Effect of a six-month treatment with lanreotide on cardiovascular risk factors and arterial intima-media thickness in patients with acromegaly

Objective: To evaluate the effect of a 6-month treatment with slow-release lanreotide (LAN) on cardiovascular risk and atherosclerosis in 24 normotensive patients with active acromegaly (GH = 67.4 ± 12.6 mU/l, IGF-I = 866.0 ± 55.8 μg/l) and 24 healthy subjects sex-, age- and body mass index-matched with the patients (as controls). Design: Open, prospective, multicenter. Methods: The following were measured before and after 6 months of LAN treatment (dose 60-90 mg/month): fasting GH, IGF-I, LDL, HDL and total cholesterol, triglyceride, glucose, glycosylated hemoglobin, insulin and fibrinogen levels, intima-media thickness (IMT) and blood systolic and diastolic peak velocity (SPV and DPV respectively) in both common carotids. Results: At study entry, insulin, total and LDL cholesterol, triglyceride and fibrinogen levels were higher while HDL cholesterol levels were lower in patients than in controls. At the right (0.88 ± 0.04 vs 0.77 ± 0.03 mm, P = 0.05) and left (0.93 ± 0.03 vs 0.78 ± 0.02 mm, P = 0.01) common carotid IMT was significantly higher in patients than in controls; 12 patients and two controls showed an IMT of ≥ 1 mm (X² = 8.2, P = 0.004). After 6 months of LAN treatment, disease control was achieved in 15 patients (62.5%). Insulin, triglyceride and fibrinogen levels were significantly decreased, and a trend toward a decrease of IMT in the right (from 0.90 ± 0.05 to 0.78 ± 0.04 mm, P = 0.06) and left (from 0.95 ± 0.04 to 0.84 ± 0.04 mm, P = 0.06) common carotid arteries was observed only in patients with disease control, while SPV and DPV did not change. Conclusions: LAN treatment for 6 months significantly lowered GH, IGF-I, insulin and fibrinogen levels and reduced IMT of both common carotid arteries in normotensive patients with acromegaly.