Association of skin autofluorescence and carotid intima-media thickness in acromegaly patients

Abstract

Background: The Pituitary Tumors Centers of Excellence (PTCOE) concept was established to provide a multimodal approach with careful management of comorbidities. Acromegaly, one of the main concerns of PTCOE per se, leads to increased mortality rates of which cardiovascular disease is an important cause. Increased skin autofluorescence (SAF) was shown to be associated with carotid intima-media thickness (CIMT), a well-established marker of atherosclerosis, and consequently cardiovascular complications. This study aimed to evaluate SAF and CIMT in association with anthropometric, clinical, and biochemical parameters in acromegaly patients and healthy controls.

Methods: The study group included 138 acromegaly patients and 127 healthy controls from the Department of Endocrinology and Metabolism Disease, Marmara University Medical School. Growth hormone, insulin-like growth factor I, lipids, glucose, insulin levels were assessed. Advanced glycation end products (AGEs) were measured by the auto-fluorescence reader. CIMT was measured from the common carotid artery wall on B-mode ultrasound.

Results: CIMT and SAF levels were significantly higher in the acromegaly group than the control group. There was a positive correlation between SAF and CIMT both in the total cohort and acromegaly patients. The presence of acromegaly, age, and SAF were the determining factors of CIMT in the whole study cohort.

Conclusions: Our study is the first to examine the relationship between SAF and CIMT in acromegaly patients. We found higher CIMT and enhanced SAF in the acromegaly group compared to the control group with a significant positive correlation in between. The presence of acromegaly was related to increased SAF levels and CIMT. SAF was associated with CIMT in acromegaly patients. Implementation of CIMT and SAF evaluation in this clinical setting may improve cardiovascular complications, particularly in the PTCOE.