Endocrine Abstracts

Introduction: Acromegaly is a rare, challenging disease that if not appropriately treated can lead to numerous complications. Some of the most frequent complications are cardiovascular (hypertension, secondary cardiomyopathy, arrhythmias, valvulopathies, heart failure) and metabolic (secondary diabetes, various alterations of the lipid metabolisms).

Aim: The aim is to asses the impact of long-term acromegaly on the cardiovascular system and glucide and lipid metabolisms.

Patients and method: In this retrospective study the records of 107 patients with previously diagnosed acromegaly, who have been assessed at least once in our tertiary referral centre (Department of Endocrinology, University Hospital “Sfântul Spiridon”, Iaşi) over a period of 6 years have been reviewed.

Results: Out of the 107 patients with mean age 51.96 ± 12.14 years, 34 (31.78%) were male and 73 (68.22%) were female. From the total of 107 patients 93 (86.92%) had cardio-metabolic complications. Out of the assessed cardiovascular comorbidities, hypertension was present in 46 patients (42.99%), rhythm disorders were found in 8 patients (20%), cardiomyopathy in 5 patients (12.5%), valvulopathies in 3 cases (7.5%), 6 cases of heart failure (15%), chronic venous insufficiency in 2 patients (5%), cardiac ischemic events were found in 11 patients (27.5%), 2 cases of stroke (5%) and 3 cases (7.5%) of other cardiovascular diseases were also noted. Alterations of the glucide metabolism were determined in 36 patients (33.64%): type 2 diabetes mellitus was found in 21 cases (58.33%), impaired fasting glucose in 6 cases (16.67%) and impared glucose tolerance in 9 patients (25%). Dyslipidemia was found in 44 patients (41.12%), while an increased body mass index was determined in 46 patients (57.01%).

Conclusions: The design of the present research has offered a chance for thorough investigation of cardiovascular and metabolic alterations in acromegaly patients, thus revealing a significant number of complications. Although acromegaly is an orphan disease, the multi-organ severe complications rise complex issues in relation with the diagnosis and treatment approach. This aspect could justify the use of a personalised multi-modal treatment for each patient.

Key words: acromegaly, cardiovascular disease, metabolic complications