Kraniyofarenjiyoma İlişkili Hipotalamik Obezitede Leptin, Alfa-Melanosit Uyarıcı Hormon ve Beyin Türevli Nörotropik Faktör’ün Rolü

Abstract

Hypothalamic obesity develops in situations that impair the functioning of neuronal networks involved in energy balance or hypothalamic damage. In recent years, the pathway in which leptin/α-MSH/BDNF participated in is thought to be one of the most important hypothalamic pathways involved in energy balance. We aimed to investigate serum leptin/α-MSH/BDNF levels of craniopharyngioma patients, one of the common causes of hypothalamic obesity, in comparison with healthy and exogenous obese control groups. Between October 2016-October 2017 a prospective cross-sectional controlled study was conducted. The study group consisted of 31 craniopharyngioma patients (16 girl/15 boy; median age 14,6 years). Control groups had 27 exogenous obese (15 girl/12 boy; median age 13,5 years, median body mass index (BMI) SDS 2,20) and 25 healthy (18 girl/7 boy; median age 14,1 years, median BMI SDS 0,26) children/adolescents. Craniopharyngioma patients were examined in

two sub-groups: those with BMI persentile ≥95% were obese and the others were non- obese. Of the 31 31 craniopharyngioma patients 15 were (median BMI SDS 2,33)

obese; 16 (median BMI SDS 0,64) were not obese. There is significant difference in

respect to serum BDNF, α-MSH and leptin levels among 4 group (obese and non- obese craniopharyngioma, healthy control and exogenous obese). Serum leptin and

BDNF levels were correlated with BMI SDS in the population in which exogenous obese and healthy control groups were included and were higher in exogenous obese than healthy controls. Similarly, in craniopharyngioma patients serum leptin and BDNF levels were higher in obese craniopharnygioma patients than non-obese. In addition, serum BDNF and leptin levels in obese and non-obese craniopharyngioma patients were not different from BMI SDS smiliar control groups. There wasn’t any correlation between serum α-MSH level and BMI SDS in in the population in which exogenous obese and healthy control groups were included and there was no difference in serum α-MSH levels between the two groups. Serum α-MSH levels were higher in all craniopharyngioma patients than in the other two control groups. Serum α-MSH level was higher in obese craniopharyngioma patients than non-obese craniopharyngioma patients but no statistical difference was found. It is thought to be because of low number of patients. This suggests that leptin and BDNF do not play a role in hypothalamic obesity but α-MSH should play an important role. To confirm validity of these findings, prospective controlled studies are needed that have more cases.