TY - JOUR

T1 - N-terminal pro-B-type natriuretic peptide in patients with growth hormone disturbances

AU - Andreassen, Mikkel

AU - Faber, Jens

AU - Vestergaard, Henrik

AU - Kistorp, Caroline

AU - Kristensen, Lars Østergaard

PY - 2007/5

Y1 - 2007/5

N2 - BACKGROUND: Acromegaly is associated with hypertrophic cardiomyopathy, hypertension and subsequent congestive heart failure. Impairment of cardiac function has also been associated with growth hormone deficiency (GHD). B-type natriuretic peptides (BNPs) have emerged as strong diagnostic and prognostic risk markers. They are cardioprotective hormones that compensate heart disease by promoting natriuresis and modulation of cardiac hypertrophy in response to volume expansion and ventricular wall stretch.OBJECTIVE: To investigate N-terminal pro-BNP (NT-proBNP) in patients with GH disturbances before and after treatment, and in healthy gender- and age-matched controls.SUBJECTS AND METHODS: Ten acromegalic patients (age 48 +/- 12 years) and 10 patients with GHD (age 41 +/- 14 years) were studied. None had symptoms or signs of cardiovascular disease except for hypertension. Serum NT-proBNP was measured before and 3, 6, 12 and 24 months after treatment.RESULTS: Baseline NT-proBNP was lower in acromegalic patients [median (interquartile range) 24.3 (17.8-33.0) pg/ml] than in 20 healthy matched controls [57.9 (35.4-92.2) pg/ml; P < 0.001]. NT-proBNP increased during treatment (P = 0.002), concomitant with a decrease in IGF-I (P < 0.001). After 3 months of treatment NT-proBNP peaked, with a fourfold increase to 96.4 (57.8-113.2) pg/ml. NT-proBNP did not differ in patients with GHD compared with controls (P = 0.19), and did not change during treatment (P = 0.39).CONCLUSION: Untreated patients with acromegaly had low NT-proBNP levels that increased fourfold after treatment. This is in contrast to other conditions with cardiac hypertrophy. Further studies are required to determine the significance of this novel finding in relation to acromegalic cardiac disease.

AB - BACKGROUND: Acromegaly is associated with hypertrophic cardiomyopathy, hypertension and subsequent congestive heart failure. Impairment of cardiac function has also been associated with growth hormone deficiency (GHD). B-type natriuretic peptides (BNPs) have emerged as strong diagnostic and prognostic risk markers. They are cardioprotective hormones that compensate heart disease by promoting natriuresis and modulation of cardiac hypertrophy in response to volume expansion and ventricular wall stretch.OBJECTIVE: To investigate N-terminal pro-BNP (NT-proBNP) in patients with GH disturbances before and after treatment, and in healthy gender- and age-matched controls.SUBJECTS AND METHODS: Ten acromegalic patients (age 48 +/- 12 years) and 10 patients with GHD (age 41 +/- 14 years) were studied. None had symptoms or signs of cardiovascular disease except for hypertension. Serum NT-proBNP was measured before and 3, 6, 12 and 24 months after treatment.RESULTS: Baseline NT-proBNP was lower in acromegalic patients [median (interquartile range) 24.3 (17.8-33.0) pg/ml] than in 20 healthy matched controls [57.9 (35.4-92.2) pg/ml; P < 0.001]. NT-proBNP increased during treatment (P = 0.002), concomitant with a decrease in IGF-I (P < 0.001). After 3 months of treatment NT-proBNP peaked, with a fourfold increase to 96.4 (57.8-113.2) pg/ml. NT-proBNP did not differ in patients with GHD compared with controls (P = 0.19), and did not change during treatment (P = 0.39).CONCLUSION: Untreated patients with acromegaly had low NT-proBNP levels that increased fourfold after treatment. This is in contrast to other conditions with cardiac hypertrophy. Further studies are required to determine the significance of this novel finding in relation to acromegalic cardiac disease.

KW - Acromegaly

KW - Adult

KW - Aged

KW - Analysis of Variance

KW - Antineoplastic Agents, Hormonal

KW - Biomarkers

KW - Case-Control Studies

KW - Female

KW - Follow-Up Studies

KW - Growth Hormone

KW - Humans

KW - Insulin-Like Growth Factor Binding Protein 3

KW - Insulin-Like Growth Factor I

KW - Male

KW - Middle Aged

KW - Natriuretic Peptide, Brain

KW - Octreotide

KW - Peptide Fragments

KW - Peptides, Cyclic

KW - Protein Precursors

KW - Retrospective Studies

KW - Somatostatin

KW - Statistics, Nonparametric

KW - Journal Article

U2 - 10.1111/j.1365-2265.2007.02782.x

DO - 10.1111/j.1365-2265.2007.02782.x

M3 - Journal article

VL - 66

SP - 619

EP - 625

JO - Clinical Endocrinology

JF - Clinical Endocrinology

SN - 0300-0664

IS - 5

ER -