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Arterial properties in acromegaly: relation to disease activity and associated cardiovascular risk factors

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Abstract

Purpose

Acromegaly is associated with increased cardiovascular morbidity and mortality when inadequately treated, which may be secondary to associated comorbidities or to direct IGF-1 effects on the cardiovascular system. By using a control group carefully matched for traditional cardiovascular risk factors, we aimed to assess the direct contribution of disease activity and IGF-1 levels to arterial damage as assessed by measurements of arterial stiffness and endothelial function.

Methods

Twenty-nine subjects with acromegaly (11 males, 52 ± 14 year; 15 active acromegaly) and 24 matched controls underwent evaluation of large and small artery compliance using applanation tonometry, pulse wave velocity (PWV), augmentation index (Alx), carotid ultrasonography intima-media thickness, (IMT) and flow-mediated dilatation (FMD).

Results

IGF-1 expressed as times the upper limit of the normal range (x ULN) was 2.2 ± 1.1 in patients with active disease versus 0.7 ± 0.2 in patients in remission. Irrespective of disease activity, FMD was lower in patients with acromegaly than in control subjects, (3.4 ± 2.7 % in active acromegaly, 4.4 ± 3.3 % in controlled acromegaly and 7.5 ± 3.8 % in controls; p = 0.004). There were no significant differences in PWV, Alx, and IMT between groups. A positive correlation was found between IGF-1× ULN and IMT (r = 0.4; P = 0.02). Asymmetric dimethylarginine (ADMA), a novel cardiovascular risk factor, was positively correlated to arterial stiffness (r = 0.46; p = 0.017) and negatively with small vessel compliance (r = −0.44, p = 0.02).

Conclusions

Patients with acromegaly have significantly impaired endothelial function as assessed by FMD, but other tested vascular parameters were similar to a control group that was adequately matched for cardiovascular risk factors.

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Acknowledgments

An independent research award was granted by Novartis Pharma.

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Authors and Affiliations

  1. Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Weizmann 6 Street, 64239, Tel Aviv, Israel

    Marianna Yaron, Elena Izkhakov, Jessica Sack, Ibrahim Azzam, Etty Osher, Karen Tordjman, Naftali Stern & Yona Greenman

  2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Karen Tordjman, Naftali Stern & Yona Greenman

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  1. Marianna Yaron
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  2. Elena Izkhakov
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  3. Jessica Sack
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  4. Ibrahim Azzam
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Correspondence to Marianna Yaron.

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Yaron, M., Izkhakov, E., Sack, J. et al. Arterial properties in acromegaly: relation to disease activity and associated cardiovascular risk factors. Pituitary 19, 322–331 (2016). https://doi.org/10.1007/s11102-016-0710-9

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