Adiponectin and Cardiac Hypertrophy in Acromegaly

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Sabriye Gurbulak¹, Fulya Akin², Emrah Yerlikaya³

¹Department of Internal Medicine, Pamukkale University, Turkey.

Advances in Clinical and Experimental Medicine : Official Organ Wroclaw Medical University

|September 16, 2016

Insights

Adiponectin levels are elevated in acromegaly patients, potentially indicating cardiac involvement. Further multi-centered studies are needed to confirm adiponectin as a reliable cardiac indicator in acromegaly.

Area of Science:

Endocrinology
Cardiology
Metabolic Disorders

Background:

Adiponectin, an adipocyte-derived hormone, has insulin-sensitizing and anti-inflammatory properties.
Previous studies on adiponectin levels in acromegaly have yielded contradictory results.
The relationship between adiponectin and cardiac parameters in acromegaly remains unexplored.

Purpose of the Study:

To investigate adiponectin levels in acromegaly patients.
To explore the correlation between adiponectin levels and cardiac parameters in acromegaly.

Main Methods:

Study included 30 acromegaly patients and 30 healthy controls.
Serum levels of glucose, insulin, growth hormone (GH), insulin-like growth factor-1 (IGF-1), and adiponectin were measured.
Echocardiographic assessments were performed to evaluate cardiac structure and function.

Main Results:

Adiponectin levels were significantly higher in acromegaly patients compared to controls.
No significant correlation was found between adiponectin and GH or IGF-1 levels in acromegalic patients.
Acromegaly significantly affected cardiac function and structure, with elevated left ventricle mass index (LVMI). Adiponectin showed a weak positive correlation with LVMI.

Conclusions:

Elevated adiponectin levels in acromegaly may be influenced by GH-lowering therapies.
Adiponectin levels may serve as a potential indicator of cardiac involvement in acromegaly.
Larger, multi-centered studies are recommended to validate the use of adiponectin as a cardiac biomarker in acromegaly.

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Abstract

Background:

Adiponectin is an adipocytes-derived hormone which has been shown to possess insulin-sensitizing, antiatherogenic, and anti-inflammatory properties. In acromegaly, the data on adiponectin is contradictory. The relationship between adiponectin levels and cardiac parameters has not been studied.

Objectives:

The aim of this study was to find out how adiponectin levels were affected in acromegalic patients and the relationship between adiponectin levels and cardiac parameters.

Material And Methods:

We included 30 subjects (15 male, 15 female), diagnosed with acromegaly and 30 healthy (10 male, 20 female) subjects. Serum glucose, insulin, GH, IGF-1 and adiponectin levels were obtained and the insulin resistance of the subjects was calculated. Echocardiographic studies of the subjects were performed.

Results:

We determined that adiponectin levels were significantly higher in the acromegalic group than the control group. In the acromegalic group, there was no statistically significant relation between serum adiponectin and growth hormone (GH), or insulin-like growth factor-1 (IGF-1) levels (p = 0.3, p = 0.1). We demonstrated that cardiac function and structure are affected by acromegaly. IVST, PWT, LVMI, E/A ratio, DT, ET, IVRT, VPR, and LVESV values were increased and the results were statistically significant. In the acromegalic group, adiponectin levels were positively related with left ventricle mass index (LVMI) but this correlation was found to be statistically weak (p = 0.03). In our study, there was a positive correlation between VAI and LVM. We also could not find any correlation between VAI and adiponectin levels.

Conclusions:

Although insulin resistance and high insulin levels occur in active acromegaly patients, adiponectin levels were higher in our study as a consequence of GH lowering therapies. Our study showed that adiponectin levels may be an indicator of the cardiac involvement acromegaly. However, the usage of serum adiponectin levels in acromegalic patients as an indicator of cardiac involvement should be supported with other, wide, multi-centered studies.

Keywords:

acromegaly adiponectin cardiac hypertrophy echocardiography insulin resistance

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