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J. Clin. Med. 2015, 4(9), 1774-1797; doi:10.3390/jcm4091774

Hypothalamic Obesity in Craniopharyngioma Patients: Disturbed Energy Homeostasis Related to Extent of Hypothalamic Damage and Its Implication for Obesity Intervention

Seattle Children's Hospital Research Institute, University of Washington, Department of Pediatrics, Center for Integrative Brain Research, 1900 Ninth Ave, P.O. Box 5371 M/S-C9S, Seattle, WA 98101, USA
Academic Editors: Günter Stalla and Anna Kopczak
Received: 30 June 2015 / Revised: 26 August 2015 / Accepted: 31 August 2015 / Published: 9 September 2015
(This article belongs to the Special Issue Neuroendocrine Disturbances after Brain Damage)
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Abstract

Hypothalamic obesity (HO) occurs in patients with tumors and lesions in the medial hypothalamic region. Hypothalamic dysfunction can lead to hyperinsulinemia and leptin resistance. This review is focused on HO caused by craniopharyngiomas (CP), which are the most common childhood brain tumors of nonglial origin. Despite excellent overall survival rates, CP patients have substantially reduced quality of life because of significant long-term sequelae, notably severe obesity in about 50% of patients, leading to a high rate of cardiovascular mortality. Recent studies reported that both hyperphagia and decreased energy expenditure can contribute to severe obesity in HO patients. Recognized risk factors for severe obesity include large hypothalamic tumors or lesions affecting several medial and posterior hypothalamic nuclei that impact satiety signaling pathways. Structural damage in these nuclei often lead to hyperphagia, rapid weight gain, central insulin and leptin resistance, decreased sympathetic activity, low energy expenditure, and increased energy storage in adipose tissue. To date, most efforts to treat HO have shown disappointing long-term success rates. However, treatments based on the distinct pathophysiology of disturbed energy homeostasis related to CP may offer options for successful interventions in the future. View Full-Text
Keywords: hypothalamic obesity; craniopharyngioma; risk factors; neuroimaging; rodent models; inflammation; pharmacological interventions hypothalamic obesity; craniopharyngioma; risk factors; neuroimaging; rodent models; inflammation; pharmacological interventions
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Roth, C.L. Hypothalamic Obesity in Craniopharyngioma Patients: Disturbed Energy Homeostasis Related to Extent of Hypothalamic Damage and Its Implication for Obesity Intervention. J. Clin. Med. 2015, 4, 1774-1797.

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