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Peer-reviewedCC BY 4.0Cancers

Beyond BMI: Roles of SPISE, Central Adiposity and Body Composition in Pediatric Brain Tumor Survivors

  • Amanda Casirati1,2
  • Giacomo Tantari1
  • Giuseppe D’Annunzio1
  • Alessandro Suppa2
  • Marco Del Monte2
  • Margherita Di Jorgi2
  • Valentina Petrone2
  • Marta Panciroli1,2
  • Gianluca Piccolo3
  • Marta Molteni3
  • Antonia Ramaglia4
  • Anna Elsa Maria Allegri1
7 more authors
  • Alessia Angelelli1
  • Daniela Fava1
  • Alessandro Naim1
  • Flavia Napoli1
  • Caterina Tedesco1
  • Mohamad Maghnie1,2
  • Natascia Di Iorgi1,2
4 affiliations
  1. 1Pediatric Clinic and Endocrinology Unit, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
  2. 2Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16132 Genoa, Italy
  3. 3Neurooncology Unit, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
  4. 4Neuroradiology Unit, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
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Abstract

Background/Objectives. Pediatric brain tumor survivors (PBTS) are at increased risk of cardiometabolic complications due to tumor- and treatment-related hypothalamic–pituitary (HP) damage and adverse body composition. We evaluated associations of the Single-Point Insulin Sensitivity Estimator (SPISE) with central adiposity, DXA-derived body composition, metabolic abnormalities, and HP involvement. Methods. In this retrospective study, 119 PBTSs (median age, 12.7 years; median time since therapy, 2.4 years) were evaluated. SPISE, BMI, waist-to-height ratio (WHtR), DXA-derived fat-to-lean ratio (FLR), and metabolic syndrome (MetS) were assessed. Multivariable logistic regression evaluated the association between SPISE and central adiposity. Exploratory receiver operating characteristic analyses compared the discriminatory performance of SPISE, BMI-SDS, HOMA-IR, and FLR. Results. Central adiposity was present in 58.8% of participants, whereas BMI-defined obesity occurred in 21.8%. Lower SPISE values were associated with central adiposity, obesity, MetS, HP damage, and multiple pituitary hormone deficiencies (all p < 0.05). SPISE declined across pubertal stages and remained associated with central adiposity after adjustment for age and selected HP variables (OR = 0.58, 95% CI 0.46–0.73). SPISE showed good discrimination of central adiposity (AUC = 0.81), with an exploratory, cohort-derived threshold of 7.82; FLR provided complementary information on body composition. Conclusions. Central adiposity was common and not fully captured by BMI-defined obesity. Lower SPISE values were associated with concurrent anthropometric and metabolic abnormalities, while DXA-derived FLR added descriptive information on body composition. Whether these indices improve cardiometabolic risk stratification beyond conventional measures requires prospective investigation.

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Cite

BibTeXRIS
BibTeX
@article{casirati2026beyond,
  title = {{Beyond BMI: Roles of SPISE, Central Adiposity and Body Composition in Pediatric Brain Tumor Survivors}},
  author = {Amanda Casirati and Giacomo Tantari and Giuseppe D’Annunzio and Alessandro Suppa and Marco Del Monte and Margherita Di Jorgi and Valentina Petrone and Marta Panciroli and Gianluca Piccolo and Marta Molteni and Antonia Ramaglia and Anna Elsa Maria Allegri and Alessia Angelelli and Daniela Fava and Alessandro Naim and Flavia Napoli and Caterina Tedesco and Mohamad Maghnie and Natascia Di Iorgi},
  journal = {Cancers},
  year = {2026},
  month = oct,
  doi = {10.3390/cancers18213494},
  url = {https://www.mdpi.com/2072-6694/18/21/3494},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Beyond BMI: Roles of SPISE, Central Adiposity and Body Composition in Pediatric Brain Tumor Survivors
AU  - Amanda Casirati
AU  - Giacomo Tantari
AU  - Giuseppe D’Annunzio
AU  - Alessandro Suppa
AU  - Marco Del Monte
AU  - Margherita Di Jorgi
AU  - Valentina Petrone
AU  - Marta Panciroli
AU  - Gianluca Piccolo
AU  - Marta Molteni
AU  - Antonia Ramaglia
AU  - Anna Elsa Maria Allegri
AU  - Alessia Angelelli
AU  - Daniela Fava
AU  - Alessandro Naim
AU  - Flavia Napoli
AU  - Caterina Tedesco
AU  - Mohamad Maghnie
AU  - Natascia Di Iorgi
PY  - 2026
DA  - 2026/10/29
JO  - Cancers
DO  - 10.3390/cancers18213494
UR  - https://www.mdpi.com/2072-6694/18/21/3494
AB  - Background/Objectives. Pediatric brain tumor survivors (PBTS) are at increased risk of cardiometabolic complications due to tumor- and treatment-related hypothalamic–pituitary (HP) damage and adverse body composition. We evaluated associations of the Single-Point Insulin Sensitivity Estimator (SPISE) with central adiposity, DXA-derived body composition, metabolic abnormalities, and HP involvement. Methods. In this retrospective study, 119 PBTSs (median age, 12.7 years; median time since therapy, 2.4 years) were evaluated. SPISE, BMI, waist-to-height ratio (WHtR), DXA-derived fat-to-lean ratio (FLR), and metabolic syndrome (MetS) were assessed. Multivariable logistic regression evaluated the association between SPISE and central adiposity. Exploratory receiver operating characteristic analyses compared the discriminatory performance of SPISE, BMI-SDS, HOMA-IR, and FLR. Results. Central adiposity was present in 58.8% of participants, whereas BMI-defined obesity occurred in 21.8%. Lower SPISE values were associated with central adiposity, obesity, MetS, HP damage, and multiple pituitary hormone deficiencies (all p < 0.05). SPISE declined across pubertal stages and remained associated with central adiposity after adjustment for age and selected HP variables (OR = 0.58, 95% CI 0.46–0.73). SPISE showed good discrimination of central adiposity (AUC = 0.81), with an exploratory, cohort-derived threshold of 7.82; FLR provided complementary information on body composition. Conclusions. Central adiposity was common and not fully captured by BMI-defined obesity. Lower SPISE values were associated with concurrent anthropometric and metabolic abnormalities, while DXA-derived FLR added descriptive information on body composition. Whether these indices improve cardiometabolic risk stratification beyond conventional measures requires prospective investigation.
SN  - 2072-6694
ER  -