Alterations in biomarkers of cardiovascular disease (CVD) in active acromegaly

Abstract

Taken together, the alterations described seem to contribute to constituting a state of higher propensity for the development of atherosclerotic cardiovascular disease, which adds to the presence of specific cardiomyopathy.

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

“…Conflicting data exist about the effect of acromegaly on lipid levels. Some studies indicate a worse lipid profile in active acromegaly (9,24) while other authors reported better values (22,25,26) and a worse profile after therapy (26). We found total cholesterol and triglycerides to be significantly lower both in controlled and non-controlled acromegaly.…”

“…Similarly, the extent of carotid atherosclerosis and carotic internal media thickening in acromegalic patients was not higher than that in non-acromegalic subjects (6,8). The reasons for this unexpected observation are still unclear, but this finding suggests that the known atherogenic effects of hypertension, insulin resistance, and diabetes induced by GH excess (9) are counterbalanced by cardioprotective factors (7).…”

“…Two such markers are the inflammatory protein high-sensitive C-reactive protein (hs-CRP), which is related to cardiovascular disease and is stimulated by the proinflammatory cytokine interleukin 6 (IL6) (10), and the N-terminal pro-brain natriuretic peptide (NT-proBNP), used as a diagnostic parameter for congestive heart failure (11). Previous studies on patients with active acromegaly have shown lower than normal values of hs-CRP in most (9,12,13,14,15), but not all studies (16). Data on NT-proBNP are contradictory, since values were found to be either lower in active acromegaly (13,17) or not influenced by the acromegaly status (16,18).…”

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

“…In another study, active acromegaly, GH sufficient, and GH deficient groups were compared and it was found that hs CRP serum levels were lowest in the active acromegaly group and highest in the GH deficient group [45]. However, others studies have reported no significant difference in hs CRP levels between acromegaly and control groups [14,18,46]. Taken together, subclinical inflammation does not appear to contribute to the development of atherosclerosis 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.…”