Circulating adiponectin levels and cardiovascular risk factors in acromegalic patients

Abstract

Objective: Adiponectin (ApN) is an adipocytokine expressed in human adipose cells with anti-atherogenic and anti-inflammatory properties that plays a role in the pathophysiology of insulin resistance, metabolic syndrome and coronary artery disease. The aim of the study was to evaluate ApN secretion in patients with acromegaly, a chronic disease associated with insulin resistance and increased cardiovascular mortality, and to correlate ApN levels with hormonal, metabolic and cardiovascular parameters. Design and methods: The study included 32 patients with active acromegaly (11 male and 21 female, aged 48^11 years, duration of disease: 8^6 years, GH: 9.2^9.8 mg/l, IGF-I: 80^33 nmol/l (meansŜ .D.)) and 38 control subjects sex-and body mass index (BMI)-matched. In all subjects, serum ApN, leptin and ghrelin levels, BMI, waist circumference, insulin resistance (assessed by homeostasis model assessment and the quantitative insulin check index), lipid profile and blood pressure values were evaluated. Results: Acromegalic patients and control subjects had similar ApN levels (9.4^3.5 vs 9.5^4.0 mg/l, NS), while when considering obese subjects acromegalic patients had ApN levels significantly higher than controls (10.2^4 vs 7.5^3 mg/l, P , 0.05). No significant correlation between ApN and GH/IGF-I levels or duration of disease was found. ApN concentrations negatively correlated with BMI, waist circumference, glucose and diastolic blood pressure and positively with high-density lipoprotein cholesterol and ghrelin in controls, while all these correlations were lost in acromegalic patients. Conclusions: We provide evidence that, although metabolic and cardiovascular abnormalities are present in most acromegalic patients, in these subjects ApN levels are not reduced and, contrary to what is found in BMI-matched controls, do not correlate with cardiovascular risk factors. These data support the view that atherosclerosis is not the main determinant of cardiovascular mortality in acromegaly and suggest a permissive action of GH and/or IGF-I excess on ApN secretion.

Serum visfatin levels in acromegaly: Correlation with disease activity and metabolic alterations

“…Silha et al [39] showed increased adiponectin levels in acromegalic patients, without direct or inverse correlation with metabolic or hormonal parameters, probably because adiponectin are negatively correlated with body fat, which is reduced in acromegaly [46]. In the current study, we found no significant difference in adiponectin levels between uncontrolled and controlled patients, as well as in the different treatment groups, and these results are consistent with those of Ronchi et al who did not demonstrate the validity of adiponectin as a marker of cardiovascular risk, because the lack of correlation with BMI, hormonal and metabolic parameters [47]. Therefore, acromegaly would differ from the other conditions of insulin resistance that are associated with hypoadiponectinemia [48,49].…”

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

“…Adiponectin has anti-atherogenic and anti-inflammatory properties with direct effects on endothelial cells and macrophage-to-foam cell transformation. We and others (38,39) failed to find any difference in levels of adiponectin between active acromegaly and controlled disease. These results support the view that adiponectin levels do not significantly improve during treatment of acromegaly.…”

Adiponectin and Cardiac Hypertrophy in Acromegaly

“…Data regarding adiponectin levels in active acromegaly available in the literature is variable as lower than [22], higher than [18] or similar to [19,20] those in normal controls. The effect of GH-reducing therapy on serum adiponectin levels has also been studied [21,22].…”