肢端肥大症治疗后纤维蛋白原水平升高的情况会降低。

Elevated fibrinogen levels decrease following treatment of acromegaly.

作者信息

Landin-Wilhelmsen K, Tengborn L, Wilhelmsen L, Bengtsson B A

机构信息

Department of Medicine, Sahlgrenska Hospital, Göteborg, Sweden.

出版信息

Clin Endocrinol (Oxf). 1997 Jan;46(1):69-74. doi: 10.1046/j.1365-2265.1997.d01-1743.x.

DOI:10.1046/j.1365-2265.1997.d01-1743.x

PMID:9059560

Abstract

OBJECTIVE

Acromegaly is associated with increased morbidity and mortality from cardiovascular disease and from stroke in particular. Fibrinogen is an established risk factor for stroke and myocardial infarction and high levels of plasminogen activator inhibitor-1 (PAI-1) activity were predictive of a recurrent myocardial infarction. The aim of this study was to analyse fibrinogen and PAI-1 activity in patients with acromegaly before and after treatment.

PATIENTS

Twenty patients with acromegaly were compared with healthy controls matched for sex (12 men, 8 women), age (mean 53 +/- 7 years), body mass index (mean 26.5 +/- 2.5 kg/m2) and smoking. Fibrinogen was also compared with a random population sample of men and women (n = 392), aged 25-64 years, from the WHO's MONICA Project, Göteborg, Sweden.

RESULTS

The acromegalic patients had a higher lean body mass of 65 +/- 11 vs 59 +/- 11 kg (P < 0.05), lower body fat of 17 +/- 8 vs 25 +/- 10 kg (P < 0.01), higher plasma fibrinogen of 4.0 +/- 0.9 vs 2.4 +/- 0.5 g/l (P < 0.001) and plasma insulin of 15 +/- 14 vs 7 +/- 2 mU/l (P < 0.01), serum triglycerides of 1.5 +/- 0.5 vs 1.2 +/- 0.5 mmol/l (P < 0.05), as well as serum insulin-like growth factor-I (IGF-I) levels of 742 +/- 271 vs 168 +/- 51 micrograms/l (P < 0.001) compared with the matched controls. PAI-1 activity was similar, as was total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, fasting blood glucose and blood pressure for acromegalic patients compared with controls. All the acromegalic patients had higher fibrinogen levels (p < 0.001) than the population mean. Plasma fibrinogen correlated positively with serum IGF-I in acromegaly (r = 0.55, P < 0.05). Fibrinogen decreased to a mean value of 3.2 +/- 0.3 g/l on treatment.

CONCLUSION

Acromegaly is associated with high fibrinogen levels which may be one explanation for the increased risk of cardiovascular events, and stroke in particular, in this disease. Fibrinogen levels decreased following treatment of acromegaly.

摘要

目的

肢端肥大症与心血管疾病尤其是中风导致的发病率和死亡率增加有关。纤维蛋白原是中风和心肌梗死的既定危险因素，高水平的纤溶酶原激活物抑制剂-1（PAI-1）活性可预测心肌梗死复发。本研究的目的是分析肢端肥大症患者治疗前后的纤维蛋白原和PAI-1活性。

患者

将20例肢端肥大症患者与性别（12名男性，8名女性）、年龄（平均53±7岁）、体重指数（平均26.5±2.5kg/m²）和吸烟情况相匹配的健康对照者进行比较。还将纤维蛋白原与来自瑞典哥德堡世界卫生组织MONICA项目的年龄在25-64岁的392名男女随机人群样本进行比较。

结果

与匹配的对照组相比，肢端肥大症患者的瘦体重更高，分别为65±11kg和59±11kg（P<0.05），体脂更低，分别为17±8kg和25±10kg（P<0.01），血浆纤维蛋白原更高，分别为4.0±0.9g/l和2.4±0.5g/l（P<0.001），血浆胰岛素更高，分别为15±14mU/l和7±2mU/l（P<0.01），血清甘油三酯更高，分别为1.5±0.5mmol/l和1.2±0.5mmol/l（P<0.05），血清胰岛素样生长因子-I（IGF-I）水平更高，分别为742±271μg/l和168±51μg/l（P<0.001）。与对照组相比，肢端肥大症患者的PAI-1活性、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、空腹血糖和血压相似。所有肢端肥大症患者的纤维蛋白原水平均高于人群均值（p<0.001）。肢端肥大症患者血浆纤维蛋白原与血清IGF-I呈正相关（r=0.55，P<0.05）。治疗后纤维蛋白原降至均值3.2±0.3g/l。