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

Hae Woon Jung; Hwa Young Kim; Ji Young Kim; Jung-Eun Cheon; In-One Kim; Seung-Ki Kim; Choong Ho Shin; Sei Won Yang; Young Ah Lee

doi:10.1055/a-1169-0307

Hormone and Metabolic Research, Table of Contents

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

Authors

Hae Woon Jung

¹Department of Pediatrics, Kyung Hee University Medical Center, Seoul, Korea
Hwa Young Kim

²Department of Pediatrics, Kangwon National University School of Medicine, Chuncheon, Korea
Ji Young Kim

³Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
Jung-Eun Cheon

⁴Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
In-One Kim

⁴Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
Seung-Ki Kim

⁵Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea
Choong Ho Shin

³Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
Sei Won Yang

³Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
Young Ah Lee

³Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea

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.

Key words

autonomic nervous system dysfunction - heart rate variability - metabolic syndrome - craniopharyngioma

Full Text

References

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