Without adequate treatment patients with acromegaly die prematurely from cardiovascular disease (CVD); however the contribution of atherosclerosis in this process is controversial. Increased carotid IMT is an early morphological marker of atherosclerosis and predictor of subsequent cardiovascular events. Contradictory data exist regarding IMT in patients with acromegaly.
We measured carotid IMT in 79 patients with acromegaly (47 male, mean age 55±14 years) and 22 age-matched healthy controls (12 males, 57±11) [P=0.5]. 32 patients had HT, 16 DM, 8 IHD, 2 PVD, 19 hyperlipidaemia (on treatment) and 16 smoked; 8 controls smoked. Three measurements were taken bilaterally: at the carotid bifurcation and 1 cm above and below, the mean was calculated for each side.
Median IGF-I was 255 ng/ml (62 1155) and SDS 2.0 (−2.85 +5.76) in patients and 148 ng/ml (67 − 201) and 0.54 (−1.68 +1.70) respectively in controls [P <0.0001]. Median BP was similar in patients (130/78) and controls (139/69). Total cholesterol and LDL were 5 mmol/l (3 8) and 3 mmol/l (1 6) in patients and 6 mmol/l (4 7) and 4 mmol/l (2 4) in controls respectively [P=0.07, P=0.06].
Median IMT did not differ in patients: 0.75 mm (0.43 1.17) compared to controls: 0.71 mm (0.45 1.03) [P=0.3]. When comparing IMT in patients with high IGF-I levels and patients with normal IGF-I levels no difference was found [P=0.6]. No correlation was found with IGF-I or BP and IMT. 17 (21.5%) patients had 1/more plaques present and 4 (18.2%) controls [P=1].
In summary, carotid IMT does not differ in patients with acromegaly when compared to controls. The lack of increase in IMT is against the development of premature atherosclerosis in this patient group.
01 - 05 Apr 2006
European Society of Endocrinology