title: Changes in arterial stiffness but not carotid intimal thickness in acromegaly.
abstract: BACKGROUND
  Acromegaly increases cardiovascular morbidity. We tested the hypothesis that increased arterial stiffness together with left ventricular hypertrophy may be a contributory factor.
  
  
  METHODS
  Fifty-six patients (40 males, 54 ± 13 yr; 25 active disease, 31 in remission) and 46 healthy controls (30 males, 52 ± 13 yr) underwent measurements of aortic pulse wave velocity (PWV), carotid Doppler (IMT), echocardiography, and cardiovascular risk factors.
  
  
  RESULTS
  Mean serum IGF-I was 323 ± 286 ng/ml (sd score 1.8 ± 1.9) in all patients. Age, body mass index, diastolic blood pressure (BP), and lipid levels were similar comparing patients and controls. Systolic BP (130.8 ± 19.9 vs. 122 ± 14 mm Hg controls, P < 0.01) and PWV (11.7 ± 3.8 vs. 9.7 ± 2.8 m/sec, 95% confidence interval -3.4 to -0.7, P <0.01) were higher in patients than controls. Regression analysis revealed age, presence of acromegaly, systolic BP, and body mass index, inversely, as significantly and independently associated with PWV. No difference in carotid IMT was seen (0.8 ± 0.2 patients vs. 0.7 ± 0.2 mm controls, P = 0.5) or between active/controlled disease. In the subset of participants with echocardiography (n = 32), left ventricular mass was higher by a mean of 38.2 g (95% confidence interval -80.9 to +4.6, P = 0.08).
  
  
  CONCLUSIONS
  In summary, patients with acromegaly had independently and significantly increased aortic PWV as evidence of arterial stiffening but unaltered carotid IMT compared with controls, also influenced by age and systolic BP. Premature cardiovascular disease in patients with acromegaly is likely related to pressure-related arterial and left ventricular stiffening rather than atherosclerotic disease.
authors.affiliation: Department of Endocrinology, The Christie National Health Service Foundation Trust, Manchester M20 4BX, United Kingdom. anpaisley@doctors.org.uk
authors.forename: A N
authors.initials: AN
authors.lastname: Paisley
authors.forename: M
authors.initials: M
authors.lastname: Banerjee
authors.forename: M
authors.initials: M
authors.lastname: Rezai
authors.forename: R E
authors.initials: RE
authors.lastname: Schofield
authors.forename: S
authors.initials: S
authors.lastname: Balakrishnannair
authors.forename: A
authors.initials: A
authors.lastname: Herbert
authors.forename: J A L
authors.initials: JA
authors.lastname: Lawrance
authors.forename: P J
authors.initials: PJ
authors.lastname: Trainer
authors.forename: J K
authors.initials: JK
authors.lastname: Cruickshank
mesh_terms: D000172:Acromegaly / Q000000981:diagnostic imaging / Q000473:pathology*; D000328:Adult; D000368:Aged; D001158:Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology; D007328:Insulin / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D016683:Supine Position / Q000502:physiology; D014463:Ultrasonography
chemical_list: D001786:Blood Glucose; D002097:C-Reactive Protein; D005340:Fibrinogen; D006442:Glycated Hemoglobin; D007328:Insulin; D007334:Insulin-Like Growth Factor I; D008055:Lipids