<scp>GH</scp> levels and insulin sensitivity are differently associated with biomarkers of cardiovascular disease in active acromegaly

Boero, Laura; Manavela, Marcos; Meroño, Tomás; Maidana, Patricia; Rosso, Leonardo Gómez; Brites, Fernando

doi:10.1111/j.1365-2265.2012.04414.x

Cited by 26 publications

(18 citation statements)

References 36 publications

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“…[7,8,17] Furthermore, patients with active acromegaly have been shown to have elevated serum triglyceride, low-density lipoprotein-cholesterol, apoB, and FFA levels. [18] Even during medical treatment for acromegaly, somatostatin analogues and GH receptor antagonists influence glucose intolerance and lipid metabolism. [19] However, few studies have evaluated the effects of surgical resection of the GH secreting pituitary adenoma on metabolic parameter changes.…”

Section: Discussionmentioning

confidence: 99%

No differences in metabolic outcomes between nadir GH 0.4 and 1.0 ng/mL during OGTT in surgically cured acromegalic patients (observational study)

Choe

Hong

et al. 2016

Medicine

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Metabolic impairment is the common cause for mortality in acromegalic patients. In this study, long-term improvements of metabolic parameters were evaluated according to 2 different remission criteria.This was an observational cohort study before and up to 1 year after transsphenoidal adenomectomy (TSA). Participants were 187 patients with acromegaly. At 6 months after TSA, remitted patients with age- and sex-matched normalized IGF-1 were divided into 2 groups: remission 1 (R1), nadir growth hormone (GH) below 0.4 ng/mL; and remission 2 (R2), nadir GH between 0.4 and 1.0 ng/mL in oral glucose tolerance test (OGTT). Metabolic parameters during serial OGTTs were evaluated for 12 months. Remission was achieved in 157 (R1–136; R2–21) patients. Immediate postoperative metabolic parameters including body weight, body mass index, glucose, insulin, and free fatty acid in OGTT were all significantly improved in R1 and R2. HOMA-%β and HOMA-IR scores also improved in both R1 and R2. These improvements persisted for duration (12 months) of this study. However, no difference was present in metabolic parameters between R1 and R2. Although the patients with preoperative adrenal insufficiency presented significantly increased HOMA scores before TSA, there was no difference between classifications of deficient pituitary axes and changes of metabolic parameters after TSA. Remitted patients exhibited rapid restoration of metabolic parameters immediate postoperative period. Long-term improvements in metabolic parameters were not different between the 2 different nadir GH cut-offs, 0.4 and 1.0 ng/mL.

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Section: Discussionmentioning

confidence: 99%

No differences in metabolic outcomes between nadir GH 0.4 and 1.0 ng/mL during OGTT in surgically cured acromegalic patients (observational study)

Choe

Hong

et al. 2016

Medicine

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“…CRP levels are lower in active than controlled acromegaly (44,45) and rise as acromegaly is treated (7). The cause of the reciprocal relationship between CRP and acromegaly disease status is unclear.…”

Section: Discussionmentioning

confidence: 99%

IGF-1 levels across the spectrum of normal to elevated in acromegaly: relationship to insulin sensitivity, markers of cardiovascular risk and body composition

et al. 2015

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Purpose Activity of acromegaly is gauged by levels of GH and IGF-1 and epidemiological studies demonstrate that their normalization reduces acromegaly’s excess mortality rate. However, few data are available linking IGF-1 levels to features of the disease that may relate to cardiovascular (CV) risk. Therefore, we tested the hypothesis that serum IGF-1 levels relative to the upper normal limit relate to insulin sensitivity, serum CV risk markers and body composition in acromegaly. Methods In this prospective, cross-sectional study conducted at a pituitary tumor referral center we studied 138 adult acromegaly patients, newly diagnosed and previously treated surgically, with fasting and post-oral glucose levels of endocrine and CV risk markers and body composition assessed by DXA. Results Active acromegaly is associated with lower insulin sensitivity, body fat and CRP levels than acromegaly in remission. %ULN IGF-1 strongly predicts insulin sensitivity, better than GH and this persists after adjustment for body fat and lean tissue mass. %ULN IGF-1 also relates inversely to CRP levels and fat mass, positively to lean tissue and skeletal muscle estimated (SME) by DXA, but not to blood pressure, lipids, BMI or waist circumference (WC). Gender interacts with the IGF-1-lean tissue mass relationship. Conclusions Active acromegaly presents a unique combination of features associated with CV risk, reduced insulin sensitivity yet lower body fat and lower levels of some serum CV risk markers, a pattern that is reversed in remission. %ULN IGF-1 levels strongly predict these features. Given the known increased CV risk of active acromegaly, these findings suggest that of these factors insulin resistance is most strongly related to disease activity and potentially to the increased CV risk of active acromegaly.

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“…There has been limited data concerning the evaluation of endothelial adhesion molecules in patients with acromegaly. Boero et al . evaluated VCAM‐1 concentration in 22 patients with AA and age‐ and sex‐matched controls and found no differences between both groups.…”

Section: Discussionmentioning

confidence: 99%

“…37 There has been limited data concerning the evaluation of endothelial adhesion molecules in patients with acromegaly. Boero et al 38 evaluated VCAM-1 concentration in 22 patients with AA and age-and sex-matched controls and found no differences between both groups. Akgul et al 39 studied p-selectin in both cured and active patients with acromegaly and found a significant increase in both the acromegaly groups as compared to the control group.…”

Section: ·00 3·00mentioning

confidence: 98%

Three noninvasive methods in the evaluation of subclinical cardiovascular disease in patients with acromegaly: epicardial fat thickness, aortic stiffness and serum cell adhesion molecules

Topaloğlu

Arslan

Turak

et al. 2013

Clinical Endocrinology

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GH levels and insulin sensitivity are differently associated with biomarkers of cardiovascular disease in active acromegaly

Cited by 26 publications

References 36 publications

No differences in metabolic outcomes between nadir GH 0.4 and 1.0 ng/mL during OGTT in surgically cured acromegalic patients (observational study)

No differences in metabolic outcomes between nadir GH 0.4 and 1.0 ng/mL during OGTT in surgically cured acromegalic patients (observational study)

IGF-1 levels across the spectrum of normal to elevated in acromegaly: relationship to insulin sensitivity, markers of cardiovascular risk and body composition

Three noninvasive methods in the evaluation of subclinical cardiovascular disease in patients with acromegaly: epicardial fat thickness, aortic stiffness and serum cell adhesion molecules

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