Abstract
Disclosure: C.S. Martins: None. M.C. Nogueira: None. A. Bueno: None. A.S. Berbel-Júnior: None. A.C. Moreira: None. S.R. Antonini: None. M. De Castro: None. Purpose: In patients with adamantinomatous craniopharyngiomas (aCP), hypothalamic obesity may occur due to hypothalamic involvement by the tumor or therapeutic interventions. Studies on appetite sensations and modulation of orexigenic and anorexigenic hormones may contribute to understand the pathogenesis of obesity in aCP patients. Patients and Methods: Fifteen patients (9F, 6M; 31.1±12.0 years) presenting aCP submitted to surgical resection and 15 controls paired by sex, age (31±11.7 years) and Body Mass Index (BMI) were evaluated. Leptin and adiponectin were measured in basal conditions, whereas glucose, insulin, GLP-1, PYY and ghrelin levels were assessed in basal conditions and 30, 60, 120 and 180 minutes after a standard meal test consisted by 70 g of hyposodic soy protein isolate-based powder diluted in 250 mL water to be consumed in up to 10 minutes, resulting in a drink of 315 Kcal with 44.1 g carbohydrate, 10.5 g fat, and 11.0 g protein (56%, 30%, and 14% of total calories, respectively). At the same time points, sensations of hunger, fullness and prospective food consumption were measured by a Visual Analogic Scale (VAS) composed of horizontal lines. Individuals were asked to mark across the line the point correspondent to their sensations, and the distance to the left end of the line was quantified. The term “hunger” was evaluated by the question “How much hunger do you feel?” The answers at the VAS were “I’m not hungry at all” and “I’ve never been so hungry.” The feeling of fullness was evaluated by the question “How satisfied are you?” and the answers were “I am completely empty” and “I am completely full.” Prospective consumption was evaluated by the question “How much do you think you can eat?” and the answers were “nothing” and “too much”. Results: Patients’ BMI were 30.9 ± 7.6 kg/m(2). In aCP patients, differently from controls, the decrease of hunger from baseline to 60 minutes after the meal was not observed, demonstrating a more transient reduction in the sensation of hunger. In addition, a decrease of fullness sensation from 30 to 120 minutes (p=0.03) was observed, demonstrating a less durable sensation of fullness. There was a tendency towards higher fasting leptin concentrations in patients with aCP (p=0.06), while adiponectin levels were lower in patients (p=0.002). Insulin (p=0.01) and HOMA-IR (p=0.001) were higher in aCP patients compared to controls at 3 hours after meal, whereas GLP-1 (P=0.03) and PYY (p=0.02) were higher at 2 hours after the meal. PYY and ghrelin showed earlier postprandial rise and fall, respectively, in aCP patients. Conclusions: After the test, aCP patients exhibited more transient reduction in the sensation of hunger and less durable sensation of fullness than controls. Changes in appetite sensations and unregulated secretion of orexigenic and anorexigenic hormones may contribute to increased food intake and to the pathogenesis of obesity in aCP patients. Presentation: Friday, June 16, 2023