The Journal of clinical endocrinology and metabolism · 2010
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.
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Berg Christian, Petersenn Stephan, Lahner Harald, Herrmann Burkhard L, Buchfelder Michael, Droste Michael, Stalla Günter K, Strasburger Christian J, Roggenbuck Ulla, Lehmann Nils, Moebus Susanne, Jöckel Karl-Heinz, Möhlenkamp Stephan, Erbel Raimund, Saller Bernhard, Mann Klaus, Investigative Group of the Heinz Nixdorf Recall Study and the German Pegvisomant Observational Study Board and Investigators
Аннотация
CONTEXT: 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.
DESIGN AND SETTING: We conducted a retrospective, comparative study at a university referral center.
PATIENTS: 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.
MAIN OUTCOME MEASURES: 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.
SUMMARY: 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.
CONCLUSION: Disease control is important to reduce the likelihood for development of coronary heart disease.
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.
DESIGN AND SETTING: We conducted a retrospective, comparative study at a university referral center.
PATIENTS: 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.
MAIN OUTCOME MEASURES: 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.
SUMMARY: 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.
CONCLUSION: Disease control is important to reduce the likelihood for development of coronary heart disease.