title: Reduced arterial stiffness in patients with acromegaly: non-invasive assessment by the cardio-ankle vascular index (CAVI).
abstract: In patients with acromegaly, cardiovascular diseases are the most common cause of death.  Arterial stiffness is increasingly recognized as a valuable surrogate marker for predicting cardiovascular events. To evaluate the vascular status of acromegalic patients, we used the cardio-ankle vascular index (CAVI) to reflect the arterial stiffness from the heart to the ankles. We analyzed 21 acromegalic patients, comprising five patients with untreated active acromegaly, one patient treated with medication and 15 patients who underwent transsphenoidal surgery. Among the 15 patients with surgery, 10 received additional therapies with dopamine agonists and/or somatostatin analogs.  All patients with acromegaly unexpectedly showed significant reductions in the CAVI, indicating reduced arterial stiffness, compared with age- and sex-matched controls, regardless of whether they underwent surgery.  There was a significant negative correlation between the CAVI and the serum insulin-like growth factor (IGF)-I level in these patients.  Active acromegalic patients were associated with lower CAVI than controlled patients.  Sequential measurements of the CAVI and serum IGF-I before and after treatment with octreotide and transsphenoidal surgery revealed that a reduced IGF-I level after treatment was accompanied by CAVI elevation.  The present findings indicate that the CAVI is negatively correlated with the serum IGF-I level in acromegaly.  These findings are consistent with previous reports indicating that the GH/IGF-I axis reduces peripheral vascular resistance.  This non-invasive assessment can reflect the present vascular status and would be a useful marker for evaluation of therapeutic effects in patients with acromegaly.
authors.affiliation: Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
authors.forename: Yayoi
authors.initials: Y
authors.lastname: Matsuda
authors.forename: Hisaya
authors.initials: H
authors.lastname: Kawate
authors.forename: Chitose
authors.initials: C
authors.lastname: Matsuzaki
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Sakamoto
authors.forename: Ichiro
authors.initials: I
authors.lastname: Abe
authors.forename: Kimitaka
authors.initials: K
authors.lastname: Shibue
authors.forename: Michiko
authors.initials: M
authors.lastname: Kohno
authors.forename: Masahiro
authors.initials: M
authors.lastname: Adachi
authors.forename: Keizo
authors.initials: K
authors.lastname: Ohnaka
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Nomura
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Takayanagi
mesh_terms: D000172:Acromegaly / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology*; D000328:Adult; D000368:Aged; D001786:Blood Glucose; D059168:Carotid Intima-Media Thickness; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D014655:Vascular Resistance / Q000502:physiology*; D059289:Vascular Stiffness / Q000502:physiology*
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I