Early vascular alterations in acromegaly.
Acromegaly is associated with increased cardiovascular mortality; however, little is known about the early atherosclerotic changes occurring in such patients. Endothelial function, in the form of flow-mediated dilation (FMD) of the brachial artery, and intima-media thickness (IMT) of the carotid artery were measured by B-Mode ultrasound in: 1) 18 patients with active acromegaly; 2) 12 subjects cured from acromegaly; 3) 18 subjects without acromegaly, each of them matched to an acromegalic patients for age, sex, risk factors and treatments; and 4) 10 healthy subjects. Results are expressed as median plus (25th, 75th) percentile. In active acromegalic patients, FMD was 5.7 (3.9, 7.7)%, significantly lower than in both healthy subjects (P < 0.01) and matched controls (P < 0.01). No difference between groups was observed for endothelium-independent vasodilation. Acromegalic patients had also higher IMT than healthy controls (P < 0.05), whereas no difference was observed with matched controls. In cured acromegalic patients, FMD was 9.2 (7.7, 10.5)%, significantly lower (P < 0.01) than in healthy controls but higher (P < 0.01) than in active patients. No difference in IMT was observed between active and cured patients. In conclusion, patients with acromegaly have functional and morphological vascular alteration that seems, at least in part, dependent on the GH excess itself.
Brevetti
Gregorio
G
Department of Medicine, University Federico II, Via G. Iannelli 45/A, 80131 Naples, Italy. brevetti@unina.it
Marzullo
Paolo
P
Silvestro
Antonio
A
Pivonello
Rosario
R
Oliva
Gabriella
G
di Somma
Carolina
C
Lombardi
Gaetano
G
Colao
Annamaria
A
D000172:Acromegaly / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000628:therapy; D000328:Adult; D001916:Brachial Artery / Q000503:physiopathology*; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012039:Regional Blood Flow / Q000502:physiology; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging; D014463:Ultrasonography; D014664:Vasodilation