Endocrine Abstracts

İntroduction

The aim of this study was to evaluate the association between fibroblast growth factor-21 (FGF-21) levels and carotid intima media thickness (CIMT) in acromegalic patients in relation to the atherosclerotic complications.

Metarials and methods

The study goroup included 70 acromegalic patients. According to the disease activity, patients cathegorized inti 2 groups: controlled and active acromegaly. Seventy-two patients were recruited to the control group. FGF-21, GH, IGF-1, lipids, glucose, insuline levels were assesed. Patients with acromegaly and control subjects were evaluated for their body mass index (BMI) (weight/height squared). CIMT was measured with a B-mode ultrasound.

Results

Median FGF-21 levels were significantly higher in control group compared to acromegaly group (472.5 vs. 192.5 pg/ml, P < 0.001, respectively). Acromegalic patients had higher CIMT than controls (0.63 ± 0.15 mm, 0.44 ± 0.08 mm; P < 0.001). FGF-21 levels and CIMT were not significantly different between controlled and active acromegaly patients (P = 0.34; P = 0.24, respectively). Although, there was no correlation between FGF-21 levels and CIMT in acromegalic patients (P = 0.44); a positive correlation was found between High-density lipoprotein (HDL) cholesterol and FGF-21 level (P = 0.02). In multiple regresyon analysis, HDL-C was the only determinant of FGF-21 (β coefficient = 0.604, P = 0.02). Regarding CIMT in multiple regresion analysis, fasting plasma glucose (β coefficient=0.461, P = 0.02), LDL (low-density lipoprotein) cholesterol (β coefficient = –1.295, P = 0.04), and systolic blood pressure (β coefficient=0.511, P = 0.04) were the influencing factors.

Conclusion

Acromegaly is associated with increased mortality due to cardiovascular complications. Data on serum FGF-21 levels in acromegaly were limited and conflicted. We found lower FGF-21 levels in acromegaly group than controls, despite high CIMT in these group. There was no association between FGF-21 levels and CIMT. This result may be associated with the improving effects of growth hormone on liver fat where the main regulation of FGF-21 take place. We found that glucose intolerance, lipid dysregulation, and hypertension were the factors influencing CIMT in acromegaly.

References

1. Lee CH. et al. Role of Circulating Fibroblast Growth Factor 21 Measurement in Primary Prevention of Coronary Heart Disease Among Chinese Patients With Type 2 Diabetes Mellitus. J Am Heart Assoc. 2017;6(6):e005344.

2. Braun Lr et al. Fibroblast growth factor 21 decreases after liver fat reduction via growth hormone augmentation. Growth Horm IGF Res. 2017 Dec;37:1–6.