Fractures, Bone mineral density, and final height in craniopharyngioma patients with a follow-up of 16 years

Selveta S. Van Santen, Daniel S. Olsso, Marry M. Van Den Heuvel-Eibrink, Mark Wijnen, Casper Hammarstrand, Joseph A.M.J.L. Janssen, Gudmundur Johannsson, Aart J. Van Der Lely, Sebastian J.C.M.M. Neggers

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


Context: Pituitary hormonal deficiencies in patients with craniopharyngioma may impair their bone health. Objective: To investigate bone health in patients with craniopharyngioma. Design: Retrospective cross-sectional study. Setting: Dutch and Swedish referral centers. Patients: Patients with craniopharyngioma (n = 177) with available data on bone health after a median follow-up of 16 years (range, 1-62) were included (106 [60%] Dutch, 93 [53%] male, 84 [48%] childhood-onset disease). Main outcome measures: Fractures, dual X-ray absorptiometry-derived bone mineral density (BMD), and final height were evaluated. Low BMD was defined as T- or Z-score =-1 and very low BMD as ≤-2.5 or ≤-2.0, respectively. Results: Fractures occurred in 31 patients (18%) and were more frequent in men than in women (26% vs. 8%, P = .002). Mean BMD was normal (Z-score total body 0.1 [range, -4.1 to 3.5]) but T- or Z-score ≤-1 occurred in 47 (50%) patients and T-score ≤-2.5 or Z-score ≤-2.0 in 22 (24%) patients. Men received less often treatment for low BMD than women (7% vs. 18%, P = .02). Female sex (OR 0.3, P = .004) and surgery (odds ratio [OR], 0.2; P = .01) were both independent protective factors for fractures, whereas antiepileptic medication was a risk factor (OR, 3.6; P = .03), whereas T-score ≤-2.5 or Z-score ≤-2.0 was not (OR, 2.1; P = .21). Mean final height was normal and did not differ between men and women, or adulthood and childhoodonset patients. Conclusions: Men with craniopharyngioma are at higher risk than women for fractures. In patients with craniopharyngioma, a very low BMD (T-score ≤-2.5 or Z-score ≤-2.0) seems not to be a good predictor for fracture risk.

Original languageEnglish
Pages (from-to)E1397-E1407
JournalJournal of Clinical Endocrinology and Metabolism
Issue number4
Publication statusPublished - 1 Apr 2020


  • Bone health
  • Bone mineral density
  • Craniopharyngioma
  • Final height
  • Fractures


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