Cardiovascular risk factors in patients with uncontrolled and long-term acromegaly: comparison with matched data from the general population and the effect of disease control.
BACKGROUND
Data on cardiovascular risk in acromegaly are scanty and lack a clear correlation to epidemiological data.


OBJECTIVE
Our aim was an evaluation of cardiovascular risk factors in patients with active acromegaly, a calculation of the Framingham risk score (FRS) compared with age- and gender-matched controls of the general population, and an evaluation of the effect of IGF-I normalization.


METHODS
We conducted a retrospective, comparative study at a university referral center.


METHODS
A total of 133 patients with acromegaly (65 men, aged 45-74 yr) from the German Pegvisomant Observational Study were matched to 665 controls from the general population.


METHODS
Risk factors were measured at baseline and after 12 months of treatment with pegvisomant (n=62).


RESULTS
Patients with acromegaly had increased prevalence of hypertension, mean systolic and diastolic blood pressure (BP), history of diabetes mellitus and glycosylated hemoglobin (all P<0.001) and decreased high-density lipoprotein, low-density lipoprotein, and total cholesterol (all P<0.001). FRS was significantly higher in patients with acromegaly compared with controls (P<0.001). At 12 months, systolic BP (P=0.04) and glycosylated hemoglobin (P=0.02) as well as FRS (P=0.005) decreased significantly. IGF-I was normalized in 62% (41 of 62). In these patients, glucose and systolic and diastolic BP was significantly lower than in partially controlled patients.


CONCLUSIONS
We found an increased prevalence of cardiovascular risk factors in acromegalic patients compared with controls. Control of acromegaly led to a significant decrease of FRS, implying a reduced risk for coronary heart disease. This was most significant in those patients who completely normalized their IGF-I levels.


CONCLUSIONS
Disease control is important to reduce the likelihood for development of coronary heart disease.
Berg
Christian
C
Department of Endocrinology, Institute for Medical Informatics, Biometry, and Epidemiology, West-German Heart Centre Essen, University Hospital of Essen, University of Duisburg-Essen, Department of Endocrinology, Hufelandstrasse 55, 45122 Essen, Germany. christian.berg@uni-essen.de
Petersenn
Stephan
S
Lahner
Harald
H
Herrmann
Burkhard L
BL
Buchfelder
Michael
M
Droste
Michael
M
Stalla
Günter K
GK
Strasburger
Christian J
CJ
Roggenbuck
Ulla
U
Lehmann
Nils
N
Moebus
Susanne
S
Jöckel
Karl-Heinz
KH
Möhlenkamp
Stephan
S
Erbel
Raimund
R
Saller
Bernhard
B
Mann
Klaus
K
D000172:Acromegaly / Q000150:complications* / Q000503:physiopathology; D000368:Aged; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000150:complications*; D002319:Cardiovascular System / Q000503:physiopathology; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000503:physiopathology; D005260:Female; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors
D007334:Insulin-Like Growth Factor I