Potter Brian J, Beauregard Catherine, Serri Omar
Department of Medicine, Division of Endocrinology, Centre Universitaire de l'Université de Montréal Research Center, Notre-Dame Hospital, 1560, rue Sherbrooke E, Montreal, Quebec H2L 4M1, Canada.
Pituitary. 2008;11(1):49-53. doi: 10.1007/s11102-007-0067-1.
Acromegaly is associated with increased morbidity and mortality from cardiovascular disease. Inflammatory markers, such as C-reactive protein and leucocyte count, haemostatic markers, such as fibrinogen and factor VIII and cardiac hypertrophy marker, B-type natriuretic peptide, have emerged as important cardiovascular risk markers in the general population. The objective of this study was to assess the serum levels of conventional, inflammatory, haemostatic markers and NT-pro BNP in mostly non-diabetic normotensive patients with acromegaly, as well as the effect of 6 months of octreotide LAR therapy on these markers. We studied 12 patients with active acromegaly, 12 patients in whom remission of acromegaly had been achieved by surgery and 12 healthy control subjects matched for age, gender and body mass index. At baseline fasting blood was obtained for measurements of GH, IGF-1, glucose, insulin, lipids, lipoprotein (a), C-reactive protein, leucocyte count, fibrinogen, factor VIII and NT-pro BNP. After baseline evaluation, patients with active acromegaly were treated with octreotide LAR for 24 weeks. At 24 weeks, measurements were repeated as on baseline. Insulin resistance index and fibrinogen levels were higher in patients with active acromegaly than patients and subjects in control groups. CRP, leucocyte count, factor VIII and NT-pro BNP were similar in the three groups. Octreotide LAR reduced GH, IGF-1 and insulin resistance index but did not alter levels of CRP and NT-pro BNP.
肢端肥大症与心血管疾病导致的发病率和死亡率增加相关。炎症标志物,如C反应蛋白和白细胞计数,止血标志物,如纤维蛋白原和凝血因子VIII,以及心脏肥大标志物B型利钠肽,已成为普通人群中重要的心血管风险标志物。本研究的目的是评估大多数非糖尿病正常血压肢端肥大症患者的传统、炎症、止血标志物和NT-pro BNP的血清水平,以及长效奥曲肽治疗6个月对这些标志物的影响。我们研究了12例活动性肢端肥大症患者、12例通过手术实现肢端肥大症缓解的患者以及12名年龄、性别和体重指数相匹配的健康对照者。在基线时采集空腹血,用于测量生长激素(GH)、胰岛素样生长因子-1(IGF-1)、血糖、胰岛素、血脂、脂蛋白(a)、C反应蛋白、白细胞计数、纤维蛋白原、凝血因子VIII和NT-pro BNP。基线评估后,活动性肢端肥大症患者接受长效奥曲肽治疗24周。在24周时,重复进行与基线相同的测量。活动性肢端肥大症患者的胰岛素抵抗指数和纤维蛋白原水平高于对照组的患者和对照者。三组的C反应蛋白、白细胞计数、凝血因子VIII和NT-pro BNP相似。长效奥曲肽降低了生长激素、胰岛素样生长因子-1和胰岛素抵抗指数,但未改变C反应蛋白和NT-pro BNP的水平。