Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2016) 41 EP883 | DOI: 10.1530/endoabs.41.EP883

1Department of Clinical and Experimental Medicine, Endocrinology Section, University of Pisa, Pisa, Italy; 2Epidemiology and Biostatistics Unit, Institute of Clinical Physiology, National Research Council (C.N.R.), Pisa, Italy; 3Department of Pathology, University of Pisa, Pisa, Italy.

Context: Acromegalic patients have a high-risk cardiovascular profile. However, the determinants of cardiovascular risk factors and major cardiovascular events (MACE), which may develop after diagnosis of acromegaly, are not fully understood.

Objectives: To identify the predictors for systemic comorbidities and MACE, after diagnosis of disease. The role of therapy for acromegaly on the occurrence of such complications was also evaluated.

Patients and methods: Retrospective cohort study on 200 consecutive acromegalic patients. The following outcomes were evaluated: diabetes mellitus, arterial hypertension, hypercholesterolemia and MACE. Each patient was included in the analysis for a specific outcome if it was not present at diagnosis of acromegaly and further classified as: 1) in remission after adenomectomy (Hx), 2) controlled by somatostatin analogues (SSA) (SSAc) or 3) not controlled by SSA (SSAnc). Data were evaluated using Cox regression analysis.

Results: After diagnosis of acromegaly, diabetes occurred in 40.8% of the patients (Hx 27.3%; SSAc 40%; SSAnc 65%; P=0.002); lack of control of acromegaly was decisive for the onset of the outcome (HR=3.32; P=0.006). Hypertension arose in 35.5% of the patients (Hx 33.3%; SSAc 36.8%; SSAnc 50%; P=0.0172). The strongest determinants of this outcome were age at diagnosis of acromegaly (HR=1.059; P=0.014) and body mass index (HR=1.05; P=0.014). Hypercholesterolemia occurred in 47.8% of the patients without differences among the 3 groups (P=0.322). Disease activity was a predictor of hypercholesterolemia (HR=2.14; P=0.004). MACE were recorded in 12.7% of the patients (Hx 15%; SSAc 10.9%; SSAnc 13.6%; P=0.247). Age at diagnosis of acromegaly (HR=1.09; P=0.005) and smoking habit (HR=5.95; P=0.001) were associated with an increased risk of MACE.

Conclusion: After diagnosis of acromegaly, control of disease (irrespectively to the type of treatment) and lifestyle are predictors of the occurrence of cardiovascular risk factors and cardiovascular events.

Article tools

My recent searches

No recent searches.