Endocrine Abstracts

Patients with acromegaly have 2–3 fold increased mortality from cardiovascular diseases. It is associated with elevated growth hormone (GH) levels. Alterations of acute phase proteins, observed in patients with acromegaly, could lead to increased cardiovascular mortality. There are limited data on influences of GH excess on acute phase reactants.

The aim of the study was to evaluate selected acute phase proteins levels: fibrinogen and C-reactive protein (CRP) in patients with acromegaly.

Seventy-seven patients were divided into two groups: active acromegaly (AA, n=56) and controlled acromegaly (CA, n=21) according to minimal GH level during an oral glucose tolerance test and IGF-1 levels. Twenty sex matched healthy subjects were controls. The following parameters were measured: fibrinogen, CRP, fasting glucose, insulin, total cholesterol, LDL and HDL cholesterol, triglycerides and BMI.

Comparison of all groups using Mann-Whitney U testing revealed statistically significant: higher LDL cholesterol and insulin levels and lower CRP levels and BMI values in AA than CA groups (P<0.04, 0.02, 0.01 and 0.03, respectively); higher fibrinogen, triglycerides, glucose levels and BMI values in AA group than controls (P<0.000001, 0.002, 0.01 and 0.001, respectively); higher CRP, fibrinogen, triglycerides levels and BMI values in CA group than controls (P<0.01, 0.002, 0.04 and 0.001, respectively).

Fibrinogen levels in all patients with acromegaly were significantly higher than in healthy subjects irrespective of disease status. CRP levels were significantly and paradoxically lower in patients with active acromegaly than in patients with well controlled disease and did not explain increased cardiovascular mortality in acromegaly. The role of CRP levels as a cardiovascular risk factor in the mortality of patients with uncontrolled acromegaly ought to be better explained in future studies.