"Subclinical atherosclerosis in acromegaly: Possible association with cardiovascular risk factors rather than disease activity".

Autor: de Almeida MCC; Hospital of Clinics of the Federal University of Minas Gerais, Brazil; Ecocenter, Socor Hospital, Santa Casa de Belo Horizonte, Brazil., Freire CMV; Hospital of Clinics of the Federal University of Minas Gerais, Brazil; Ecocenter, Socor Hospital, Santa Casa de Belo Horizonte, Brazil., Nunes MDCP; Hospital of Clinics of the Federal University of Minas Gerais, Brazil., Soares BS; Hospital of Clinics of the Federal University of Minas Gerais, Brazil., Barbosa MM; Ecocenter, Socor Hospital, Santa Casa de Belo Horizonte, Brazil., Giannetti AV; Hospital of Clinics of the Federal University of Minas Gerais, Brazil., Zille GP; Ecocenter, Socor Hospital, Santa Casa de Belo Horizonte, Brazil., Miranda PAC; Endocrinology and Metabolism Unit, Santa Casa de Belo Horizonte, Brazil., Ribeiro-Oliveira A Jr; Hospital of Clinics of the Federal University of Minas Gerais, Brazil., Drummond JB; Hospital of Clinics of the Federal University of Minas Gerais, Brazil. Electronic address: jubeaudette@ufmg.br.
Jazyk: angličtina
Zdroj: Growth hormone & IGF research : official journal of the Growth Hormone Research Society and the International IGF Research Society [Growth Horm IGF Res] 2022 Feb; Vol. 62, pp. 101442. Date of Electronic Publication: 2021 Dec 16.
DOI: 10.1016/j.ghir.2021.101442
Abstrakt: Objective: Cardiovascular (CV) disease is still a major cause of excessive morbidity and mortality in patients with active acromegaly, which may be attributed to a high prevalence of associated pro-atherosclerotic risk factors. However, a direct effect of GH/IGF-1 excess on the vasculature has been previously suggested, warranting further investigation. The present study was designed to investigate whether chronic GH/IGF-1 excess is associated with an increased prevalence of subclinical atherosclerosis in patients with acromegaly.
Design: We measured carotid intima-media thickness (cIMT) and assessed carotid plaques by ultrasonography along with classical CV risk factors in 54 acromegaly patients (34 females, 50 ± 12 years and compared those with 62 (42 females, 53 ± 13 years) age-, sex- and CV risk factors- matched controls. In order to compare cIMT measurements between patients and controls we analyzed common carotid artery far wall data as well as a combined measurement result, which consisted of the mean value of the six different measurements, three at each side.
Results: mean ± SD serum GH and IGF-1 levels were 2.76 ± 4.65 ng/mL and 1.7 ± 1.25 x ULN, respectively, in all acromegaly patients. Age, body mass index, blood pressure, lipid levels, fasting glucose and Framingham's global cardiovascular risk score classification were similar comparing patients and controls. Combined median [IQR] cIMT measurements were similar in acromegaly patients and matched controls (0.59 [0.52-0.66] mm vs. 0.59 [0.52-0.69] mm; P = 0.872) as well as in acromegaly patients with active and controlled disease (0.59 [0.51-0.68] mm vs. 0.60 [0.54-0.68] mm; P = 0.385). No significant correlations were observed between cIMT measurements and GH (Spearman r = 0.1, P = 0.49) or IGF-1 (Spearman r = 0.13, P = 0.37) levels in patients with acromegaly. Carotid atherosclerotic plaques prevalence was similar in patients and controls (26% vs. 32%; P = 0.54) as well as in patients with active and controlled acromegaly (22% vs. 30%; P = 0.537).
Conclusions: Our data suggest that GH/IGF-1 excess itself is not one of the main drivers of subclinical morphological atherosclerosis changes in patients with acromegaly and that optimal control of acromegaly-associated CV risk factors may preserve vasculature structure even when strict biochemical control is not achieved.
(Copyright © 2021. Published by Elsevier Ltd.)
Databáze: MEDLINE
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