Distúrbios cardiovasculares na acromegalia

Fedrizzi, Daniela; Czepielewski, Mauro Antônio

doi:10.1590/s0004-27302008000900004

Cited by 11 publications

(4 citation statements)

References 68 publications

(96 reference statements)

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“…(15) were applied because they had been previously used in this cohort (28). Nonetheless, four patients changed category (from cured to not cured) due to the application of new criteria recently reported in the last consensus (29), which did not alter the association between diabetes and active disease.…”

Section: Discussionmentioning

confidence: 99%

Diabetes mellitusin a cohort of patients with acromegaly

Rodrigues

Costenaro

Fedrizzi

et al. 2011

Arq Bras Endocrinol Metab

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Objectives: To evaluate the presence of diabetes mellitus (DM) in a cohort of patients with acromegaly. Methods: This was a cross sectional study. Results: Fifty-eight acromegalic patients were assessed. Only 29% met the criteria for cure, and 27% had the disease controlled. Twenty-two had DM; HbA1c was equal to 7.34 ± 2.2%. Most of the diabetic patients (18 out of 22, 82%) did not meet criteria for cure. They were more often hypertensive [16/22 (73%)

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Section: Discussionmentioning

confidence: 99%

Diabetes mellitusin a cohort of patients with acromegaly

Rodrigues

Costenaro

Fedrizzi

et al. 2011

Arq Bras Endocrinol Metab

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“…A multicentric study performed in Italy using 24-h ECG-Holter monitoring reported a lower but still very significant rate of ventricular extrasistoles (in 33% of the ACM cases evaluated; Lombardi et al 2002). Twenty-four-hour ECG-Holter monitoring might be useful in the preoperative evaluation of the patients (Fedrizzi & Czepielewski 2008), especially those with clinically detected abnormalities.…”

Section: Complicationsmentioning

confidence: 95%

60 YEARS OF NEUROENDOCRINOLOGY: Acromegaly

Căpățînă¹,

Wass²

2015

Journal of Endocrinology

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Acromegaly (ACM) is a chronic, progressive disorder caused by the persistent hypersecretion of GH, in the vast majority of cases secreted by a pituitary adenoma. The consequent increase in IGF1 (a GH-induced liver protein) is responsible for most clinical features and for the systemic complications associated with increased mortality. The clinical diagnosis, based on symptoms related to GH excess or the presence of a pituitary mass, is often delayed many years because of the slow progression of the disease. Initial testing relies on measuring the serum IGF1 concentration. The oral glucose tolerance test with concomitant GH measurement is the gold-standard diagnostic test. The therapeutic options for ACM are surgery, medical treatment, and radiotherapy (RT). The outcome of surgery is very good for microadenomas (80-90% cure rate), but at least half of the macroadenomas (most frequently encountered in ACM patients) are not cured surgically. Somatostatin analogs are mainly indicated after surgical failure. Currently their routine use as primary therapy is not recommended. Dopamine agonists are useful in a minority of cases. Pegvisomant is indicated for patients refractory to surgery and other medical treatments. RT is employed sparingly, in cases of persistent disease activity despite other treatments, due to its long-term side effects. With complex, combined treatment, at least three-quarters of the cases are controlled according to current criteria. With proper control of the disease, the specific complications are partially improved and the mortality rate is close to that of the background population.

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“…sleep apnea), bone and joint features, soft tissue and skin changes, malignancies, endocrine consequences (thyroid goiter) and a variety of neurological complications, such as nerve compression syndromes [3]. Unless adequate biochemical control is achieved, acromegaly is associated to elevated morbidity and mortality, mostly because of cardiovascular disease [4, 5]. …”

Section: Introductionmentioning

confidence: 99%

Adverse anthropometric risk profile in biochemically controlled acromegalic patients: comparison with an age- and gender-matched primary care population

et al. 2010

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GH and IGF-1 play an important role in the regulation of metabolism and body composition. In patients with uncontrolled acromegaly, cardiovascular morbidity and mortality are increased but are supposed to be normalised after biochemical control is achieved. We aimed at comparing body composition and the cardiovascular risk profile in patients with controlled acromegaly and controls. A cross-sectional study. We evaluated anthropometric parameters (height, weight, body mass index (BMI), waist and hip circumference, waist to height ratio) and, additionally, cardiovascular risk biomarkers (fasting plasma glucose, HbA1c, triglycerides, total cholesterol, HDL, LDL, and lipoprotein (a), in 81 acromegalic patients (58% cured) compared to 320 age- and gender-matched controls (ratio 1:4), sampled from the primary care patient cohort DETECT. The whole group of 81 acromegalic patients presented with significantly higher anthropometric parameters, such as weight, BMI, waist and hip circumference, but with more favourable cardiovascular risk biomarkers, such as fasting plasma glucose, total cholesterol, triglycerides and HDL levels, in comparison to their respective controls. Biochemically controlled acromegalic patients again showed significantly higher measurements of obesity, mainly visceral adiposity, than age- and gender-matched control patients (BMI 29.5 ± 5.9 vs. 27.3 ± 5.8 kg/m2; P = 0.020; waist circumference 100.9 ± 16.8 vs. 94.8 ± 15.5 cm; P = 0.031; hip circumference 110.7 ± 9.9 vs. 105.0 ± 11.7 cm; P = 0.001). No differences in the classical cardiovascular biomarkers were detected except for fasting plasma glucose and triglycerides. This effect could not be attributed to a higher prevalence of type 2 diabetes mellitus in the acromegalic patient group, since stratified analyses between the subgroup of patients with acromegaly and controls, both with type 2 diabetes mellitus, revealed that there were no significant differences in the anthropometric measurements. Biochemically cured acromegalic patients pertain an adverse anthropometric risk profile, mainly because of elevated adiposity measurements, such as BMI, waist and hip circumference, compared to an age- and gender-matched primary care population.

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Distúrbios cardiovasculares na acromegalia

Cited by 11 publications

References 68 publications

Diabetes mellitusin a cohort of patients with acromegaly

Diabetes mellitusin a cohort of patients with acromegaly

60 YEARS OF NEUROENDOCRINOLOGY: Acromegaly

Adverse anthropometric risk profile in biochemically controlled acromegalic patients: comparison with an age- and gender-matched primary care population

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