Mortality risk is increased in acromegalics, due to cerebrovascular and cardiovascular events. These events are namely related to atherosclerotic vascular alterations, both at coronary and peripheral level. Systemic comorbidities increase the risk of atherosclerosis, but the role of GH and IGF-1 excess is still debated. To evaluate the relationship between GH/IGF-1 excess, systemic atherogenic complications and vascular alterations we investigated stiffness index (β), pulse wave velocity (PWV) and intima-media thickness (IMT) of right and left common carotids in 11 patients (9F:2M, mean age 52.8±4.2) with active acromegaly complicated by systemic comorbidities (hyperlipidemia, blood hypertension and/or diabetes mellitus), in 8 healthy subject (HS, 6F:2M, mean age 48.8±3.2) and in 11 non acromegalic patients matched for comorbidities (NP, 7F:4M, mean age 55.7±3.3). To exclude the role of aging in atherosclerosis, patients and healthy subjects were younger than 60 years of age. Acromegalics showed higher β, PWV and IMT than HS (β: 9.2±1.8 vs 5.3±1.7, P 0.0004; PWV: 7.0±0.8 vs 4.8±1.0, P 0.0004; IMT: 0.9±0.2 vs 0.4±0.1, P 0.0001) but not than NP. The β (8.6±1.3 vs 13.1±1.4, P 0.005) and PWN (7.0±1.0 vs 8.5±0.5, P 0.005), but not IMT, were significantly increased in patients with longer duration of acromegaly (≤10 years vs >10 years). Serum GH and IGF-1 S.D. values did not correlated with β, PWV and IMT in acromegalics and no differences in these index were found on the basis of number of comorbidities (acromegalics with 1 comorbidity vs acromegalics with 2 or more comorbities). In conclusion, 4060 years old acromegalic patients are at risk for early atherosclerotic vascular abnormalities more than healthy subjects and systemic comorbidities play a critical role on these alterations. Despite the increase of atherosclerotic index is not correlated with GH and/or IGF-1 concentrations, early vascular abnormalities are increased in patients with longer duration of the disease.
03 - 07 May 2008
European Society of Endocrinology