title: Disease activity and lifestyle influence comorbidities and cardiovascular events in patients with acromegaly.
abstract: OBJECTIVE
  The primary objective of this study is to identify the predictors of comorbidities and major adverse cardiovascular events (MACE) that can develop after diagnosis of acromegaly. The role of therapy for acromegaly in the event of such complications was also evaluated.
  
  
  METHODS
  Retrospective cohort study was conducted on 200 consecutive acromegalic patients in a tertiary referral center. The following outcomes were evaluated: diabetes, hypertension and MACE. Each patient was included in the analysis of a specific outcome, unless they were affected when acromegaly was diagnosed, and further classified as follows: (i) in remission after adenomectomy (Hx), (ii) controlled by somatostatin analogues (SSA) (SSAc) or (iii) not controlled by SSA (SSAnc). Data were evaluated using Cox regression analysis.
  
  
  RESULTS
  After diagnosis of acromegaly, diabetes occurred in 40.8% of patients. The SSAnc group had a three-fold higher risk of diabetes (HR: 3.32, P = 0.006), whereas the SSAc group had a 1.4-fold higher risk of diabetes (HR: 1.43, P = 0.38) compared with the Hx group. Hypertension occurred in 35.5% of patients, after diagnosis. The determinants of hypertension were age (HR: 1.06, P = 0.01) and BMI (HR: 1.05, P = 0.01). MACE occurred in 11.8% of patients, after diagnosis. Age (HR: 1.09, P = 0.005) and smoking habit (HR: 5.95, P = 0.01) were predictors of MACE. Conversely, therapy for acromegaly did not influence hypertension or MACE.
  
  
  CONCLUSIONS
  After diagnosis of acromegaly, control of the disease (irrespective of the type of treatment) and lifestyle are predictors of comorbidities and major adverse cardiovascular events.
authors.affiliation: Department of Clinical and Experimental MedicineSection of Endocrinology, University of Pisa, Pisa, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Sardella
authors.affiliation: Department of Clinical and Experimental MedicineSection of Endocrinology, University of Pisa, Pisa, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Cappellani
authors.affiliation: Department of Clinical and Experimental MedicineSection of Endocrinology, University of Pisa, Pisa, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Urbani
authors.affiliation: Department of Clinical and Experimental MedicineSection of Endocrinology, University of Pisa, Pisa, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Manetti
authors.affiliation: Department of Clinical and Experimental MedicineSection of Endocrinology, University of Pisa, Pisa, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Marconcini
authors.affiliation: Department of Clinical and Experimental MedicineSection of Endocrinology, University of Pisa, Pisa, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Tomisti
authors.affiliation: Department of Clinical and Experimental MedicineSection of Endocrinology, University of Pisa, Pisa, Italy.
authors.forename: Isabella
authors.initials: I
authors.lastname: Lupi
authors.affiliation: Epidemiology and Biostatistics UnitInstitute of Clinical Physiology, National Research Council (C.N.R.), Pisa, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Rossi
authors.affiliation: Department of Clinical and Experimental MedicineSection of Endocrinology, University of Pisa, Pisa, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Scattina
authors.affiliation: Department of Clinical and Experimental MedicineSection of Endocrinology, University of Pisa, Pisa, Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Lombardi
authors.affiliation: Department of PathologyUniversity of Pisa, Pisa, Italy.
authors.forename: Vitantonio
authors.initials: V
authors.lastname: Di Bello
authors.affiliation: Department of Clinical and Experimental MedicineSection of Endocrinology, University of Pisa, Pisa, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Marcocci
authors.affiliation: Department of Clinical and Experimental MedicineSection of Endocrinology, University of Pisa, Pisa, Italy.
authors.forename: Enio
authors.initials: E
authors.lastname: Martino
authors.affiliation: Department of Clinical and Experimental MedicineSection of Endocrinology, University of Pisa, Pisa, Italy fausto.bogazzi@med.unipi.it.
authors.forename: Fausto
authors.initials: F
authors.lastname: Bogazzi
mesh_terms: D000172:Acromegaly / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D008019:Life Style; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects; D013004:Somatostatin / Q000031:analogs & derivatives
chemical_list: D013004:Somatostatin