ECE2022 Poster Presentations Pituitary and Neuroendocrinology (127 abstracts)
Very-low-calorie-ketogenic-diet (VLCKD) approach to manage obesity in craniopharingioma patients
Oana Ruxandra Cotta 1 , Ylenia Alessi 1 , Rosaria Certo 1 , Alessandra Piccione 1 , Rosalinda Casablanca 1 , Giuseppe Paola 1 , Martina Buda 2 , Monica Scaramuzzo 1 , Francesco Ferrau’ 1,2 & Salvatore Cannavo’ 1,2
1University of Messina, Unit of Endocrinology, Messina, Italy; 2University of Messina, Department of Human Pathology of Adulthood and Childhood “G. Barresi”, Italy
Background: Craniopharingioma patients frequently experience severe obesity, unresponsive to caloric restriction or lifestyle modifications. Recently very-low-ketogenic-diets (VLCKD) proved to be a promising lifestyle intervention for obesity management, but no data are available regarding their effect on hypothalamic obesity (HO).
Introduction: We present the outcome of VLCKD protocol applied in young patients with HO following neurosurgery for craniopharingioma.
Methods: Three patients who developed HO after surgery for craniopharingioma (1 male, mean weight 125±2.8 kg, mean BMI 43.9±3.9 kg/m2) were treated with VLCKD protocol. All patients had previously undergone largely unsuccessful dietary interventions. BMI, weight, waist circumference changes and adverse effects were assessed during a follow-up period of 7.5±7.3 months (range 3-16 months).
Results: The two female patients presented panhypopituitarism and diabetes insipidus, while the male had multiple pituitary deficiencies (central hypothyroidism, hypogonadotropic hypogonadism and growth hormone deficiency); all patients were on adequate replacement therapy. Both female patients presented visual field impairment. All patients showed non-alcoholic steatoepatitis, hyperinsulinism but not diabetes mellitus, while the male patient also presented hyperuricemia. VLCKD resulted in a significant weight loss (125±2.8 kg vs 112.4±3.6 kg, P0.008) as well as waist circumference reduction (111.7±3.8 vs 102.3±3.0, P0.029). At last follow-up, BMI (43.9±3.9 kg/m2 vs 39.4±2.8 kg/m2 P0.17) and HOMA Index (9.66±2.6 vs 5.12±3.5, P0.14) remarkably decreased, although not significantly. The only side effect registered was persistent hyponatriemia in one female patient, normalising after VLCKD suspension, corticosteroid and desmopressin replacement treatment adjusting.
Conclusions: The use of VLCKD protocol is a promising, safe and effective treatment option for HO in craniopharingioma patients. Frequent control of electrolytes is mandatory.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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