The association between biochemical control and cardiovascular risk factors in acromegaly

John D. Carmichael, Michael S. Broder, Dasha Cherepanov, Eunice Chang, Adam Mamelak, Qayyim Said, Maureen P. Neary, Vivien Bonert

The study aim was to estimate the proportion of acromegaly patients with various comorbidities and to determine if biochemical control was associated with reduced proportion of cardiovascular risk factors. Data were from a single-center acromegaly registry. Study patients were followed for ≥12 months after initial treatment. Study period was from first to last insulin-like growth factor-I and growth hormone tests. Of 121 patients, 55% were female. Mean age at diagnosis was 42.4 (SD: 15.0). Mean study period was 8.8 (SD: 7.2) years. Macroadenomas were observed in 93 of 106 patients (87.7%), and microadenomas in 13 (12.3%). Initial treatment was surgery in 104 patients (86%), pharmacotherapy in 16 (13.2%), and radiation therapy in 1 (0.8%). Of 120 patients, 79 (65.8%) achieved control during the study period. New onset comorbidities (reported 6 months after study start) were uncommon (<10%). Comorbidities were typically more prevalent in uncontrolled versus controlled patients-24 (58.5%) vs. 33 (41.8%) had hypertension, 17 (41.5%) vs. 20 (25.3%) had diabetes, 11 (26.8%) vs. 16 (20.3%) had sleep apnea, and 3 (7.3%) vs. 3 (3.8%) had cardiomyopathy-except for colon polyps or cancer (19.5% vs. 20.3%), left ventricular hypertrophy (9.8% vs. 11.4%), and visual defects (14.6% vs. 17.7%). A greater number of comorbidities were observed in biochemically uncontrolled patients with acromegaly compared to their controlled counterparts in this single-center registry. About a third of the patients remained uncontrolled after a mean of >8 years of treatment, demonstrating the difficulty of achieving control in some patients.