Persistent inflammation and endothelia dysfunction in patients with treated acromegaly
| Autor: | A. R. M. M. Hermus, Niels P. Riksen, Dick H. J. Thijssen, Romana T. Netea-Maier, N van Leeuwen, C.D.C.C. van der Heijden, Thalijn L C Wolters, Jan W. A. Smit, Mihai G. Netea, Bregina T. P. Hijmans-Kersten |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Endocrinology Diabetes and Metabolism medicine.medical_treatment Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4] 030209 endocrinology & metabolism Inflammation Rare cancers Radboud Institute for Molecular Life Sciences [Radboudumc 9] 030204 cardiovascular system & hematology lcsh:Diseases of the endocrine glands. Clinical endocrinology Gastroenterology endothelial dysfunction Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] 03 medical and health sciences All institutes and research themes of the Radboud University Medical Center 0302 clinical medicine Endocrinology cardiovascular disease Internal medicine Acromegaly Internal Medicine medicine Endothelial dysfunction Pulse wave velocity Whole blood lcsh:RC648-665 business.industry Growth factor Research IGF1 Vascular damage Radboud Institute for Molecular Life Sciences [Radboudumc 16] Metabolic Disorders Radboud Institute for Molecular Life Sciences [Radboudumc 6] medicine.disease R1 3. Good health Cytokine inflammation acromegaly Interleukin 18 medicine.symptom business |
| Zdroj: | Endocrine Connections Endocrine Connections, 8, 1553-1567 Endocrine Connections, Vol 8, Iss 12, Pp 1553-1567 (2019) Endocrine Connections, 8, 12, pp. 1553-1567 |
| ISSN: | 2049-3614 |
| Popis: | Objective Acromegaly is characterized by an excess of growth hormone (GH) and insulin-like growth factor 1 (IGF1). Cardiovascular disease (CVD) risk factors are common in acromegaly and often persist after treatment. Both acute and long-lasting pro-inflammatory effects have been attributed to IGF1. Therefore, we hypothesized that inflammation persists in treated acromegaly and may contribute to CVD risk. Methods In this cross-sectional study, we assessed cardiovascular structure and function, and inflammatory parameters in treated acromegaly patients. Immune cell populations and inflammatory markers were assessed in peripheral blood from 71 treated acromegaly patients (with controlled or uncontrolled disease) and 41 matched controls. Whole blood (WB) was stimulated with Toll-like receptor ligands. In a subgroup of 21 controls and 33 patients with controlled disease, vascular ultrasound measurements were performed. Results Leukocyte counts were lower in patients with controlled acromegaly compared to patients with uncontrolled acromegaly and controls. Circulating IL18 concentrations were lower in patients; concentrations of other inflammatory mediators were comparable with controls. In stimulated WB, cytokine production was skewed toward inflammation in patients, most pronounced in those with uncontrolled disease. Vascular measurements in controlled patients showed endothelial dysfunction as indicated by a lower flow-mediated dilatation/nitroglycerine-mediated dilatation ratio. Surprisingly, pulse wave analysis and pulse wave velocity, both markers of endothelial dysfunction, were lower in patients, whereas intima-media thickness did not differ. Conclusions Despite treatment, acromegaly patients display persistent inflammatory changes and endothelial dysfunction, which may contribute to CVD risk and development of CVD. |
| Databáze: | OpenAIRE |
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