Cardiovascular diasease (CV) is the leading cause of mortality in acromegalic patients. Although acromegalic cardiomyopathy has been extensively investigated, there is a lack of data about atherosclerosis in acromegaly.
We aimed to the evaluate the extent of carotid atherosclerosis with various CV biomarkers in acromegaly. Sixty-one acromegalic patients and 21 age and sex matched healthy controls were included. We measured carotid intima media thickness (CIMT) and performed OGTT and hormonal evaluation. CV risk factors including microalbuminuria (MAU), cystatin C, proBNP, uric acid (UA), CRP and serum lipids were also measured. Cystatin C and total cholestrol levels were higher in acromegalic patients (P=0.012 and P=0.005, respectively), while LDL levels were lower than controls (P=0.022). CRP, UA, proBNP, degree of MAU and CIMT were not different from controls. Patients with normal IGF-1 for age or patients who achieved the nadir GH level of <1 ng/ml after OGTT were found to have lower microalbuminuria when compared to their counterparts (P<0.028 and P<0.028, respectively). However, other parameters were not statistically different between acromegalic patients achieving normal IGF-1 and/or nadir GH<1 ng/ml. We found no difference between diabetic and nondiabetic acromegalic patients in terms of CV risk parameters. We found a weak but positive correlation between CIMT and cystatin C levels (R=0.201, P<0.001), CIMT and UA (R=0.164, P<0.005) and CIMT and proBNP (R=0.202, P<0.001) in acromegalic patients.
CIMT was not higher than controls despite well documented CV risk factors in acromegalics. Disease activity was not associated with CIMT as well.
Correlation between CIMT and cystatin C, UA and proBNP may suggest a cluster effect of some CV risk factors in acromegalics for developing atherosclerosis. Evaluation of vascular abnormalities in conjuction with other CV risk factors may better predict those at higher risk for atherosclerosis and CV events in acromegalics.
25 - 29 Apr 2009
European Society of Endocrinology