Autonomic dysfunction is associated with increased cardiometabolic risk in patients with childhood-onset craniopharyngioma
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.
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Decreased heart rate variability is a manifestation of autonomic impairment that has been demonstrated in individuals with hypothalamic injury.
“Decreased heart rate variability, the loss of the typical beat-to-beat fluctuation in rhythm, is a manifestation of autonomic impairment that has been demonstrated in individuals with hypothalamic injury (57, 58).”
From Approach to the patient with acquired hypothalamic syndrome (2026) · cites this paper as [57]
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Acquired hypothalamic obesity: A clinical overview and update
Roth, C. L., & McCormack, S. E. (2024) · Diabetes, Obesity and Metabolism · doi:10.1111/dom.15530 · Cited by 42 · see citing works
Approach to the patient with acquired hypothalamic syndrome
Grishman, E. K., & McCormack, S. E. (2026) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgag197
- Authors
- Jung, H. W., Kim, H. Y., Kim, J. Y., Cheon, J.-E., Kim, I.-O., Kim, S.-K., Shin, C. H., Yang, S. W., & Lee, Y. A.
- Affiliations
- Kyung Hee University Medical Center (KR)
- Kangwon National University (KR)
- Seoul National University (KR)
- ORCID
- Venue
- Hormone and Metabolic Research
- Publisher
- Georg Thieme Verlag KG
- Published
- 2020-06-08
- Volume
- 52
- Issue
- 07
- Pages
- 500-508
- ISSN
- 0018-5043 (ISSN-L)
- 1439-4286
- OpenAlex
- W3033610905
- Cited by
- 9
- References
- 0
- Citations by year
- 2026: 3 · 2024: 2 · 2022: 2 · 2021: 1 · 2020: 1
- FWCI
- 0.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Hormone and Metabolic Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
- Keywords
- craniopharyngioma, childhood-onset craniopharyngioma, autonomic dysfunction, heart rate variability, metabolic syndrome, cardiometabolic risk, hypothalamic injury, parasympathetic modulation, insulin resistance, triglycerides, blood pressure, hypothalamic obesity
- MeSH terms
- Cancer Survivors, Cardiometabolic Risk Factors, Adolescent, Adult, Arrhythmias, Cardiac, Autonomic Nervous System, Autonomic Nervous System Diseases, Blood Pressure, Child, Craniopharyngioma, Cross-Sectional Studies, Female, Follow-Up Studies, Heart Rate, Humans, Insulin Resistance, Male, Pituitary Neoplasms, Risk Factors, Age of Onset, Paraneoplastic Syndromes, Nervous System, Metabolic Syndrome, Young Adult, Republic of Korea
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