Abstract
Cardiovascular accidents are major causes of death in acromegaly because of its frequent association with multiple cardiovascular risk factors such as diabetes, hypertension and dyslipidemia. Elevated serum lipoprotein (a) (Lp (a)) level is another independent risk factor. However, little is known about the contribution of Lp (a) to cardiovascular disorders in acromegaly. We determined the serum concentrations of Lp (a) in acromegalic patients before and after pituitary adenomectomy. In pre-operative 12 patients, serum Lp (a) levels were significantly higher compared with 32 healthy volunteers (27.5±4.3 mg/dl vs. 14.5±1.8 mg/dl, p<0.005). After operation, serum GH levels markedly decreased from 24.0±6.7 ng/ml to 3.9±1.1ng/ml (p<0.02), and serum Lp (a) levels slightly (although not significantly) decreased from 27.7±7.4 mg/dl to 14.0±4.0 mg/dl (p=0.067). Serum triglyceride levels decreased from 155±33 mg/dl to 81±11 mg/dl (p<0.05), and serum HDL-cholesterol levels increased from 37±6 mg/dl to 59±7 mg/dl (p<0.05). Serum total cholesterol levels were unaffected by operation (173±17 mg/dl vs. 180±13 mg/dl). Our data suggest that GH may be involved in the regulation of serum Lp (a) levels, and that in untreated acromegalic patients, elevated Lp (a) levels might accelerate the development of atherosclerosis in concert with other cardiovascular risk factors.
