Peer-reviewed article
RARE-07. Low resting energy expenditure is associated with clinical and radiological hypothalamic damage in children surviving a suprasellar brain tumor
·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This is a medical study about resting energy expenditure in children who have survived brain tumors affecting the hypothalamus. The study measures metabolic rates and compares them to clinical and radiological indicators of hypothalamic damage. While it involves children, it is a narrow clinical study focused on a rare medical condition and does not address child well-being in the broader sense.
Key points
- 67% of children with suspected hypothalamic dysfunction had low resting energy expenditure compared to predicted levels
- Low resting energy expenditure was significantly associated with severe hypothalamic dysfunction symptoms
- Children with posterior hypothalamic damage showed lower energy expenditure than those with no or anterior damage
- Tumor progression, severe hypothalamic dysfunction, and panhypopituitarism were risk factors for reduced energy expenditure
- Not all children with hypothalamic damage have low resting energy expenditure
Limitations
This is a retrospective cohort study of a highly specific medical population (children surviving suprasellar brain tumors) with no comparison to healthy children. The findings apply only to this rare condition and cannot be generalized to broader child health or well-being populations.
Abstract
Abstract INTRODUCTION: Children with suprasellar brain damage are at risk for hypothalamic dysfunction (HD). HD may lead to decreased resting energy expenditure (REE) contributing to the development of hypothalamic obesity. Decreased REE, however, is not present in all children with hypothalamic damage. Our aim was to assess which children suspect for HD have low REE, and if REE outcome can be associated with clinical severity of HD or with radiological posterior hypothalamic damage. METHODS: A retrospective cohort study was performed evaluating all children diagnosed with brain injury at risk for HD in whom REE measurement was performed. Measured REE (mREE) was compared to predicted REE (pREE) using amongst others the Schofield equation. Low REE was defined as mREE<90% compared to pREE. Radiologic hypothalamic damage was scored using Muller grading score. The mREE/pREE quotient was associated to a clinical score for HD symptoms and to radiological hypothalamic damage. RESULTS: Sixty-seven children suspected for HD (94% brain tumor diagnosis) with a mean BMI SDS of +2.3 ± 1.0 were included. Of these, 45 (67.2%) had mREE <90% compared to the pREE. Children with severe HD symptoms had a significant lower mean mREE/pREE quotient compared to children with no, mild, or moderate HD symptoms. Mean mREE/pREE quotient of children with posterior hypothalamic damage was significantly lower compared to children with no damage or with anterior damage. Tumor progression or tumor recurrence, severe clinical HD, and panhypopituitarism with DI were significant risk factors for reduced REE. CONCLUSION: Not all children suspect for HD have a low REE. Low REE is associated with clinical and radiological scores for hypothalamic damage. REE measurements in childhood brain tumor survivors may be useful to distinguish between those who may benefit from obesity treatment that increases REE from those who would be better helped using other obesity interventions.