Akromegali ve Prolaktinoma Tanılı Hastalarda Kardiyak Steatozis, Kardiyovasküler Risk ve İlişkili Biyomarkerlar

Abstract

In systemic diseases, early recognition of dysfunctions related to cardiovascular complications is important. The aim of the current study was to assess the relationship of four-dimensional echocardiographic measurements with asprosin, GDF-15 levels and epicardial fat thickness in patients with acromegaly and prolactinoma. The study included 41 acromegaly, 29 prolactinoma patients and 33 healthy control subjects. Anthropometric, biochemical and echocardiographic measurements were performed in all participants. The Framingham cardiovascular risk score (FS) was highest in patients with acromegaly (p=0.004). In two-dimensional echocardiographic assessment; the left ventricular ejection fraction was lower in acromegaly [63% (63- 65)] and prolactinoma [%63 (60-65)] patients compared to the healthy controls [66% (63-68)](p=0.003). In both acromegaly and prolactinoma groups; global longitudinal strain, global circumferential strain, global areal strain, and global radial strain measurements identified by four-dimensional echocardiography were lower than the control group (Acromegaly: p = 0.007, p = 0.008, p = 0.015, p = 0.008; prolactinoma: p = 0.033, p = 0.019 , p = 0.030, p = 0.025, respectively). There was no significant difference between the groups related to epicardial fat thickness. Plasma asprosin concentration in the prolactinoma group [2.4 ng/mL (0.0-9.7)] was significantly lower than the concentration in both the acromegaly group [6.8 ng/mL (2.6-9.9)] and the control group [10.2 ng/mL (2.3-18.0)](p=0.022, p=0.006, respectively). In study population, the plasma asprosin level is independently associated with age. Plasma GDF-15 concentration was lower in prolactinoma group [262.2 pg/mL (169.3-336.1)] than in the acromegaly [332.5 pg/mL (257.4-438.8)] and control groups [331.3 pg/mL (233.6-428.9)](p=0.008, p=0.047, respectively). In both patient groups, the plasma GDF-15 level was independently positively related to the FS. In conclusion, there is a subclinical systolic dysfunction identified by strain echocardiography in patients with acromegaly and prolactinoma, and GDF-15 can be used as a biomarker to predict cardiovascular risk in these patient groups. Keywords: Strain echocardiography, acromegaly, prolactinoma, asprosin, GDF-15