title: Active acromegaly is associated with decreased hs-CRP and NT-proBNP serum levels: insights from the Belgian registry of acromegaly.
abstract: OBJECTIVE
  Patients with active acromegaly have an increased prevalence of cardiomyopathy and heart failure but a less than expected risk of coronary artery disease, considering the frequent association of diabetes mellitus and hypertension. We examined whether changes in high-sensitive C-reactive protein (hs-CRP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) might contribute to this phenomenon.
  
  
  METHODS
  Two hundred patients of the Belgian acromegaly registry (AcroBel) were divided in two groups: active disease (IGF1 Z-score >2; n=95) and controlled disease (IGF1 Z-score ≤2; n=105). Serum levels of hs-CRP and NT-proBNP were measured and correlated with BMI, blood pressure, fasting lipids, fasting glucose and insulin, HbA1c, IGF1, interleukin 6 (IL6), adiponectin, and sE-selectin. In a subset of acromegaly patients, hs-CRP, IL6, and NT-proBNP levels were also compared with those/the values of an age-, gender-, and BMI-matched reference group.
  
  
  RESULTS
  Patients with active acromegaly had significantly lower levels of hs-CRP (median (interquartile range), 0.5 mg/l (0.1, 0.9) vs 1.3 mg/l (0.5, 4.1); P<0.001) and NT-proBNP, (47.0 ng/l (26.0, 86.0) vs 71.0 ng/l (43.0, 184.0); P<0.001) compared with patients with controlled acromegaly. Compared with the reference population, hs-CRP was not different in controlled acromegaly but significantly lower in active acromegaly (median, 0.4 mg/l (0.1, 0.8) vs 1.4 mg/l (0.8, 2.9); P<0.001), while NT-proBNP was similar in active acromegaly but significantly higher in controlled acromegaly (66.5 ng/l (40.0, 119.5) vs 50.8 ng/l (26.5, 79.7); P<0.001).
  
  
  CONCLUSIONS
  Patients with active acromegaly have significantly lower values of NT-proBNP and hs-CRP compared with patients with controlled disease and even lower values of hs-CRP compared with control subjects.
authors.affiliation: Department of Endocrinology, ZNA Middelheim, Lindendreef 1, B-2020 Antwerp, Belgium. johan.verhelst@zna.be
authors.forename: Johan
authors.initials: J
authors.lastname: Verhelst
authors.forename: Brigitte
authors.initials: B
authors.lastname: Velkeniers
authors.forename: Dominique
authors.initials: D
authors.lastname: Maiter
authors.forename: Patrick
authors.initials: P
authors.lastname: Haentjens
authors.forename: Guy
authors.initials: G
authors.lastname: T'Sjoen
authors.forename: Ernst
authors.initials: E
authors.lastname: Rietzschel
authors.forename: Bernard
authors.initials: B
authors.lastname: Corvilain
authors.forename: Pascale
authors.initials: P
authors.lastname: Abrams
authors.forename: Frank
authors.initials: F
authors.lastname: Nobels
authors.forename: Roger
authors.initials: R
authors.lastname: Abs
authors.forename: Marie
authors.initials: M
authors.lastname: Bex
mesh_terms: D000172:Acromegaly / Q000097:blood*; D000328:Adult; D000368:Aged; D001530:Belgium; D001794:Blood Pressure; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D012042:Registries
chemical_list: D007328:Insulin; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein