A retrospective analysis on biochemical parameters, cardiovascular risk and cardiomyopathy in elderly acromegalic patients.
This analytical, observational, retrospective, case-control study was designed to describe clinical presentation, biochemical disease severity, presence, and severity of metabolic and cardiovascular complications in patients diagnosed as having acromegaly at 60 yr or older (no.=57) as compared to sex- and age-matched healthy controls. Patients and controls underwent a complete endocrine, metabolic, and cardiovascular check-up. The age at diagnosis was equally distributed between 60 to 75 yr while only a minority of the patients (5.3%) was diagnosed after 75 yr. Median GH and IGF-I levels were 15 microg/l and 557 microg/l. The prevalence of microadenomas, enclosed macroadenomas, and extrasellar/invasive macroadenomas was 30%, 49%, and 21%, respectively. All patients had joint complaints and goiter (euthyroid in 65% and pre-toxic/toxic in 35%), 82% had hypertension, 58% diabetes and 54% had both. As compared to controls, a higher number of patients were receiving treatment with anti-arrhythmiacs (p=0.033), anti-aggregants (p=0.013), levothyroxine (p=0.015), and metformin (p=0.022). Nevertheless, the patients had higher systolic and diastolic blood pressure, heart rate, left ventricular mass index, lipids, glucose and insulin levels as well as percent function of beta cells than controls. In conclusion, the high prevalence of systemic complications makes elderly acromegalics more susceptible than controls to cardiovascular events. We suggest that an accurate clinical check-up and, possibly, a more aggressive treatment of hypertension and diabetes are required in elderly acromegalics.
Colao
A
A
Section of Endocrinology, Department of Molecular and Clinical Endocrinology and Oncology, Federico II University of Naples, 80131 Naples, Italy. colao@unina.it
Pivonello
R
R
Spinelli
L
L
Galderisi
M
M
Auriemma
R S
RS
Galdiero
M
M
Vitale
G
G
De Leo
M
M
Lombardi
G
G
D000172:Acromegaly / Q000150:complications / Q000378:metabolism / Q000503:physiopathology; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D009202:Cardiomyopathies / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D002320:Cardiovascular Physiological Phenomena; D016022:Case-Control Studies; D005260:Female; D005947:Glucose / Q000378:metabolism; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D005947:Glucose