Abstract | OBJECTIVE: PATIENTS: Twenty patients (9 male, mean age 58.7 years, range 28-79) with active acromegaly (baseline serum IGF-I > 130% the age-related upper limit of normal) received pegvisomant and achieved a normal serum IGF-I [585.2 +/- 54.3 (mean +/- SEM) to 169.2 +/- 13.9 ng/ml, P < 0.0001]. MEASUREMENTS: RESULTS: Normalization of serum IGF-I resulted in an increase in TC (5.0 +/- 0.3 to 5.7 +/- 0.4 mmol/l, P = 0.0068), an increase in LDL (3.0 +/- 0.25 to 3.7 +/- 0.31 mmol/l, P = 0.0093) and an increase in apo B (110.6 +/- 7.76 to 127.1 +/- 8.86 mg/l, P = 0.014). TC and LDL increased in all but four patients. Despite a significant fall in fasting insulin levels (9.9 to 8.3 mU/l, range 8.85-19.8 to 6.33-11.6, P < 0.001) and insulin resistance (2.7 to 1.9, range 1.2-10.4 to 1-6.2, P < 0.001), mean serum TG and HDL levels were unaffected by IGF-I normalization. The protein component of HDL, apo A1, increased (153 +/- 4 to 166.4 +/- 5.43 mg/l, P = 0.026) and Lp(a) declined (median 342 to 235 mg/l, range 60-1013 to 74-671), P = 0.0035). Baseline serum TC and LDL were below the age- and sex-matched mean population value but after normalization of serum IGF-I the distribution of serum TC and LDL values was similar to that of the general population. CONCLUSIONS: Active acromegaly is associated with lowered mean serum TC and LDL. Successful management using pegvisomant increases lowered baseline serum TC and LDL levels, restoring the distribution of values to that of the general population, and improves insulin resistance. These findings are consistent with the reported lipoprotein changes following GH administration to normal and GH-deficient individuals.
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Authors | C Parkinson, W M Drake, G Wieringa, A P Yates, G M Besser, P J Trainer |
Journal | Clinical endocrinology
(Clin Endocrinol (Oxf))
Vol. 56
Issue 3
Pg. 303-11
(Mar 2002)
ISSN: 0300-0664 [Print] England |
PMID | 11940041
(Publication Type: Journal Article)
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Chemical References |
- Insulin
- Lipoproteins
- Lipoproteins, LDL
- Receptors, Somatotropin
- Human Growth Hormone
- Insulin-Like Growth Factor I
- Cholesterol
- pegvisomant
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Topics |
- Acromegaly
(blood, drug therapy)
- Adult
- Aged
- Cholesterol
(blood)
- Female
- Follow-Up Studies
- Human Growth Hormone
(analogs & derivatives, therapeutic use)
- Humans
- Insulin
(blood)
- Insulin Resistance
- Insulin-Like Growth Factor I
(metabolism)
- Lipoproteins
(blood)
- Lipoproteins, LDL
(blood)
- Male
- Middle Aged
- Receptors, Somatotropin
(antagonists & inhibitors)
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