Assessment of Obesity, Dyslipidemia, Hyperglycemia, and Pro-Inflammatory Cytokines as Cardiovascular Disease Risk Factors in Acromegaly Patients

Main Article Content

Noor Thair. Tahir
https://orcid.org/0000-0001-9518-6634
Sura A. Abdulsattar
https://orcid.org/0000-0002-4707-7799
Fatin F. Alkazzaz

Abstract

Cardiovascular disease is one of the most common comorbidities associated with enlarged extremities, occurring in 60 % of patients with acromegaly. The aim of this study is to evaluate the relationship of growth hormone and insulin such as growth factor-1 with obesity, dyslipidemia, hyperglycemia, and pro-inflammatory cytokines (IL-2, IL-6, IL-10), as risk factors for cardiovascular disorder in acromegaly patients. Eighty subjects were included and categorized into two groups: 40 acromegaly patients and 40 of the control group. The results indicated weight excess, hyperglycemia, hypertension, lipid disorder, and elevated levels of interleukins (2, 6, and 10). The correlation of both GH and IGF-1 with each of weight, BMI, systolic blood pressure, diastolic blood pressure, FBS, HbA1c, cholesterol, triglyceride, LDL, IL6, IL2, and the atherogenic index was found to be positive and significant. Meanwhile, only IGF-1 was significantly correlated with IL10. We conclude that elevated levels of IL2, IL6, IL 10 and their association with both GH and IGF-1 as well as to lipid disorder, hyperglycemia, and hypertension criteria of acromegaly patients are all risk factors for cardiovascular disease, suggesting the necessary clinical examination for cardiovascular disorder in patients with acromegaly patients.

Downloads

Download data is not yet available.

Article Details

How to Cite
1.
Tahir NT, Abdulsattar SA, Alkazzaz FF. Assessment of Obesity, Dyslipidemia, Hyperglycemia, and Pro-Inflammatory Cytokines as Cardiovascular Disease Risk Factors in Acromegaly Patients. Baghdad Sci.J [Internet]. 2022 Oct. 1 [cited 2022 Nov. 29];19(5):0976. Available from: https://bsj.uobaghdad.edu.iq/index.php/BSJ/article/view/6002
Section
article

References

AlDallal S. Acromegaly: a challenging condition to diagnose. Int J Gen Med. 2018;11:337-347. DOI: 10.2147/IJGM.S169611

Melmed S, Casanueva FF, Klibanski A, Bronstein MD, Chanson P, Lamberts SW, et al. A consensus on the diagnosis and treatment of acromegaly complications. Pituitary. 2013;16(3):294–302. DOI: 10.1007/s11102-012-0420-x

Zahr R, Fleseriu M. Updates in diagnosis and treatment of acromegaly. Eur Endocrinol. 2018;14(2):57-61. DOI: 10.17925/EE.2018.14.2.57

Lugo G, Pena L, Cordido F. Clinical manifestations and diagnosis of acromegaly. Int J Endocrinol. 2012;2012:540398. doi: 10.1155/2012/540398

Mizera ME, Daroszewski J, Bolanowski M. Cardiovascular complications of acromegaly. Acta Endocrinol. 2018;14(3):365-374. DOI: 10.4183/aeb.2018.365

Ridker PM, Everett BM, Thuren T, MacFadyen JG, Chang WH, Ballantyne C, et al. Antiinflammatory therapy with canakinumab for atherosclerotic disease. N Engl J Med. 2017;377(12):1119–31. DOI: 10.1056/NEJMoa1707914

Wolters TLC, Netea MG, Riksen NP, Hermus A, Netea-Maier RT. Acromegaly, inflammation and cardiovascular disease: a review. Rev Endocr Metab Disord. 2020 Dec;21(4):547-568. DOI: 10.1007/s11154-020-09560-x

Szalecki M, Malinowska A, Prokop-Piotrkowska M, Janas R. Interactions between the growth hormone and cytokines–a review. Adv Med Sci. 2018;63(2):285–9. DOI: 10.1016/j.advms.2018.03.001

Jourdan M, Bataille R, Seguin J, Zhang XG, Chaptal PA, Klein B. Constitutive production of interleukin‐6 and immunologic features in cardiac myxomas. Arthritis Rheum Off J Am Coll Rheumatol. 1990;33(3):398–402. DOI: 10.1002/art.1780330313

Sharma AN, Tan M, Amsterdam EA, Singh GD. Acromegalic cardiomyopathy: epidemiology, diagnosis, and management. Clin Cardiol. 2018;41(3):419–25. DOI: 10.1002/clc.22867

Bolfi F, Neves AF, Boguszewski CL, Nunes-Nogueira VS. Mortality in acromegaly decreased in the last decade: a systematic review and meta-analysis. Eur J Endocrinol. 2018;179(1):59–71.DOI: 10.1530/EJE-18-0255

Ramos-Leví AM, Marazuela M. Bringing cardiovascular comorbidities in acromegaly to an update. How should we diagnose and manage them? Front Endocrinol (Lausanne). 2019;10:120. DOI: 10.3389/fendo.2019.00120

Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Himmelfarb CD, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018;71(19):e127–248. DOI: 10.1161/HYP.0000000000000066

Bondanelli M, Ambrosio MR, degli Uberti EC. Pathogenesis and prevalence of hypertension in acromegaly. Pituitary. 2001;4(4):239–49. DOI: 10.1023/a:1020798430884

Powlson AS, Gurnell M. Cardiovascular disease and sleep-disordered breathing in acromegaly. Neuroendocrinology. 2016;103(1):75–85. DOI.org/10.1159/000438903

Anagnostis P, Efstathiadou ZA, Gougoura S, Polyzos SA, Karathanasi E, Dritsa P, et al. Oxidative stress and reduced antioxidative status, along with endothelial dysfunction in acromegaly. Horm Metab Res. 2013;45(04):314–8. DOI: 10.1055/s-0032-1323765

Hunter CA, Jones SA. IL-6 as a keystone cytokine in health and disease. Nat Immunol. 2015;16(5):448–57. DOI: 10.1038/ni.3153

Wolters TLC, van der Heijden CDCC, van Leeuwen N, Hijmans-Kersten BTP, Netea MG,Smit JW, Thijssen DHJ, Hermus A, Riksen NP, Netea-Maier R. Persistent inflammation and endothelial dysfunction in patients with treated acromegaly. Endocr Connect. 2019 Dec;8(12):1553-1567. DOI: 10.1530/EC-19-0430.

Verhelst J, Velkeniers B, Maiter D, Haentjens P, T'Sjoen G, Rietzschel E, Corvilain B, Abrams P, Nobels F, Abs R, Bex M. Active acromegaly is associated with decreased hs-CRP and NT-proBNP serum levels: insights from the Belgian registry of acromegaly. Eur J Endocrinol. 2013 Jan 17;168(2):177-84. DOI: 10.1530/EJE-12-0753

Olarescu NC, Ueland T, Godang K, Lindberg-Larsen R, Jørgensen JO, Bollerslev J. Inflammatory adipokines contribute to insulin resistance in active acromegaly and respond differently to different treatment modalities. Eur J Endocrinol. 2013 Nov 22;170(1):39-48. DOI: 10.1530/EJE-13-0523