Pituitary abnormalities in Prader-Willi syndrome and early onset morbid obesity
Prader–Willi syndrome (PWS) is a well‐defined syndrome of childhood‐obesity which can serve as a model for investigating early onset childhood obesity. Many of the clinical features of PWS (e.g., hyperphagia, hypogonadotropic hypogonadism, growth hormone deficiency) are hypothesized to be due to abn...
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| Veröffentlicht in: | American journal of medical genetics. Part A 2008-03, Vol.146A (5), p.570-577 |
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| container_title | American journal of medical genetics. Part A |
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| creator | Miller, Jennifer L. Goldstone, Anthony P. Couch, Jessica A. Shuster, Jonathan He, Guojun Driscoll, Daniel J. Liu, Yijun Schmalfuss, Ilona M. |
| description | Prader–Willi syndrome (PWS) is a well‐defined syndrome of childhood‐obesity which can serve as a model for investigating early onset childhood obesity. Many of the clinical features of PWS (e.g., hyperphagia, hypogonadotropic hypogonadism, growth hormone deficiency) are hypothesized to be due to abnormalities of the hypothalamus and/or pituitary gland. Children who become severely obese very early in life (i.e., before age 4 years) may also have a genetic etiology of their obesity, perhaps with associated neuroendocrine and hypothalamo‐pituitary defects, as infants and very young children have limited access to environmental factors that contribute to obesity. We hypothesized that morphologic abnormalities of the pituitary gland would be seen in both individuals with PWS and other subjects with early onset morbid obesity (EMO). This case‐control study included individuals with PWS (n = 27, age 3 months to 39 years), patients with EMO of unknown etiology (n = 16, age 4–22 years; defined as body mass index greater than the 97th centile for age before age 4 years), and normal weight siblings (n = 25, age 7 months to 43 years) from both groups. Participants had 3‐dimensional magnetic resonance imaging to evaluate the pituitary gland, a complete history and physical examination, and measurement of basal pituitary hormones. Subjects with PWS and EMO had a higher prevalence of pituitary morphological abnormalities than did control subjects (74% PWS, 69% EMO, 8% controls; P |
| doi_str_mv | 10.1002/ajmg.a.31677 |
| format | Article |
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Many of the clinical features of PWS (e.g., hyperphagia, hypogonadotropic hypogonadism, growth hormone deficiency) are hypothesized to be due to abnormalities of the hypothalamus and/or pituitary gland. Children who become severely obese very early in life (i.e., before age 4 years) may also have a genetic etiology of their obesity, perhaps with associated neuroendocrine and hypothalamo‐pituitary defects, as infants and very young children have limited access to environmental factors that contribute to obesity. We hypothesized that morphologic abnormalities of the pituitary gland would be seen in both individuals with PWS and other subjects with early onset morbid obesity (EMO). This case‐control study included individuals with PWS (n = 27, age 3 months to 39 years), patients with EMO of unknown etiology (n = 16, age 4–22 years; defined as body mass index greater than the 97th centile for age before age 4 years), and normal weight siblings (n = 25, age 7 months to 43 years) from both groups. Participants had 3‐dimensional magnetic resonance imaging to evaluate the pituitary gland, a complete history and physical examination, and measurement of basal pituitary hormones. Subjects with PWS and EMO had a higher prevalence of pituitary morphological abnormalities than did control subjects (74% PWS, 69% EMO, 8% controls; P < 0.001). Anterior pituitary hormone deficiencies were universal in individuals with PWS (low IGF‐1 in 100%, P < 0.001 PWS vs. controls; central hypothyroidism in 19%, P = 0.052, and hypoplastic genitalia or hypogonadotropic hypogonadism in 100%, P < 0.001), and was often seen in individuals with EMO (6%, P = 0.89 vs. control, 31%, P = 0.002, and 25%, P = 0.018, respectively). The presence of a hypoplastic pituitary gland appeared to correlate with the presence of anterior pituitary hormone deficiencies in individuals with EMO, but no correlation was apparent in individuals with PWS. In conclusion, the high frequency of both morphological and hormonal abnormalities of the pituitary gland in both individuals with PWS and EMO suggests that abnormalities in the hypothalamo‐pituitary axis are features not only of PWS, but also frequently of EMO of unknown etiology. © 2007 Wiley‐Liss, Inc.</description><identifier>ISSN: 1552-4825</identifier><identifier>EISSN: 1552-4833</identifier><identifier>DOI: 10.1002/ajmg.a.31677</identifier><identifier>PMID: 17431897</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Adolescent ; Adult ; Age of Onset ; Biological and medical sciences ; Child ; Child, Preschool ; Complex syndromes ; early onset obesity ; Humans ; Infant ; Medical genetics ; Medical sciences ; Metabolic diseases ; Obesity ; Obesity, Morbid - epidemiology ; pituitary gland ; Pituitary Gland - abnormalities ; Prader-Willi syndrome ; Prader-Willi Syndrome - diagnosis ; Prader-Willi Syndrome - pathology</subject><ispartof>American journal of medical genetics. Part A, 2008-03, Vol.146A (5), p.570-577</ispartof><rights>Copyright © 2007 Wiley‐Liss, Inc.</rights><rights>2008 INIST-CNRS</rights><rights>(c) 2007 Wiley-Liss, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4987-f9683ee1fa2453baf8b0e6227c74560d515b1732a663331cb1f00e63a71aaf083</citedby><cites>FETCH-LOGICAL-c4987-f9683ee1fa2453baf8b0e6227c74560d515b1732a663331cb1f00e63a71aaf083</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fajmg.a.31677$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fajmg.a.31677$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20188291$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17431897$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Miller, Jennifer L.</creatorcontrib><creatorcontrib>Goldstone, Anthony P.</creatorcontrib><creatorcontrib>Couch, Jessica A.</creatorcontrib><creatorcontrib>Shuster, Jonathan</creatorcontrib><creatorcontrib>He, Guojun</creatorcontrib><creatorcontrib>Driscoll, Daniel J.</creatorcontrib><creatorcontrib>Liu, Yijun</creatorcontrib><creatorcontrib>Schmalfuss, Ilona M.</creatorcontrib><title>Pituitary abnormalities in Prader-Willi syndrome and early onset morbid obesity</title><title>American journal of medical genetics. Part A</title><addtitle>Am. J. Med. Genet</addtitle><description>Prader–Willi syndrome (PWS) is a well‐defined syndrome of childhood‐obesity which can serve as a model for investigating early onset childhood obesity. Many of the clinical features of PWS (e.g., hyperphagia, hypogonadotropic hypogonadism, growth hormone deficiency) are hypothesized to be due to abnormalities of the hypothalamus and/or pituitary gland. Children who become severely obese very early in life (i.e., before age 4 years) may also have a genetic etiology of their obesity, perhaps with associated neuroendocrine and hypothalamo‐pituitary defects, as infants and very young children have limited access to environmental factors that contribute to obesity. We hypothesized that morphologic abnormalities of the pituitary gland would be seen in both individuals with PWS and other subjects with early onset morbid obesity (EMO). This case‐control study included individuals with PWS (n = 27, age 3 months to 39 years), patients with EMO of unknown etiology (n = 16, age 4–22 years; defined as body mass index greater than the 97th centile for age before age 4 years), and normal weight siblings (n = 25, age 7 months to 43 years) from both groups. Participants had 3‐dimensional magnetic resonance imaging to evaluate the pituitary gland, a complete history and physical examination, and measurement of basal pituitary hormones. Subjects with PWS and EMO had a higher prevalence of pituitary morphological abnormalities than did control subjects (74% PWS, 69% EMO, 8% controls; P < 0.001). Anterior pituitary hormone deficiencies were universal in individuals with PWS (low IGF‐1 in 100%, P < 0.001 PWS vs. controls; central hypothyroidism in 19%, P = 0.052, and hypoplastic genitalia or hypogonadotropic hypogonadism in 100%, P < 0.001), and was often seen in individuals with EMO (6%, P = 0.89 vs. control, 31%, P = 0.002, and 25%, P = 0.018, respectively). The presence of a hypoplastic pituitary gland appeared to correlate with the presence of anterior pituitary hormone deficiencies in individuals with EMO, but no correlation was apparent in individuals with PWS. In conclusion, the high frequency of both morphological and hormonal abnormalities of the pituitary gland in both individuals with PWS and EMO suggests that abnormalities in the hypothalamo‐pituitary axis are features not only of PWS, but also frequently of EMO of unknown etiology. © 2007 Wiley‐Liss, Inc.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age of Onset</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Complex syndromes</subject><subject>early onset obesity</subject><subject>Humans</subject><subject>Infant</subject><subject>Medical genetics</subject><subject>Medical sciences</subject><subject>Metabolic diseases</subject><subject>Obesity</subject><subject>Obesity, Morbid - epidemiology</subject><subject>pituitary gland</subject><subject>Pituitary Gland - abnormalities</subject><subject>Prader-Willi syndrome</subject><subject>Prader-Willi Syndrome - diagnosis</subject><subject>Prader-Willi Syndrome - pathology</subject><issn>1552-4825</issn><issn>1552-4833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqF0E1v1DAQBmALgegH3DgjX-BEtrYntpNjVdGFaukHAvVoTZIJcnGSYmcF-ffNdrfLDU4zh2fekV7G3kixkEKoE7zrfixwAdJY-4wdSq1VlhcAz_e70gfsKKU7IUBoa16yA2lzkEVpD9nVtR_XfsQ4caz6IXYY_Ogpcd_z64gNxezWh-B5mvomDh1x7BtOGMPEhz7RyLshVr7hQ0XJj9Mr9qLFkOj1bh6z7-cfv519ylZXy89np6uszsvCZm1pCiCSLapcQ4VtUQkyStna5tqIRktdSQsKjQEAWVeyFTMAtBKxFQUcs_fb3Ps4_FpTGl3nU00hYE_DOjkrAIzJy_9CJUQpTLlJ_LCFdRxSitS6--i7uRgnhds07TZNO3SPTc_87S53XXXU_MW7amfwbgcw1RjaiH3t094pIYtClXJ2sHW_faDpn0_d6cWX5dP7bHvl00h_9lcYfzpjwWp3e7l0Fzfy_OarXLkVPABloKXs</recordid><startdate>20080301</startdate><enddate>20080301</enddate><creator>Miller, Jennifer L.</creator><creator>Goldstone, Anthony P.</creator><creator>Couch, Jessica A.</creator><creator>Shuster, Jonathan</creator><creator>He, Guojun</creator><creator>Driscoll, Daniel J.</creator><creator>Liu, Yijun</creator><creator>Schmalfuss, Ilona M.</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Wiley-Liss</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>20080301</creationdate><title>Pituitary abnormalities in Prader-Willi syndrome and early onset morbid obesity</title><author>Miller, Jennifer L. ; Goldstone, Anthony P. ; Couch, Jessica A. ; Shuster, Jonathan ; He, Guojun ; Driscoll, Daniel J. ; Liu, Yijun ; Schmalfuss, Ilona M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4987-f9683ee1fa2453baf8b0e6227c74560d515b1732a663331cb1f00e63a71aaf083</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age of Onset</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Complex syndromes</topic><topic>early onset obesity</topic><topic>Humans</topic><topic>Infant</topic><topic>Medical genetics</topic><topic>Medical sciences</topic><topic>Metabolic diseases</topic><topic>Obesity</topic><topic>Obesity, Morbid - epidemiology</topic><topic>pituitary gland</topic><topic>Pituitary Gland - abnormalities</topic><topic>Prader-Willi syndrome</topic><topic>Prader-Willi Syndrome - diagnosis</topic><topic>Prader-Willi Syndrome - pathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Miller, Jennifer L.</creatorcontrib><creatorcontrib>Goldstone, Anthony P.</creatorcontrib><creatorcontrib>Couch, Jessica A.</creatorcontrib><creatorcontrib>Shuster, Jonathan</creatorcontrib><creatorcontrib>He, Guojun</creatorcontrib><creatorcontrib>Driscoll, Daniel J.</creatorcontrib><creatorcontrib>Liu, Yijun</creatorcontrib><creatorcontrib>Schmalfuss, Ilona M.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of medical genetics. Part A</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Miller, Jennifer L.</au><au>Goldstone, Anthony P.</au><au>Couch, Jessica A.</au><au>Shuster, Jonathan</au><au>He, Guojun</au><au>Driscoll, Daniel J.</au><au>Liu, Yijun</au><au>Schmalfuss, Ilona M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pituitary abnormalities in Prader-Willi syndrome and early onset morbid obesity</atitle><jtitle>American journal of medical genetics. Part A</jtitle><addtitle>Am. J. Med. Genet</addtitle><date>2008-03-01</date><risdate>2008</risdate><volume>146A</volume><issue>5</issue><spage>570</spage><epage>577</epage><pages>570-577</pages><issn>1552-4825</issn><eissn>1552-4833</eissn><abstract>Prader–Willi syndrome (PWS) is a well‐defined syndrome of childhood‐obesity which can serve as a model for investigating early onset childhood obesity. Many of the clinical features of PWS (e.g., hyperphagia, hypogonadotropic hypogonadism, growth hormone deficiency) are hypothesized to be due to abnormalities of the hypothalamus and/or pituitary gland. Children who become severely obese very early in life (i.e., before age 4 years) may also have a genetic etiology of their obesity, perhaps with associated neuroendocrine and hypothalamo‐pituitary defects, as infants and very young children have limited access to environmental factors that contribute to obesity. We hypothesized that morphologic abnormalities of the pituitary gland would be seen in both individuals with PWS and other subjects with early onset morbid obesity (EMO). This case‐control study included individuals with PWS (n = 27, age 3 months to 39 years), patients with EMO of unknown etiology (n = 16, age 4–22 years; defined as body mass index greater than the 97th centile for age before age 4 years), and normal weight siblings (n = 25, age 7 months to 43 years) from both groups. Participants had 3‐dimensional magnetic resonance imaging to evaluate the pituitary gland, a complete history and physical examination, and measurement of basal pituitary hormones. Subjects with PWS and EMO had a higher prevalence of pituitary morphological abnormalities than did control subjects (74% PWS, 69% EMO, 8% controls; P < 0.001). Anterior pituitary hormone deficiencies were universal in individuals with PWS (low IGF‐1 in 100%, P < 0.001 PWS vs. controls; central hypothyroidism in 19%, P = 0.052, and hypoplastic genitalia or hypogonadotropic hypogonadism in 100%, P < 0.001), and was often seen in individuals with EMO (6%, P = 0.89 vs. control, 31%, P = 0.002, and 25%, P = 0.018, respectively). The presence of a hypoplastic pituitary gland appeared to correlate with the presence of anterior pituitary hormone deficiencies in individuals with EMO, but no correlation was apparent in individuals with PWS. In conclusion, the high frequency of both morphological and hormonal abnormalities of the pituitary gland in both individuals with PWS and EMO suggests that abnormalities in the hypothalamo‐pituitary axis are features not only of PWS, but also frequently of EMO of unknown etiology. © 2007 Wiley‐Liss, Inc.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>17431897</pmid><doi>10.1002/ajmg.a.31677</doi><tpages>8</tpages></addata></record> |
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| ispartof | American journal of medical genetics. Part A, 2008-03, Vol.146A (5), p.570-577 |
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| subjects | Adolescent Adult Age of Onset Biological and medical sciences Child Child, Preschool Complex syndromes early onset obesity Humans Infant Medical genetics Medical sciences Metabolic diseases Obesity Obesity, Morbid - epidemiology pituitary gland Pituitary Gland - abnormalities Prader-Willi syndrome Prader-Willi Syndrome - diagnosis Prader-Willi Syndrome - pathology |
| title | Pituitary abnormalities in Prader-Willi syndrome and early onset morbid obesity |
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