The association of epicardial fat thickness and carotid intima-media thickness with metabolic parameters in patients acromegaly

Acromegaly is a syndrome characterized by excessive secretion of growth hormone (GH) and insuline like growth factor (IGF-1). The association between GH and cardiovascular system has been intriguing as the higher prevalence of cardiovascular events among acromegaly patients were found. Hypertension is common in acromegaly. The leading cause of mortality in acromegaly is cardiovascular events including coronary artery disease, arrythmias, and heart failure . Epicardial fat thickness measurement is reported as a new, applicable method in predicting the development of atherosclerosis, hypertension, ischemic heart disease and cardiovascular events. The assessment of carotis intima-media thickness can be a feasible method in predicting the risks of atherosclerosis development, cerebrovascular and cardiovascular events. In this study, we aim to investigate the association of epicardial fat thickness and carotis intima-media thickness with serum GH, IGF-1 levels and duration of diagnosis in acromegaly patients in remission or/and active disease. Material-method: In this study, 40 acromegaly patients (23 female, 17 male) and 40 control groups (23 female, 17 male) were included. Patients with concurrent heart disease, diabetes mellitus, obesity (BMI>30 ), hypertension (BP>140/90) ,hyperlipidemia, metabolic syndrome and insulin resistance detected by HOMA-IR method were excluded from this study. Patients parameters; weight, height, BMI, waist circumference, systolic and diastolic blood pressure, lipid profile, serum urea, creatinine, GH and IGF-1 levels, CBC were recorded. Epicardial fat thickness and carotis intima media thickness were evaluated by echocardiography. In this study, SPSS 18.0 computer based-statistical program was used for estimation. (P<0.05) Findings: The mean age of patients were 39.5 ± 10.1 years in acromegaly and 39.3 ± 10.1 years in control group. ( male 17 , female 23). Acromegaly patients with any concurrent disease were excluded from this study. In acromegaly group, mean GH levels: 2.73 ± 2.5 ,mean IGF-1 levels: 421.1 ± 283.5 , mean epicardial fat thickness 7,17 ±1.32 mm , mean carotis intima-media thickness 0.72 ±0.13 mm were found. In control group, mean GH levels:0.28±0.06 , mean IGF-1 level:155.2 ±31.3 , mean epicardial fat thickness 3.22 ±0.79 mm, mean carotis intima-media thickness 0.39 ± 0.11 mm were found. There was statistically significant positive correlation of serum GH and IGF-1 levels with epicardial fat thickness and carotis intima-media thickness. Result : This study, epicardial fat thickness and carotid intima-media thickness was found to be a positive correlation between GH and IGF-1 levels in patients with acromegaly. İncreased GH levels ,increased EFT and CIMT values were seen. Found similar results with literature in predicting the early development of atherosclerosis. Further studies need to be done for using this applicable method in routine clinical practise