ABSTRACT

Objective:

In acromegaly, the incidence of cardiovascular disease is higher compared to healthy population because of the association of secondary cardiovascular disease risk factors such as hypertension, glucose intolerance, dyslipidemia, and insulin resistance. This study aimed to evaluate the relationship between Growth Hormone (GH), Insulin-like Growth Factor-1 (IGF-1), and lipid profiles in patients with newly diagnosed acromegaly.

Methods:

This study included 57 newly diagnosed acromegaly patients and 31 healthy control cases. Blood samples were taken after a 12-hour night fasting to analyze the levels of the hormones, the lipid profiles, and the fasting blood glucose.

Results:

The mean of LDL-C level in the acromegaly group and control group were respectively 140.2±61.3 mg/dL and 115.6±30.4 mg/dL, (p=0.029), triglyceride level 137.6±84.0 mg/dL and 102.9±43.0 mg/dL, (p=0.027) and HDL-C level 41.5±10.5 mg/dL and 50.5±10.6 mg/dL, (p=0.001). There was a significant positive correlation between GH levels of LDL (r=0.375, p=0.002), TG (r=0.302, p=0.01), IGF-1 (r=0.634, p=0.0001) and HOMA-IR (r=0.699, p=0.0001), IGF-1 and LDL levels (r=0.295, p=0.01) and TG (r=0.476, p=0.0001). There was a negative correlation between HDL and GH (r=-0.399, p=0.001) and HDL with IGF-1 (r=-0.310, p=0.01).

Conclusions:

Acromegaly is a disorder characterized by an excess of GH and GH appears to adversely affect the lipid profile. It can be considered that this risk factor may be eliminated by the control of the levels of GH and IGF-1 in acromegaly patients. Further studies seem necessary for more clarifica-tion.

Keywords: Acromegaly, dyslipidemias, atherosclerosis

References

Hoskuldsdottir GT, Fjalldal SB, Sigurjonsdottir HA. The incidence and prevalence of acromegaly, a nationwide study from 1955 through 2013. Pituitary 2015;18:803-7.

Lavrentaki A, Paluzzi A, Wass JA, Karavitaki N. Epidemiology of acromegaly: review of population studies. Pituitary 2017;20:4-9.

Lopez-Velasco R, Escobar-Morreale HF, Vega B, Vılla E, Sancho JM, Moya-Mur JL, et al. Cardiac involvement in acromegaly: specific myocardiopathy or consequence of systemic hypertension? J Clin Endocrinol Metab 1997;82:1047-53.

Mearns BM. Targeting levels and functions of blood lipids in the prevention of CVD. Nat Rev Cardiol 2011;8:179-80.

CVD Statistics - European Heart Network. European Cardiovascular Disease Statistics 2017 [online]. Available from URL: http://www.ehnheart.org/cvd-statistics/cvd-statistics-2017.html

Carmichael JD, Bonert VS, Mirocha JM, Melmed S. The utility of oral glucose tolerance testing for diagnosis and assessment of treatment outcomes in 166 patients with acromegaly. J Clin Endocrinol Metab 2009;94:523-7.

Minuto F, Resmini E, Boschetti M, Arvigo M, Sormani MP, Giusti M, et al. Assessment of disease activity in acromegaly by means of a single blood sample: comparison of the 120th minute postglucose value with spontaneous GH secretion and with the IGF system. Clin Endocrinol (Oxf) 2004;61:138-44.

Carroll PV, Jenkins PJ. Acromegaly. Editors In: De Groot LJ, Beck-Peccoz P, Chrousos G, Dungan K, Grossman A, Hershman JM, Koch C, McLachlan R, New M, Rebar R, Singer F, Vinik A, Weickert MO, editors. Endotext (Internet). South Dartmouth (MA): MD Text.com, Inc; 2000-2012 Mar 26

Reyes-Vidal CM, Mojahed H, Shen W, Jin Z, Arias-Mendoza F, Fernandez JC, et al. Adipose tissue redistribution and ectopic lipid deposition in active acromegaly and effects of surgical treatment. J Clin Endocrinol Metab 2015;100:2946-55.

Işıldak M, Güven GS, Gürlek A. Metabolik sendrom ve insulin direnci. Haccettepe Tıp Dergisi 2004;35:96-9.

Vilar L, Naves LA, Costa SS, Abdalla LF, Coelho CE, Casulari LA. Increase of classic and nonclassic cardiovascular risk factors in patients with acromegaly. Endocr Pract 2007;13:363-72.

Boero L, Manavela M, Merono T, Maidana P, Gomez Rosso L, Brites F. GH levels and insulin sensitivity are differently associated with biomarkers of cardiovascular disease in active acromegaly. Clin Endocrinol (Oxf) 2012;77:579-85.

Boero L, Cuniberti L, Magnani N, Manavela M, Yapur V, Bustos M, et al . Increased oxidized low density lipoprotein associated with high ceruloplasmin activity in patients with active acromegaly. Clin Endocrinol (Oxf ) 2010;72:654-60.

Olarescu NC, Heck A, Godang K, Ueland T, Bollorslev J. The metabolic risk in patients newly diagnosed with acromegaly is related to fat distribution and circulating adipokines and improves after treatment. Neuroendocrinology 2016;103:197-206.

Galesanu C, Buzduga C, Florescu A, Moisii L, Ciubotaru V. Diabetes mellitus, chronic complication in patients with acromegaly: case report and review of the literature. Rev Med Chir Soc Med Nat Iasi 2015;119:92-6.

Evaluation of Serum Lipid Parameters in Acromegaly Patients

ABSTRACT

References