Illustration of a child silhouette facing a glowing brain tumor intertwined with fatty liver cells, representing the connection between craniopharyngioma and NAFLD.

Periostin and Childhood Craniopharyngioma: Unveiling the Connection

Kai Mendoza in Health & Wellness November 2025 • 4 min read.

"Is Periostin a Marker for NAFLD Risk in Children with Craniopharyngioma? New research investigates the relationship between periostin levels and metabolic health in these patients."

Childhood-onset craniopharyngiomas (CP) are rare brain tumors that can lead to a host of long-term health issues. One particularly concerning complication is the development of non-alcoholic fatty liver disease (NAFLD), affecting roughly half of CP patients who also experience hypothalamic syndrome. NAFLD is characterized by excessive fat accumulation in the liver and can progress to more severe liver damage.

Scientists have been searching for reliable markers to identify individuals at higher risk of NAFLD so that interventions can be implemented early. One such marker is periostin, a protein involved in tissue repair and fibrosis. Periostin is highly expressed in the tumor environment of CP and has also been implicated in NAFLD. This raises an important question: could periostin levels in children with CP indicate their risk of developing NAFLD?

A recent study aimed to investigate whether periostin concentrations are elevated in the biological fluids of children with CP and if these levels correlate with indicators of liver health. The findings shed light on the complex relationship between CP, periostin, and NAFLD risk, offering potential insights into improved monitoring and care for these vulnerable patients.

Decoding Periostin: What the Study Revealed

Illustration of a child silhouette facing a glowing brain tumor intertwined with fatty liver cells, representing the connection between craniopharyngioma and NAFLD.

The research team conducted a cross-sectional study involving 35 patients with sellar masses, including 32 with craniopharyngioma, recruited from the German Childhood Craniopharyngioma Registry. Additionally, the study included control groups consisting of children with growth hormone deficiency (GHD), those with decreased insulin-like growth factor-1 (IGF-1), and healthy children. Periostin levels were measured in serum, urine, and saliva samples.

The study looked at various factors, including hypothalamic involvement (damage to the brain region controlling hunger, thirst, and hormone release), the degree of obesity, and liver enzyme levels, to see if they were associated with elevated periostin concentrations. Here's a summary of the key findings:

Periostin Levels: No significant differences were found in periostin concentrations in serum, urine, or saliva between CP patients and the control groups.
Hypothalamic Involvement & Obesity: Hypothalamic involvement/lesions and the degree of obesity were not associated with elevated periostin concentrations.
Liver Health: Similarly, liver enzyme levels did not correlate with periostin levels.
IGF-1 Levels: Interestingly, a subgroup of patients with decreased IGF-1 levels showed elevated serum periostin concentrations compared to other groups.

While the study didn't find a direct link between periostin and traditional NAFLD risk factors in CP, the elevated periostin levels in patients with low IGF-1 warrant further investigation. The researchers emphasized that due to the small number of patients with confirmed NAFLD and the lack of comprehensive liver imaging data, definitive conclusions about periostin as a NAFLD marker in CP couldn't be drawn from the study.

The Implications: Why This Research Matters

This study provides valuable insights into the complex relationship between periostin and metabolic health in children with craniopharyngioma. Although periostin doesn't appear to be a reliable marker for NAFLD risk in this population, the research highlights the importance of continued investigation into the factors that contribute to NAFLD development in CP patients.

The unexpected finding of elevated periostin levels in CP patients with low IGF-1 opens up new avenues for research. Future studies could explore the role of periostin in IGF-1 signaling and its potential connection to metabolic dysfunction in this specific subgroup.

Ultimately, a deeper understanding of the metabolic challenges faced by children with craniopharyngioma is crucial for developing targeted strategies to prevent and manage complications like NAFLD, improving their long-term health and quality of life.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1007/s40618-018-0987-9, Alternate LINK

Title: Periostin Concentrations In Childhood-Onset Craniopharyngioma Patients

Subject: Endocrinology

Journal: Journal of Endocrinological Investigation

Publisher: Springer Science and Business Media LLC

Authors: K. Heinks, C. De Schutter-Nüsse, S. Boekhoff, A. Bogusz, J. Zhu, J. Peng, H. L. Müller

Published: 2018-11-24

Everything You Need To Know

What is Periostin and why was it studied in relation to craniopharyngioma?

Periostin is a protein associated with tissue repair and fibrosis. In the context of craniopharyngioma (CP), it is highly expressed in the tumor environment. The research investigated whether periostin levels could serve as a marker for non-alcoholic fatty liver disease (NAFLD) in children with CP. The study aimed to understand if periostin concentrations in serum, urine, or saliva correlated with indicators of liver health and hypothalamic involvement, due to the high incidence of NAFLD in CP patients.

What is the connection between craniopharyngioma and non-alcoholic fatty liver disease, and why is it important to this research?

Craniopharyngiomas (CP) are rare brain tumors that can cause long-term health problems, including non-alcoholic fatty liver disease (NAFLD). NAFLD is characterized by excessive fat accumulation in the liver, potentially leading to severe liver damage. The research explores the link between periostin and the risk of developing NAFLD in children with CP. Approximately half of the CP patients with hypothalamic syndrome develop NAFLD, making the identification of predictive markers crucial for early intervention and patient management.

Who were the participants in the study, and what factors were examined to understand the relationship between periostin and liver health?

The study involved 35 patients with sellar masses, primarily craniopharyngioma (CP), recruited from the German Childhood Craniopharyngioma Registry. Control groups included children with growth hormone deficiency (GHD), those with decreased insulin-like growth factor-1 (IGF-1), and healthy children. Periostin levels were measured in serum, urine, and saliva. The research investigated correlations between periostin levels and factors such as hypothalamic involvement, obesity, and liver enzyme levels, to assess NAFLD risk. The goal was to find out if periostin levels could predict which children with CP were at higher risk of developing NAFLD.

What were the main findings of the study regarding periostin levels in children with craniopharyngioma?

The research found no significant differences in periostin concentrations in serum, urine, or saliva between CP patients and control groups. Also, hypothalamic involvement/lesions, and the degree of obesity were not associated with elevated periostin levels. The study did find a subgroup of patients with decreased IGF-1 levels showing elevated serum periostin concentrations compared to other groups, which warrants further investigation, but it did not establish a direct link between periostin levels and traditional NAFLD risk factors in CP. Due to the limited patient numbers and data, definitive conclusions about periostin as a NAFLD marker could not be drawn.

Why is this research important for children with craniopharyngioma?

This research matters because it delves into the complex relationship between periostin and metabolic health in children with craniopharyngioma. While the study did not establish periostin as a reliable marker for NAFLD risk, it emphasizes the need for ongoing investigation into factors that contribute to NAFLD development in CP patients. Understanding these factors is crucial for improving monitoring and care strategies for children with craniopharyngioma, as they are at a higher risk of developing NAFLD. The study's findings contribute to the broader goal of identifying early indicators of NAFLD to enable timely interventions.