Limits...
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 Two were withdrawn due to vomiting and peripheral edema.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

BMI Change during 6 months treatment with diazoxide and metformin relative to AUCins at the beginning of Treatment (, ).
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3198743&req=5

Figure 2: BMI Change during 6 months treatment with diazoxide and metformin relative to AUCins at the beginning of Treatment (, ).

Mentions: AUCins at the commencement of the study was correlated with weight loss (, ) and BMI decrease (, ) during the study (Figure 2). The positive correlation between WBISI and BMI decrease approached statistical significance (, ) while that with weight did not (, ). There was no significant correlation between any of the weight parameters and leptin or adiponectin at the start of the study (data not shown). Figure 3 provides an example of the pre- and posttreatment insulin curves in a "responder" and a "nonresponder."


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)

BMI Change during 6 months treatment with diazoxide and metformin relative to AUCins at the beginning of Treatment (, ).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: BMI Change during 6 months treatment with diazoxide and metformin relative to AUCins at the beginning of Treatment (, ).
Mentions: AUCins at the commencement of the study was correlated with weight loss (, ) and BMI decrease (, ) during the study (Figure 2). The positive correlation between WBISI and BMI decrease approached statistical significance (, ) while that with weight did not (, ). There was no significant correlation between any of the weight parameters and leptin or adiponectin at the start of the study (data not shown). Figure 3 provides an example of the pre- and posttreatment insulin curves in a "responder" and a "nonresponder."

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