The effect of atorvastatin on serum lipoproteins in acromegaly.
OBJECTIVE
Acromegaly is associated with long-term adverse effects on cardiovascular mortality and morbidity. Reducing growth hormone secretion improves well-being and symptoms, but may not significantly improve the lipoprotein profile. An additional approach to cardiovascular risk reduction in acromegaly may therefore be to target lipoprotein metabolism directly. In this study we investigated the effect of statin treatment.


METHODS
Double blind, placebo-controlled, crossover study of the effects on circulating lipoproteins of atorvastatin 10 mg daily vs. placebo. Each treatment was given for 3 months in random order.


METHODS
Eleven patients with acromegaly.


METHODS
Lipids, lipoproteins, apolipoproteins, enzyme activity and calculated cardiovascular risk.


RESULTS
Atorvastatin treatment compared to placebo resulted in a significant decrease in serum cholesterol (5.85 +/- 1.04 mmol/l vs. 4.22 +/- 0.69 mmol/l; mean +/- SD; P < 0.001), low-density lipoprotein (LDL) cholesterol (2.95 +/- 1.07 mmol/l vs. 1.82 +/- 0.92 mmol/l; P < 0.001), very low-density lipoprotein (VLDL) cholesterol (0.31 (0.21-0.47) mmol vs. 0.23 (0.13-0.30) mmol/l median (interquartile range); P < 0.05), apolipoprotein B (111 +/- 28 mg/dl vs. 80 +/- 18 mg/dl; P < 0.001), and calculated coronary heart disease risk (6.8 (3.3-17.9) vs. 2.8 (1.5-5.7)% over next 10 years; P < 0.01). Serum triglyceride was 1.34 (1.06-1.71) mmol/l on placebo and 1.14 (0.88-1.48) mmol/l on atorvastatin (ns). HDL cholesterol, apolipoprotein A1 and Lp(a) concentrations and cholesteryl ester transfer protein and lecithin: cholesterol acyl transferase activities were also not significantly altered.


CONCLUSIONS
Atorvastatin treatment was safe, well tolerated and effective in improving the atherogenic lipoprotein profile in acromegaly.
Mishra
Manoj
M
Cardiovascular, Medicine and Surgery Central Clinical Academic Group, University of Manchester, M13 9PT, UK.
Durrington
Paul
P
Mackness
Mike
M
Siddals
Kirk W
KW
Kaushal
Kalpana
K
Davies
Rob
R
Gibson
Martin
M
Ray
David W
DW
D000172:Acromegaly / Q000097:blood / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D001055:Apolipoproteins B / Q000097:blood; D000069059:Atorvastatin; D002784:Cholesterol / Q000097:blood; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D013006:Growth Hormone / Q000097:blood; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008074:Lipoproteins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011758:Pyrroles / Q000627:therapeutic use*; D018709:Statistics, Nonparametric; D014280:Triglycerides / Q000097:blood
D000924:Anticholesteremic Agents; D001055:Apolipoproteins B; D006538:Heptanoic Acids; D008074:Lipoproteins; D011758:Pyrroles; D014280:Triglycerides; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone; D002784:Cholesterol; D000069059:Atorvastatin