumulative BMI change/year) before and during GH replacements were 2.3?.5 kg/m2/year and 0.9?.6 kg/m2/ year, respectively(P=0.005). Patients with extensive surgery were greater aBMI(P=0.036).
Conclusion
: This study suggests that GHD and damage of hypothalamus by tumor and/or modes of treatment contribute to the increment of BMI in adult survivors of childhood brain tumors. Early GH replacements may possibly prevent severe hypothalamic obesity, which should be further clarified.
Key Words: Childhood brain tumor, Adult BMI, Hypothalamic obesity


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