CP-13. MRI-DERIVED NUCHAL SKINFOLD THICKNESS AS AN INDEX OF BODY COMPOSITION IN CHILDHOOD-ONSET CRANIOPHARYNGIOMA

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Abstract BACKGROUND Survivors of childhood craniopharyngioma often develop obesity. Body mass index (BMI) is an imperfect estimate of adiposity. Nuchal skinfold thickness (NST) is a measure of upper body adiposity obtainable from routine surveillance brain MRIs. Our objective was to evaluate whether NST adds more information than BMI alone regarding excess adiposity in survivors of childhood craniopharyngioma. METHODS This was a single-site, retrospective review of children (all ages) diagnosed with craniopharyngioma between 2008 and 2020 with data at baseline, and 6 (±2) and 12 (±2) months follow-up (2008-2020). NST was measured on a mid-sagittal T1-weighted MRI image, on the line crossing the anterior and posterior margins of the foramen magnum. BMI Z-scores (BMI-Z) were calculated using extended CDC references. Mixed effects regression assessed change in NST related to time from diagnosis and BMI-Z, accounting for age and sex. RESULTS Thirty-two patients met criteria (female, n=9 [28%]; median age 8.3y [range, 2.1-15.5] at diagnosis). Mean BMI Z-scores were 0.82 (SD 1.38) at diagnosis, 1.44 (1.07) at 6 months (p=0.004 vs. diagnosis), and 1.40 at 12 months (p=0.01 vs. diagnosis). Median nuchal thickness was 7.1 mm (IQR 5.8, 9.5) at diagnosis, 9.7 mm (IQR 7.8, 10.7) at 6 months (p=0.001 vs. diagnosis), and 10.1 mm (IQR 8.1, 12.6) at 12 months (p=0.0001 vs. diagnosis). As expected, nuchal thickness positively associated with BMI-Z (β, 1.3, p<0.001). Even after accounting for age, sex, and change in BMI-Z, NST was higher at 12 months as compared to diagnosis (β, 1.8, p=0.004). CONCLUSION BMI-Z and NST increase over time in children with craniopharyngioma. Increases in NST are not explained by increases in BMI-Z alone, suggesting that NST reflects an additional dimension of body composition. Next, we will evaluate how including NST along with BMI improves cardiometabolic risk prediction in childhood craniopharyngioma. FUNDING Finamore Family Research Fund.

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