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van Roessel IMAA, Bakker B, Schouten-van Meeteren AYN, Tissing WJE, Gan HW, van Santen HM. Increased insulin-like growth factor-1 concentrations in paediatric suprasellar low-grade glioma: an international multicentre study. Eur J Endocrinol 2025; 192:641-650. [PMID: 40400261 DOI: 10.1093/ejendo/lvaf095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2024] [Revised: 04/22/2025] [Accepted: 05/05/2025] [Indexed: 05/23/2025]
Abstract
OBJECTIVE The objective of this study was to assess the prevalence of elevated insulin-like growth factor (IGF)-1 in children with suprasellar low-grade glioma (LGG) and explore the course of IGF-1 over time and its association with anthropometrics, hypothalamic syndrome, tumour characteristics, and tumour behaviour. DESIGN This retrospective study included children from the Netherlands and the United Kingdom diagnosed with a suprasellar LGG under the age of 18 between 2003 and 2023, with a minimum 1-year follow-up. Elevated IGF-1 was defined as IGF-1 standard deviation score (SDS) >+2.0 for age and biological sex, without growth hormone use. RESULTS We included 235 patients with a median age at brain tumour diagnosis of 3.8 years (IQR 1.7-7.1). Elevated IGF-1 was observed in 73 patients (31.1%) at any time point. At tumour diagnosis, 15.2% of the 138 children tested showed elevated IGF-1. Elevated IGF-1 was associated with younger age at tumour diagnosis (P = .004), neurofibromatosis type 1 (NF1; P = .028), and diencephalic syndrome (P = .047). In 55 of the 73 patients with elevated IGF-1 (75.3%), IGF-1 normalized spontaneously over time. Final height SDS corrected for target height SDS was not associated with having had an elevated IGF-1 (P = .113). No difference was found in the number of tumour progressions. CONCLUSIONS Increased IGF-1 concentrations are commonly observed in children with suprasellar LGG, especially in younger children, those with an NF1 mutation, or during underweight. Elevation of IGF-1 can resolve over time, and the absence of an effect on final height or on tumour progressions seems reassuring.
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Affiliation(s)
- Ichelle M A A van Roessel
- Department of Pediatric Neuro-oncology, Princess Máxima Center for Pediatric Onology, Heidelberglaan 25, Utrecht 3584 CS, The Netherlands
- Department of Pediatric Endocrinology, Wilhelmina Children's Hospital, University Medical Center, Lundlaan 6, Utrecht 3584 EA, The Netherlands
- Department of Paediatric Endocrinology, Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3BH, United Kingdom
| | - Boudewijn Bakker
- Department of Pediatric Endocrinology, Wilhelmina Children's Hospital, University Medical Center, Lundlaan 6, Utrecht 3584 EA, The Netherlands
| | | | - Wim J E Tissing
- Department of Pediatric Neuro-oncology, Princess Máxima Center for Pediatric Onology, Heidelberglaan 25, Utrecht 3584 CS, The Netherlands
- Department of Pediatric Oncology and Hematology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Groningen 9713 GZ, Netherlands
| | - Hoong-Wei Gan
- Department of Paediatric Endocrinology, Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3BH, United Kingdom
| | - Hanneke M van Santen
- Department of Pediatric Neuro-oncology, Princess Máxima Center for Pediatric Onology, Heidelberglaan 25, Utrecht 3584 CS, The Netherlands
- Department of Pediatric Endocrinology, Wilhelmina Children's Hospital, University Medical Center, Lundlaan 6, Utrecht 3584 EA, The Netherlands
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Carbone EA, Caroleo M, Rania M, de Filippis R, Condoleo F, Catalano F, Aloi M, De Fazio P, Arturi F, Hribal ML, Fiorentino TV, Segura-Garcia C. Influence of NUCB/Nesfatin-1 Polymorphism on Treatment Response to Naltrexone/Bupropion SR in Binge Eating Disorder and Obesity. Biomedicines 2024; 12:451. [PMID: 38398053 PMCID: PMC10887296 DOI: 10.3390/biomedicines12020451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/08/2024] [Accepted: 02/13/2024] [Indexed: 02/25/2024] Open
Abstract
Background and Objectives: The NUCB2 gene and its polymorphisms were identified as novel players in the regulation of food intake, potentially leading to obesity (OBE) and altered eating behaviors. Naltrexone/bupropion SR (NB) showed good efficacy and tolerability for treating OBE and altered eating behaviors associated with binge eating disorder (BED). This prospective study investigates the influence of NUCB2 gene polymorphism on NB treatment response in OBE and BED. Materials and Methods: Body mass index (BMI), eating (EDE-Q, BES, NEQ, GQ, Y-FAS 2.0) and general psychopathology (BDI, STAI-S) were evaluated at baseline (t0) and after 16 weeks (t1) of NB treatment in patients with OBE and BED (Group 1; N = 22) vs. patients with OBE without BED (Group 2; N = 20). Differences were evaluated according to the rs757081 NUCB2 gene polymorphism. Results: NUCB2 polymorphism was equally distributed between groups. Although weight at t0 was higher in Group 1, weight loss was similar at t1 in both groups. BMI was not influenced by NUCB2 polymorphism. In Group 1, the CG-genotype reported significant improvement in eating psychopathology while the GG-genotype reported improvement only for FA. No differences were observed in Group 2. Conclusions: Patients diagnosed with BED and treated with NB exhibited a more favorable treatment response within the CG-genotype of the NUCB2 polymorphism.
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Affiliation(s)
- Elvira Anna Carbone
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (E.A.C.); (F.C.); (F.A.); (M.L.H.); (T.V.F.)
| | - Mariarita Caroleo
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy (M.A.); (P.D.F.)
| | - Marianna Rania
- Center for Clinical Research and Treatment of Eating Disorders, University Hospital Renato Dulbecco, 88100 Catanzaro, Italy;
| | - Renato de Filippis
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy (M.A.); (P.D.F.)
| | - Francesca Condoleo
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (E.A.C.); (F.C.); (F.A.); (M.L.H.); (T.V.F.)
| | - Federica Catalano
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (E.A.C.); (F.C.); (F.A.); (M.L.H.); (T.V.F.)
| | - Matteo Aloi
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy (M.A.); (P.D.F.)
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
| | - Pasquale De Fazio
- Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy (M.A.); (P.D.F.)
| | - Franco Arturi
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (E.A.C.); (F.C.); (F.A.); (M.L.H.); (T.V.F.)
| | - Marta Letizia Hribal
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (E.A.C.); (F.C.); (F.A.); (M.L.H.); (T.V.F.)
| | - Teresa Vanessa Fiorentino
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (E.A.C.); (F.C.); (F.A.); (M.L.H.); (T.V.F.)
| | - Cristina Segura-Garcia
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (E.A.C.); (F.C.); (F.A.); (M.L.H.); (T.V.F.)
- Center for Clinical Research and Treatment of Eating Disorders, University Hospital Renato Dulbecco, 88100 Catanzaro, Italy;
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van Roessel IMAA, Schouten-van Meeteren AYN, Meijer L, Hoving EW, Bakker B, van Santen HM. Transition From Diencephalic Syndrome to Hypothalamic Obesity in Children With Suprasellar Low Grade Glioma: A Case Series. Front Endocrinol (Lausanne) 2022; 13:846124. [PMID: 35464054 PMCID: PMC9019925 DOI: 10.3389/fendo.2022.846124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/02/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Children with suprasellar low grade glioma (LGG) frequently develop problems to maintain their body weight within the normal range, due to hypothalamic dysfunction. Hypothalamic damage may result in the diencephalic syndrome (DS), characterized by underweight or failure to thrive, but also in hypothalamic obesity (HO). Children with LGG presenting with DS at young age often develop HO later in life. The underlying pathophysiology for this change in body mass index (BMI) is not understood. Previous hypotheses have focused on the tumor or its treatment as the underlying cause. To better understand its etiology, we aimed to relate changes in BMI over time in children with suprasellar LGG presenting with DS to age, tumor progression, treatment, and endocrine function. We hypothesize that the development of HO in children with LGG presenting with DS is related to maturation status of the hypothalamus at time of injury and thus age. METHODS In this retrospective case series, all cases diagnosed in the Netherlands with suprasellar located LGG, currently treated or followed, with a history of DS developing into HO were included. RESULTS In total, 10 children were included. Median age at LGG diagnosis was 1.5 years (range 0.4-5.5), median BMI SDS was -2.64. The children developed overweight at a median age of 4.5 years (2.2-9.8). The median total difference in BMI SDS between underweight and obesity was +5.75 SDS (4.5-8.7). No association could be found between transition of DS to HO and onset of a pituitary disorder (present in 70.0%), surgery, chemotherapy, or tumor behavior. Two had developed central precocious puberty (CPP), both while having underweight or normal weight. CONCLUSION The shift from DS to HO in children with hypothalamic LGG may be associated with age and not to tumor behavior, treatment characteristics or pituitary function. The development of CPP in these children seems not to be related to obesity. Our findings may indicate that the clinical picture of hypothalamic dysfunction reflects the maturation state of the hypothalamus at time of lesioning. Future prospective studies are needed to better understand underlying causative mechanisms of the morbid changes in body weight.
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Affiliation(s)
- Ichelle M. A. A. van Roessel
- Department of Pediatric Endocrinology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, Netherlands
- *Correspondence: Ichelle M. A. A. van Roessel,
| | | | - Lisethe Meijer
- Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Eelco W. Hoving
- Department of Neurosurgery, Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Boudewijn Bakker
- Department of Pediatric Endocrinology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, Netherlands
- Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Hanneke M. van Santen
- Department of Pediatric Endocrinology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, Netherlands
- Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
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The Role of the Gastric Hormones Ghrelin and Nesfatin-1 in Reproduction. Int J Mol Sci 2021; 22:11059. [PMID: 34681721 PMCID: PMC8539660 DOI: 10.3390/ijms222011059&set/a 934136356+984013925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
Ghrelin and nesfatin-1 are enteroendocrine peptide hormones expressed in rat X/A-like and human P/D1cells of the gastric mucosa. Besides their effect on food intake, both peptides are also implicated in various other physiological systems. One of these is the reproductive system. This present review illustrates the distribution of ghrelin and nesfatin-1 along the hypothalamus-pituitary-gonadal (HPG) axis, their modulation by reproductive hormones, and effects on reproductive functions as well as highlighting gaps in current knowledge to foster further research.
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Schalla MA, Stengel A. The Role of the Gastric Hormones Ghrelin and Nesfatin-1 in Reproduction. Int J Mol Sci 2021; 22:ijms222011059. [PMID: 34681721 PMCID: PMC8539660 DOI: 10.3390/ijms222011059] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/05/2021] [Accepted: 10/06/2021] [Indexed: 12/11/2022] Open
Abstract
Ghrelin and nesfatin-1 are enteroendocrine peptide hormones expressed in rat X/A-like and human P/D1cells of the gastric mucosa. Besides their effect on food intake, both peptides are also implicated in various other physiological systems. One of these is the reproductive system. This present review illustrates the distribution of ghrelin and nesfatin-1 along the hypothalamus–pituitary–gonadal (HPG) axis, their modulation by reproductive hormones, and effects on reproductive functions as well as highlighting gaps in current knowledge to foster further research.
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Affiliation(s)
- Martha A. Schalla
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, 12203 Berlin, Germany;
| | - Andreas Stengel
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, 12203 Berlin, Germany;
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, 72076 Tübingen, Germany
- Correspondence:
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Developmental changes in the hypothalamic mRNA expression levels of brain-derived neurotrophic factor and serum leptin levels: Their responses to fasting in male and female rats. Int J Dev Neurosci 2016; 54:1-5. [PMID: 27521083 DOI: 10.1016/j.ijdevneu.2016.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 08/04/2016] [Accepted: 08/08/2016] [Indexed: 01/19/2023] Open
Abstract
The actions and responses of hypothalamic appetite regulatory factors change markedly during the neonatal to pre-pubertal period in order to maintain appropriate metabolic and nutritional conditions. In this study, we examined the developmental changes in the hypothalamic mRNA levels of brain-derived neurotrophic factor (BDNF), which is a potent anorectic factor and the changes in the sensitivity of the hypothalamic expression of this factor to fasting during the neonatal to pre-pubertal period. Under fed conditions, hypothalamic BDNF mRNA expression decreased during development in both male and female rats. Similarly, the serum levels of leptin, which is a positive regulator of hypothalamic BDNF expression, also tended to fall during the developmental period. The serum leptin level and the hypothalamic BDNF mRNA level were found to be positively correlated in both sexes under the fed conditions. Hypothalamic BDNF mRNA expression was decreased by 24h fasting (separating the rats from their mothers) in the early neonatal period (postnatal day 10) in both males and females, but no such changes were seen at postnatal day 20. Twenty-four hours' fasting (food deprivation) did not affect hypothalamic BDNF mRNA expression in the pre-pubertal period (postnatal day 30). On the other hand, the rats' serum leptin levels were decreased by 24h fasting (separating the rats from their mothers at postnatal day 10 and 20, and food deprivation at postnatal day 30) throughout the early neonatal to pre-pubertal period. The correlation between serum leptin and hypothalamic BDNF mRNA levels was not significant under the fasted conditions. It can be speculated that leptin partially regulates hypothalamic BDNF mRNA levels, but only in fed conditions. Such changes in hypothalamic BDNF expression might play a role in maintaining appropriate metabolic and nutritional conditions and promoting normal physical development. In addition, because maternal separation induces a negative energy balance and short- and long-term stress responses, it is also possible that reductions in hypothalamic BDNF mRNA levels in the early neonatal period (postnatal day 10) may be partially induced by stress responses of the maternal deprivation.
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