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Cardiovascular Risk Factors in Acromegaly: What's the Impact of Disease Control?
Ana Amado1, Fernando Araújo2, Davide Carvalho3
1Faculty of Medicine University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
Insights
Acromegaly patients show cardiovascular risks like abnormal glucose and lipid levels. Disease control partially improves these factors, but they may not return to normal levels.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Metabolic Disorders
Background:
- Acromegaly, a condition caused by excess growth hormone, is associated with increased cardiovascular disease mortality.
- Cardiovascular risk factors are prevalent in acromegaly patients, impacting their overall health and prognosis.
Purpose of the Study:
- To compare cardiovascular risk factors in acromegalic patients with active disease versus those with controlled disease.
- To assess the influence of disease control on the prevalence of these risk factors.
Main Methods:
- A comparative study involving 11 active acromegaly patients, 12 controlled acromegaly patients, and 11 controls with non-functioning pituitary adenomas.
- Evaluation of blood pressure, body mass index, glucose levels, coagulation status, and lipid profiles in all groups.
Main Results:
- Both active and controlled acromegaly patients exhibited significantly higher fasting glucose and fibrinogen levels compared to controls.
- Active acromegaly patients had higher antithrombin III levels, while controlled patients showed higher high-density lipoprotein cholesterol.
- Disease control in acromegaly led to reductions in total cholesterol, low-density lipoprotein cholesterol, and antithrombin III levels compared to active disease.
Conclusions:
- Control of acromegaly leads to a partial improvement in cardiovascular risk factors.
- Despite improvements, cardiovascular risk factors in controlled acromegaly patients may not fully revert to levels seen in the general population.
Objective:
Cardiovascular disease is one of the most important causes of death in acromegalic patients. The aim of this study is to compare the prevalence of cardiovascular risk factors among acromegalic patients and to evaluate the impact of disease control on these factors.
Material And Methods:
11 acromegalic patients with active disease and 12 controlled patients were evaluated for blood pressure, body mass index, glucose, coagulation status, and lipid profile. A group of 11 patients with non-functioning pituitary adenomas was used as control population.
Results:
Significant differences were found in lipid profile, glucose and coagulation status in both active and controlled patients. Higher levels of fasting glucose (151.2±102.5 mg/dL, p=0.05 and 108.3±23.4 mg/dL, p=0.02 for active and controlled patients respectively) and fibrinogen (427.1±61.9 mg/dL, p=0.02 and 437.3±106.6 mg/dL, p=0.04 for active and controlled patients respectively) were present in both acromegalic groups. Active patients had higher levels of antithrombin III (1.1±0.1 U/mL, p=0.005) and the controlled ones had higher levels of high density lipoprotein cholesterol (56.1±12.5 mg/dL, p=0.05), compared with the non-functioning group. The differences between active and controlled acromegalic patients are that the latter have reduced total cholesterol (170.4±31.7 vs 201.7±34.6 mg/dL, p=0.02), lower density lipoprotein cholesterol (96,8±25,2 vs 130.8±31.5 mg/dL, p=0.01) and antithrombin III (1.0±0.2 vs 1.1±0.1 U/mL, p=0.05).
Conclusion:
There is some reduction in cardiovascular risk factors with control of the disease, but possibly without the return to basal levels.