Active acromegaly is associated with decreased hs-CRP and NT-proBNP serum levels: insights from the Belgian registry of acromegaly

Abstract

Objective: Patients with active acromegaly have an increased prevalence of cardiomyopathy and heart failure but a less than expected risk of coronary artery disease, considering the frequent association of diabetes mellitus and hypertension. We examined whether changes in high-sensitive C-reactive protein (hs-CRP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) might contribute to this phenomenon. Design and methods: Two hundred patients of the Belgian acromegaly registry (AcroBel) were divided in two groups: active disease (IGF1 Z-score O2; nZ95) and controlled disease (IGF1 Z-score %2; nZ105). Serum levels of hs-CRP and NT-proBNP were measured and correlated with BMI, blood pressure, fasting lipids, fasting glucose and insulin, HbA1c, IGF1, interleukin 6 (IL6), adiponectin, and sE-selectin. In a subset of acromegaly patients, hs-CRP, IL6, and NT-proBNP levels were also compared with those/the values of an age-, gender-, and BMI-matched reference group.

A Functional Interplay between IGF-1 and Adiponectin

“…Considering CV risk in acromegaly, Verhelst et al analyzed two specific markers of CV risk among acromegalic patients, subdivided into a controlled disease group (−2 < IGF-1 Z-score < +2) and an active disease one (IGF-1 Z-score > +2) [ 97 ]. They took into account highly sensitive CRP (hs-CRP), related to CVD and the N -terminal pro-BNP (NT-proBNP), diagnostic for congestive heart failure [ 97 ].…”

“…Considering CV risk in acromegaly, Verhelst et al analyzed two specific markers of CV risk among acromegalic patients, subdivided into a controlled disease group (−2 < IGF-1 Z-score < +2) and an active disease one (IGF-1 Z-score > +2) [ 97 ]. They took into account highly sensitive CRP (hs-CRP), related to CVD and the N -terminal pro-BNP (NT-proBNP), diagnostic for congestive heart failure [ 97 ]. The authors found low levels of hs-CRP in active acromegalic patients compared to control subjects, indicating a lower CV risk in active disease, whereas high NT-proBNP values were reported in controlled patients compared to healthy subjects, suggesting a controversial role for such a marker.…”

“…The authors found low levels of hs-CRP in active acromegalic patients compared to control subjects, indicating a lower CV risk in active disease, whereas high NT-proBNP values were reported in controlled patients compared to healthy subjects, suggesting a controversial role for such a marker. Serum adiponectin levels did not change between the two patient groups [ 97 ].…”

GH and the cardiovascular system: an update on a topic at heart

“…However, recent studies suggest that acromegalic patients do not have increased prevalence of coronary artery disease [ 49 , 50 ], carotid atherosclerosis, or carotid internal media thickness compared to normal subjects [ 49 , 51 ]. In a recent European study on 200 acromegalic patients matched with a control group, it was reported that patients with active acromegaly had significantly lower levels of high-sensitive C-reactive protein (hs-CRP) both compared with patients with controlled acromegaly and with a matched reference population [ 52 ]. Possibly, a lower hs-CRP may be linked to lower than expected prevalence of atherosclerosis in patients with active acromegaly, despite the presence of other risk factors such as insulin resistance and hypertension.…”

Markers of early atherosclerosis, oxidative stress and inflammation in patients with acromegaly

“…In the literature, a few studies have shown increased oxidative stress and reduced antioxidant status in acromegaly [16]. In contrast, the role of subclinical inflammation on atherosclerosis in acromegaly is still contradictory because previous studies have shown that patients with acromegaly primarily have decreased [17] as well as unchanged [18] high sensitive C-reactive protein (hs CRP) levels.…”