Effect of a six-month treatment with lanreotide on cardiovascular risk factors and arterial intima-media thickness in patients with acromegaly.
OBJECTIVE
To evaluate the effect of a 6-month treatment with slow-release lanreotide (LAN) on cardiovascular risk and atherosclerosis in 24 normotensive patients with active acromegaly (GH=67.4 +/- 12.6 mU/l, IGF--I=866.0 +/- 55.8 microg/l) and 24 healthy subjects sex-, age- and body mass index-matched with the patients (as controls).


METHODS
Open, prospective, multicenter.


METHODS
The following were measured before and after 6 months of LAN treatment (dose 60-90 mg/month): fasting GH, IGF-I, LDL, HDL and total cholesterol, triglyceride, glucose, glycosylated hemoglobin, insulin and fibrinogen levels, intima-media thickness (IMT) and blood systolic and diastolic peak velocity (SPV and DPV respectively) in both common carotids.


RESULTS
At study entry, insulin, total and LDL cholesterol, triglyceride and fibrinogen levels were higher while HDL cholesterol levels were lower in patients than in controls. At the right (0.88 +/- 0.04 vs 0.77 +/- 0.03 mm, P=0.05) and left (0.93 +/- 0.03 vs 0.78 +/- 0.02 mm, P=0.01) common carotid IMT was significantly higher in patients than in controls; 12 patients and two controls showed an IMT of > or = 1 mm (chi(2)=8.2, P=0.004). After 6 months of LAN treatment, disease control was achieved in 15 patients (62.5%). Insulin, triglyceride and fibrinogen levels were significantly decreased, and a trend toward a decrease of IMT in the right (from 0.90 +/- 0.05 to 0.78 +/- 0.04 mm, P=0.06) and left (from 0.95 +/- 0.04 to 0.84 +/- 0.04 mm, P=0.06) common carotid arteries was observed only in patients with disease control, while SPV and DPV did not change.


CONCLUSIONS
LAN treatment for 6 months significantly lowered GH, IGF-I, insulin and fibrinogen levels and reduced IMT of both common carotid arteries in normotensive patients with acromegaly.
Colao
Annamaria
A
Department of Molecular and Clinical Endocrinology and Oncology, 'Federico II' University of Naples, Via Sergio Pansini 5, 80131, Naples, Italy. colao@unina.it
Marzullo
Paolo
P
Lombardi
Gaetano
G
D000172:Acromegaly / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging*; D005260:Female; D006728:Hormones / Q000097:blood; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D010456:Peptides, Cyclic / Q000008:administration & dosage / Q000627:therapeutic use*; D012307:Risk Factors; D013004:Somatostatin / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use*; D013256:Steroids; D014463:Ultrasonography
D000893:Anti-Inflammatory Agents; D006728:Hormones; D008055:Lipids; D010456:Peptides, Cyclic; D013256:Steroids; C060347:lanreotide; D013004:Somatostatin