与心血管风险相似的非肢端肥大患者相比,肢端肥大患者的脉搏波速度降低

IF 1.6 4区 医学 Q4 CELL BIOLOGY Growth Hormone & Igf Research Pub Date : 2021-04-01 DOI:10.1016/j.ghir.2021.101395
Irina Filchenko , Lyudmila Korostovtseva , Mikhail Bochkarev , Maria Boyarinova , Asiyat Alieva , Oxana Rotar , Yuri Sviryaev , Uliana Tsoi , Elena Grineva
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引用次数: 1

摘要

据报道,肢端肥大症患者动脉僵硬度增加,这可能导致该人群频繁出现心血管并发症。生长激素和IGF-1的慢性过量可能通过不同的机制导致动脉硬化,包括高血压、糖耐量受损和血脂异常,然而,目前尚不清楚生长激素/IGF-1轴的激活是否可能独立于心血管危险因素影响动脉硬化。这项前瞻性病例对照研究的目的是比较具有相似心血管风险特征的肢端肥大症和非肢端肥大症患者用脉搏波速度(PWV)评估的动脉硬度。设计本前瞻性病例对照研究纳入27例活动性肢端肥大症患者,采用平压血压计评估临床、生理、生化参数和PWV。我们使用“俄罗斯联邦不同地区心血管疾病流行病学”研究数据库(n = 522)建立具有相似心血管风险概况的非肢端肥大症对照组(n = 54)。非肢端肥大症对照组接受与肢端肥大症患者相同的评估,除了测量血清GH和IGF-1水平。我们将肢端肥大症患者的PWV与一般非肢端肥大症队列及其亚组进行了比较,并与肢端肥大症患者的心血管危险因素进行了匹配。我们还研究了肢端肥大症和非肢端肥大症患者的PWV与临床、生理生化参数的关系,并进行了年龄和性别校正的相关和回归分析。结果肢端肥大症患者的PWV (6.70 (5.75 ~ 7.65) m/s)低于未匹配的非肢端肥大症对照组(7.50 (6.70 ~ 8.57)m/s, p = 0.01),心血管危险因素匹配的非肢端肥大症对照组(7.45 (6.73 ~ 8.60),p <0.01)。非肢端肥大症对照组PWV与BMI相关(ρ = 0.40, p <0.01;β = 0.09, p <0.01),肥胖(r = 0.46, p <0.01;β = 1.36, p <0.01),收缩压(ρ = 0.60, p <0.01;β = 0.05, p <0.01),舒张压(ρ = 0.62, p <0.01;β = 0.07, p <0.01),甘油三酯(ρ = 0.55, p <0.01;β = 0.58, p = 0.04),葡萄糖(ρ = 0.54, p <0.01;β = 0.70, p <0.01)和糖尿病(r = 0.40, p <0.01;β = 1.10, p = 0.03),肢端肥大症组PWV与IGF-1 mcg/ml表达相关(ρ = - 0.49, p≤0.01;β = - 0.002, p≤0.01),占正常值上限的百分比(ρ = - 0.47, p = 0.01;β=−0.005,p≤0.01)以及利尿剂治疗(β=−1.17,p = 0.03)。结论:肢端肥大症患者的spwv与心血管风险相似的非肢端肥大症对照组相比有所降低。未来的研究需要探索GH/IGF-1轴在动脉壁特性调节中的作用,以及PWV作为肢端肥大症心血管并发症预后指标的可靠性。
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Pulse wave velocity is decreased in acromegaly compared to non-acromegaly study participants with similar cardiovascular risk profile

Objective

Acromegaly patients were reported to have an increased arterial stiffness that could contribute to the frequent cardiovascular complications in this population. The chronic excess of GH and IGF-1 may lead to arterial stiffening via different mechanisms, including hypertension, impaired glucose tolerance and dyslipidemia, however, it is not known whether the activation of GH/IGF-1 axis might influence arterial stiffening independently of cardiovascular risk factors. The objective of this prospective case-control study was to compare arterial stiffness assessed with pulse-wave velocity (PWV) in acromegaly versus non-acromegaly group with similar cardiovascular risk profile.

Design

This prospective case-control study included 27 patients with active acromegaly, who underwent the assessment of clinical, physiological, biochemical parameters and the evaluation of PWV with applanation tonometry. We used “The epidemiology of cardiovascular disease in different regions of the Russian Federation” study database (n = 522) to establish a non-acromegaly control group with similar cardiovascular risk profile (n = 54). Non-acromegaly control participants underwent the same assessment as acromegaly patients except for the measurement of serum GH and IGF-1 levels. We compared PWV in acromegaly patients to the general non-acromegaly cohort and its subset, matched with acromegaly patients for cardiovascular risk factors. We also investigated the associations of PWV with clinical, physiological and biochemical parameters in acromegaly and non-acromegaly group using correlation and regression analysis with adjustment for age and sex.

Results

Acromegaly patients had lower PWV (6.70 (5.75–7.65) m/s) compared to unmatched non-acromegaly control cohort (7.50 (6.70–8.57) m/s, p = 0.01) and to the non-acromegaly control group matched for cardiovascular risk factors (7.45 (6.73–8.60), p < 0.01). In non-acromegaly control group PWV was associated with BMI (ρ = 0.40, p < 0.01; β = 0.09, p < 0.01), obesity (r = 0.46, p < 0.01; β = 1.36, p < 0.01), systolic blood pressure (ρ = 0.60, p < 0.01; β = 0.05, p < 0.01), diastolic blood pressure (ρ = 0.62, p < 0.01; β = 0.07, p < 0.01), triglycerides (ρ = 0.55, p < 0.01; β = 0.58, p = 0.04), glucose (ρ = 0.54, p < 0.01; β = 0.70, p < 0.01) and diabetes (r = 0.40, p < 0.01; β = 1.10, p = 0.03), while in acromegaly group PWV was associated with IGF-1 expressed in mcg/ml (ρ = −0.49, p ≤0.01; β = −0.002, p ≤0.01) and in percentage of the upper limit of the normal (ρ = −0.47, p = 0.01; β = −0.005, p ≤0.01) as well as with diuretics treatment (β = −1.17, p = 0.03).

Conclusions

PWV is decreased in acromegaly patients compared to non-acromegaly control participants with similar cardiovascular risk profile. Future studies need to explore the role of GH/IGF-1 axis in the regulation of arterial wall properties and the reliability of PWV as a prognostic marker of cardiovascular complications in acromegaly.

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来源期刊
Growth Hormone & Igf Research
Growth Hormone & Igf Research 医学-内分泌学与代谢
CiteScore
3.30
自引率
0.00%
发文量
38
审稿时长
57 days
期刊介绍: Growth Hormone & IGF Research is a forum for research on the regulation of growth and metabolism in humans, animals, tissues and cells. It publishes articles on all aspects of growth-promoting and growth-inhibiting hormones and factors, with particular emphasis on insulin-like growth factors (IGFs) and growth hormone. This reflects the increasing importance of growth hormone and IGFs in clinical medicine and in the treatment of diseases.
期刊最新文献
Editorial Board Association of rs35767 polymorphism in the IGF1 gene with athletic performance in power and endurance sports: A meta-analysis The association between change in temporal muscle mass and treatment of acromegaly Pregnancy-associated plasma protein-A (PAPP-A) and cardiovascular disease Editorial Board
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