Homocysteine, Ultrasensitive PCR, Apolipoprotein a-1 and B As Cardiometabolic Risk Markers in Acromegaly Patients

Presentation Number: SUN 461
Date of Presentation: April 2nd, 2017

Maria de Fátima Borges*1, Marília Matos Oliveira2, Janaíne Machado Tomé2, José Oliveira Ferreira2, Maria Cândida Calzada Borges2, Mariana Carvalho Garcia2, Beatriz Pires Ferreira3 and Beatriz Hallal Jorge Lara3
1Universidade Federal do Triângulo Mineiro, Uberaba, Brazil, 2Universidade Federal do Triângulo Mineiro, 3Universidade Federal do Triângulo Mineiro, Uberaba - MG, Brazil



Acromegaly is a rare disease with prevalence of 36-60 cases/million. Diagnosis is delayed due to insidious outcome and the most common etiology is a GH-secreting pituitary macroadenomas. Neuro-ophtalmic and metabolic complication must be managed by surgery and somatostatin analogs. Cardiovascular events are the main determinants of death, indicating that cardiometabolic risk needs to be monitored, so finding sensitive markers are desirable.


Evaluate homocysteine, ultrasensitive C-reactive protein (usCRP) and apolipoprotein A1 (Apo-A1) and B (Apo-B) levels, considered markers of cardiometabolic risk, in acromegaly patients compared to healthy controls.

Subjects and Methods

Thirty one subjects, 17 acromegaly patients and 14 healthy controls were selected. Clinical and laboratorial evaluation were accomplished. GH, IGF-1 and homocysteine levels were determined by immunochemiluminescence. Patients with GH <1,0ng/mL and IGF-1<2 SD for age and sex were considered within controlled criteria of the disease. Apo-A1 and Apo-B as well usCRP were determined by turbidimetric assay. Results were analyzed according to reference values. usCRP >3,0 mg/L was considered as high risk, from 1,0-3,0 medium risk and <1,0mg/L as low risk. Student’s t test was used to compare data from both groups. Correlations between GH/IGF-1 and biomarkers were evaluated by Spearman test. P-values less than 0,05 were considered significant.


Acromegaly patients were 10 men and 7 women; their ages ranged from 16–76 years (median 53 years), BMI ranged 21,6–33,6kg/m2 (median 29,7), with overweight in 6 and obesity in 7. Blood pressure was increased in 5, and impaired fasting glucose or diabetes were previously known in 10. In the healthy control group there were 8 men and 6 women, ages from 24– 63 years. They differed from affected patients in BMI, GH and IGF-1 concentrations (p<0,05). Homocysteine levels were increased in 3 acromegaly patients but their values were not different from controls (12,25 ± 4,05 vs 10,64 ± 2,48µmol/L) as well as Apo-A1 (127,5 ± 21,82 vs 118,7 ± 17,6 mg/dL), Apo-B (86,3 ± 21,91 vs 79,73 ± 13,18 mg/dL) and usCRP (2,00 ± 2,43 vs 1,43 ± 1,94 mg/L). However 10 acromegaly patients had usCRP>1,0 mg/L, indicating increased cardiovascular risk in 59%. No correlations were found between GH/IGF-1 levels and risk markers.


The cardiovascular risk markers in the acromegaly group did not differed from healthy controls, but in individual analysis of usCRP levels indicated increased risk in 59% of acromegaly patients, suggesting that usCRP measurement was more effective in disclose cardiovascular risk.


Nothing to Disclose: MDFB, MMO, JMT, JOF, MCCB, MCG, BPF, BHJ