title: Effects of normalization of GH hypersecretion on lipoprotein(a) and other lipoprotein serum levels in acromegaly.
abstract: OBJECTIVE
  Lipoprotein(a) has been recognized as an important risk factor for cardiovascular disease. Lipoprotein(a) has been found to be elevated in sera of acromegalic patients, possibly contributing to the increased incidence of coronary heart disease found in these patients. In the present study we sought to determine the effects of GH hormonal status on lipoprotein(a) and other lipid parameters, including lipoprotein lipase (LPL) activity.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Twenty acromegalic patients, with either active (n = 12) or controlled (n = 8) acromegaly, were studied. Twenty-nine healthy subjects served as control group for serum lipid measurements.
  
  
  METHODS
  Serum GH, IGF-1, IGF binding protein-3 (IGFBP-3) and insulin levels were measured in patients. Insulin resistance was measured by the homeostatic model assessment (HOMA). Plasma total cholesterol, triglycerides, HDL-lipids, apolipoproteins A-I and B, lipoprotein(a) and lipoprotein lipase activity were also measured.
  
  
  RESULTS
  The highest lipoprotein(a) levels were observed in patients with active acromegaly, followed by patients with controlled acromegaly, whose lipoprotein(a) concentrations were still significantly higher than those of the control group (means +/- SEM: active acromegaly, 0.67+/-0.13 g/l; controlled acromegaly, 0.41+/-0.12 g/l; controls 0.17+/-0.02 g/l; P<0.05). There were no differences in other lipid and lipoprotein values among the groups. In patients, significant correlations were observed between lipoprotein(a) and basal GH levels (r = 0.56, P<0.02), mean GH levels (r = 0.48, P<0.05) and with insulin resistance estimated by HOMA (r = 0.62, P<0.01). No correlations were found between lipoprotein(a) and IGF-1 or IGFBP-3 levels.
  
  
  CONCLUSIONS
  Our present results demonstrate that both active acromegalic patients and those with controlled disease have elevated serum lipoprotein(a) concentrations. The findings might suggest that the present biochemical criteria for cure of acromegaly are not strict enough to result in the normalization of all the undesirable metabolic changes found in this disease, and also that significant cardiovascular risk may persist despite successful treatment of acromegaly.
authors.affiliation: Department of Endocrinology, Hospital Ramón y Cajal, Madrid, Spain.
authors.forename: G F
authors.initials: GF
authors.lastname: Maldonado Castro
authors.forename: H F
authors.initials: HF
authors.lastname: Escobar-Morreale
authors.forename: H
authors.initials: H
authors.lastname: Ortega
authors.forename: D
authors.initials: D
authors.lastname: Gómez-Coronado
authors.forename: J A
authors.initials: JA
authors.lastname: Balsa Barro
authors.forename: C
authors.initials: C
authors.lastname: Varela
authors.forename: M A
authors.initials: MA
authors.lastname: Lasunción
mesh_terms: D000172:Acromegaly / Q000097:blood* / Q000188:drug therapy; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D013006:Growth Hormone / Q000097:blood / Q000378:metabolism*; D006801:Humans; D008071:Lipoprotein Lipase / Q000097:blood; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D008875:Middle Aged
chemical_list: D017270:Lipoprotein(a); D013006:Growth Hormone; D008071:Lipoprotein Lipase