Anomalies of lipoprotein pattern and fibrinolysis in acromegalic patients: relation to growth hormone levels and insulin-like growth factor I.
The influence of hGH and IGF-I levels on lipid-, lipoprotein metabolism and fibrinolysis were studied in 23 patients with active acromegaly (14 women and 9 men, mean age 49.8 +/- 2.1 years) compared to a sex, BMI and age-matched control group. Mean Lp(a) levels were significantly higher in acromegalics than in controls (469.8 +/- 140.1; n = 23 vs. 162.7 +/- 64.9 mg/l; n = 111; p < 0.01). We found elevated apolipoprotein A-I and Apo E-concentrations in acromegalic patients compared to controls (apo A-I: 1.79 +/- 0.06 vs. 1.46 +/- 0.04 g/l; p < 0.01; apo E: 98.35 +/- 6.4 vs. 72.53 +/- 3.38 mg/l; p < 0.05). 30% of the acromegalics showed increased plasminogen activator inhibitor activity (PAI) while 66% had increased tissue-type plasminogen activator (t-PA) concentrations. There was a correlation between hGH and Lp(a) (r = 0.414; p = 0.05), between hGH and PAI (r = -0.59; p < 0.005) and IGF-I and t-PA activity (r = -0.44; p < 0.05). In a subgroup of nine acromegalics Lp(a) was reduced by 32.2 +/- 6.7% (p < 0.05) after a six-month octreotide therapy and HDL2-cholesterol-concentration increased from 0.17 +/- 0.04 to 0.24 +/- 0.04 mmol/l (p < 0.05). In conclusion, our results demonstrate that elevated Lp(a)-concentrations and changes in fibrinolysis contribute to the cardiovascular complications and should therefore be controlled in acromegalic patients.
Wildbrett
J
J
Institute and Outpatient Department for Clinical Metabolic Research, Medical Faculty Carl Gustav Carus, Technical University Dresden, Germany.
Hanefeld
M
M
Fücker
K
K
Pinzer
T
T
Bergmann
S
S
Siegert
G
G
Breidert
M
M
D000172:Acromegaly / Q000097:blood* / Q000188:drug therapy; D000328:Adult; D016632:Apolipoprotein A-I / Q000378:metabolism; D001057:Apolipoproteins E / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D005260:Female; D005342:Fibrinolysis; D019382:Human Growth Hormone / Q000097:blood*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D017270:Lipoprotein(a) / Q000097:blood; D008074:Lipoproteins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use; D015849:Plasminogen Inactivators / Q000097:blood
D016632:Apolipoprotein A-I; D001057:Apolipoproteins E; D008076:Cholesterol, HDL; D017270:Lipoprotein(a); D008074:Lipoproteins; D015849:Plasminogen Inactivators; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D015282:Octreotide