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Hypothalamic Obesity following Craniopharyngioma Surgery: Results of a Pilot Trial of Combined Diazoxide and Metformin Therapy.

Hamilton JK, Conwell LS, Syme C, Ahmet A, Jeffery A, Daneman D - Int J Pediatr Endocrinol (2011)

Bottom Line: Conclusion.Combined diazoxide-metformin therapy was associated with reduced weight gain in patients with hypothalamic obesity.AUC(ins) at study commencement predicted effectiveness of the treatment.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada M5G 1X8.

ABSTRACT
Objective. To assess the effect of combined diazoxide-metformin therapy in obese adolescents treated for craniopharyngioma. Design. A prospective open-label 6-month pilot treatment trial in 9 obese subjects with craniopharyngioma. Diazoxide (2 mg/kg divided b.i.d., maximum 200 mg/day) and metformin (1000 mg b.i.d.). Whole body insulin sensitivity index (WBISI) and area-under-the-curve insulin (AUC(ins)) were calculated. Results. Seven subjects completed: 4M/3F, mean ± SD age 15.4 ± 2.9 years, weight 99.7 ± 26.3 kg, BMI 35.5 ± 5.6 kg/m(2), and BMI SDS 2.3 ± 0.3. Two were withdrawn due to vomiting and peripheral edema. Of participants completing the study, the mean ± SD weight gain, BMI, and BMI SDS during the 6 months were reduced compared to the 6 months prestudy (+1.2 ± 5.9 versus +9.5 ± 2.7 kg, P = .004; -0.3 ± 2.3 versus +2.2 ± 1.5 kg/m(2), P = .04; -0.04 ± 0.15 versus +0.11 ± 0.08, P = .021, resp.). AUC(ins) correlated with weight loss (r = 0.82, P = .02) and BMI decrease (r = 0.96, P = .009). Conclusion. Combined diazoxide-metformin therapy was associated with reduced weight gain in patients with hypothalamic obesity. AUC(ins) at study commencement predicted effectiveness of the treatment.

No MeSH data available.


Related in: MedlinePlus

Changes in individual (a) weight, (b) BMI, and (c) BMI SDS during the 6 months before (light bars) and after 6 months (dark bars) of metformin-diazoxide treatment.
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Figure 1: Changes in individual (a) weight, (b) BMI, and (c) BMI SDS during the 6 months before (light bars) and after 6 months (dark bars) of metformin-diazoxide treatment.

Mentions: Of participants completing the study, the mean ± SD weight gain during the 6 months of the study was significantly reduced compared to that in the 6 months prestudy ( versus  kg, ) (Figure 1(a)). The mean BMI ( versus  kg/m2, ) was also significantly reduced during the study period (Figure 1(b)). The change in BMI SDS was also significantly reduced in the 6 months during the study period ( versus , ) (Figure 1(c)).


Hypothalamic Obesity following Craniopharyngioma Surgery: Results of a Pilot Trial of Combined Diazoxide and Metformin Therapy.

Hamilton JK, Conwell LS, Syme C, Ahmet A, Jeffery A, Daneman D - Int J Pediatr Endocrinol (2011)

Changes in individual (a) weight, (b) BMI, and (c) BMI SDS during the 6 months before (light bars) and after 6 months (dark bars) of metformin-diazoxide treatment.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3198743&req=5

Figure 1: Changes in individual (a) weight, (b) BMI, and (c) BMI SDS during the 6 months before (light bars) and after 6 months (dark bars) of metformin-diazoxide treatment.
Mentions: Of participants completing the study, the mean ± SD weight gain during the 6 months of the study was significantly reduced compared to that in the 6 months prestudy ( versus  kg, ) (Figure 1(a)). The mean BMI ( versus  kg/m2, ) was also significantly reduced during the study period (Figure 1(b)). The change in BMI SDS was also significantly reduced in the 6 months during the study period ( versus , ) (Figure 1(c)).

Bottom Line: Conclusion.Combined diazoxide-metformin therapy was associated with reduced weight gain in patients with hypothalamic obesity.AUC(ins) at study commencement predicted effectiveness of the treatment.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada M5G 1X8.

ABSTRACT
Objective. To assess the effect of combined diazoxide-metformin therapy in obese adolescents treated for craniopharyngioma. Design. A prospective open-label 6-month pilot treatment trial in 9 obese subjects with craniopharyngioma. Diazoxide (2 mg/kg divided b.i.d., maximum 200 mg/day) and metformin (1000 mg b.i.d.). Whole body insulin sensitivity index (WBISI) and area-under-the-curve insulin (AUC(ins)) were calculated. Results. Seven subjects completed: 4M/3F, mean ± SD age 15.4 ± 2.9 years, weight 99.7 ± 26.3 kg, BMI 35.5 ± 5.6 kg/m(2), and BMI SDS 2.3 ± 0.3. Two were withdrawn due to vomiting and peripheral edema. Of participants completing the study, the mean ± SD weight gain, BMI, and BMI SDS during the 6 months were reduced compared to the 6 months prestudy (+1.2 ± 5.9 versus +9.5 ± 2.7 kg, P = .004; -0.3 ± 2.3 versus +2.2 ± 1.5 kg/m(2), P = .04; -0.04 ± 0.15 versus +0.11 ± 0.08, P = .021, resp.). AUC(ins) correlated with weight loss (r = 0.82, P = .02) and BMI decrease (r = 0.96, P = .009). Conclusion. Combined diazoxide-metformin therapy was associated with reduced weight gain in patients with hypothalamic obesity. AUC(ins) at study commencement predicted effectiveness of the treatment.

No MeSH data available.


Related in: MedlinePlus