Increase of classic and nonclassic cardiovascular risk factors in patients with acromegaly.
OBJECTIVE
To evaluate the prevalence of classic and nonclassic cardiovascular risk factors in patients with acromegaly.


METHODS
Sixty-two patients with acromegaly (50 with active disease and 12 with controlled acromegaly) and 36 healthy persons (the control group) underwent measurement of lipids, fasting plasma glucose, homeostasis model assessment of insulin resistance (HOMA-IR) index, Lp(a), high-sensitivity C-reactive protein (hsCRP), homocysteine, and variables primarily related to thrombogenesis (fibrinogen, antithrombin III, protein C, and protein S).


RESULTS
In comparison with control subjects, patients with active acromegaly had significantly higher mean values of fasting plasma glucose, total cholesterol, low-density lipoprotein cholesterol, very-low-density lipoprotein (VLDL) cholesterol, triglycerides, Lp(a), HOMA-IR, and fibrinogen as well as lower mean levels of high-density lipoprotein cholesterol and protein S. In both groups, homocysteine, antithrombin III, protein C, and hsCRP levels were similar. Moreover, patients with active acromegaly, in comparison with those who had controlled acromegaly, presented with significantly higher values of fasting plasma glucose, HOMA-IR, triglycerides, VLDL cholesterol, Lp(a), and fibrinogen, whereas hsCRP and protein S were significantly lower. Finally, low levels of high-density lipoprotein cholesterol and protein S as well as elevated values of VLDL cholesterol, triglycerides, HOMA-IR, and fasting plasma glucose were more prevalent in patients with active acromegaly than in the other groups.


CONCLUSIONS
Our findings demonstrate that, in comparison with control subjects and patients with controlled acromegaly, patients with active acromegaly had a higher frequency of classic and nonclassic cardiovascular risk factors. These findings are potentially very important because acromegaly is associated with a 2- to 3-fold increase in mortality rate, predominantly related to cardiovascular disease.
Division of Endocrinology, Hospital das Clínicas da Universidade Federal de Pernambuco, Recife, Brazil.
Lucio
L
Vilar
Luciana Ansaneli
LA
Naves
Sandra Soares
SS
Costa
Lídia Freire
LF
Abdalla
Carlos E
CE
Coelho
Luiz Augusto
LA
Casulari
D000172:Acromegaly / Q000097:blood / Q000453:epidemiology* / Q000628:therapy; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000990:Antithrombin III / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology*; D003327:Coronary Disease / Q000097:blood / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology*; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D018149:Glucose Intolerance / Q000097:blood / Q000453:epidemiology*; D006710:Homocysteine / Q000097:blood; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000453:epidemiology; D006973:Hypertension / Q000097:blood / Q000453:epidemiology; D007333:Insulin Resistance; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011486:Protein C / Q000378:metabolism; D012307:Risk Factors; D017678:Sex Distribution
D011486:Protein C; D006710:Homocysteine; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D000990:Antithrombin III; D005340:Fibrinogen; D002097:C-Reactive Protein