Department of Internal Medicine, Faculty of Medicine, Pamukkale University, Denizli, Turkey.
J Investig Med. 2013 Mar;61(3):582-5. doi: 10.2310/JIM.0b013e3182823390.
To find out how resistin and leptin levels were affected in patients with acromegaly and whether there is a relation between resistin levels and cardiac parameters. We also aimed to investigate whether resistin and leptin may be a link between insulin resistance and cardiac functions as well as these affected cardiac functions in the patients with acromegaly.
We included 30 subjects (15 men and 15 women) who had a diagnosis of acromegaly and 30 healthy (10 men and 20 women) subjects. Serum glucose, insulin, growth hormone, insulinlike growth factor 1 (IGF-1), resistin, and leptin levels were obtained, and insulin resistance of subjects were calculated. Echocardiographic studies of the subjects were performed.
Resistin levels of the patients with acromegaly were found lower than controls. This difference was statistically significant (P = 0.001). Leptin levels were lower in the patients with acromegaly than in the controls, but this difference was not statistically significant. Resistin and leptin levels were not correlated with growth hormone, IGF-1, and with insulin-like growth factor binding protein 3 levels. Homeostasis model assessment of insulin resistance was positively correlated with resistin levels. (P = 0.03; r = 0.531) but not correlated with leptin levels. There was a positive correlation between body mass index and leptin levels in the patients with acromegaly (P = 0.007; r = 0.482). Interventricular septum thickness, posterior wall thickness, left ventricle mass index, peak early mitral inflow velocity-peak late mitral inflow velocity ratio, deceleration time, ejection time, isovolumetric relaxation time, velocity propagation, and left ventricular end-systolic volume values were significantly greater in the patients with acromegaly. Leptin levels in the acromegalic patients were not correlated with any of them.
We found biventricular hypertrophy and impairment of diastolic and systolic function in the patients with acromegaly. We conclude that changes in resistin and leptin levels are unlikely to account for the insulin resistance of acromegaly. They do not also seem to be contributing factors of cardiovascular changes in patients with acromegaly.
探讨肢端肥大症患者抵抗素和瘦素水平的变化,以及抵抗素水平与心脏参数之间的关系。我们还旨在研究抵抗素和瘦素是否是胰岛素抵抗与心脏功能之间的联系,以及这些因素是否会影响肢端肥大症患者的心脏功能。
我们纳入了 30 名肢端肥大症患者(男 15 例,女 15 例)和 30 名健康对照者(男 10 例,女 20 例)。检测了所有受试者的血糖、胰岛素、生长激素、胰岛素样生长因子 1(IGF-1)、抵抗素和瘦素水平,并计算了胰岛素抵抗指数。对所有受试者进行了超声心动图检查。
肢端肥大症患者的抵抗素水平低于对照组,差异具有统计学意义(P=0.001)。肢端肥大症患者的瘦素水平低于对照组,但差异无统计学意义。抵抗素和瘦素水平与生长激素、IGF-1 和胰岛素样生长因子结合蛋白 3 水平均无相关性。胰岛素抵抗的稳态模型评估与抵抗素水平呈正相关(P=0.03;r=0.531),但与瘦素水平无关。肢端肥大症患者的体质指数与瘦素水平呈正相关(P=0.007;r=0.482)。肢端肥大症患者的室间隔厚度、后壁厚度、左心室质量指数、舒张早期二尖瓣血流速度与舒张晚期二尖瓣血流速度比值、减速时间、射血时间、等容舒张时间、速度传播时间和左心室收缩末期容积均显著增加,但肢端肥大症患者的瘦素水平与这些参数均无相关性。
我们发现肢端肥大症患者存在双侧心室肥厚和舒张及收缩功能障碍。我们的研究结果提示,抵抗素和瘦素水平的变化可能不是肢端肥大症胰岛素抵抗的原因,也不是肢端肥大症患者心血管变化的影响因素。