UNLABELLED: It is unknown if altered ghrelin secretion might contribute to the development of metabolic complications in acromegaly. The AIM OF THE STUDY was to: 1) assess if serum concentrations of total and acylated ghrelin in patients with acromegaly differ in the presence of various metabolic complications (hypercholesterolemia, hyperinsulinemia, hyperglicemia). 2) assess the correlations between concentrations of ghrelin and concentrations of GH, IGF-1, cholesterol, insulin and glucose in patients with acromegaly.
MATERIALS: 24 patients with previously diagnosed acromegaly (11 subjects with active and 13 subjects with inactive disease) and 12 healthy subjects. 23 subjects were treated in the past with neurosurgery, 3 subjects with radiotherapy. 7 patients were receiving octreotide LAR at the time of the study.
METHODS: In all studied subjects the concentrations of total ghrelin, acylated ghrelin, GH, IGF-1, insulin, glucose, total cholesterol, LDL cholesterol, HDL cholesterol, triglicerydes, were measured.
RESULTS: The concentrations of total and acylated ghrelin did not significantly differ between patients with active and inactive disease. The mean concentrations of total and acylated ghrelin were significantly higher in acromegalic patients who presented with hypercholesterolemia compared with patients with normocholesterolemia. In patients with hypercholesterolemia the ratio of acylated/total ghrelin was 16%. In patients with active acromegaly there was a statistically significant positive correlation between the concentration of total ghrelin and the concentration of total cholesterol and LDL cholesterol. There was also a positive correlation between the concentration of acylated ghrelin and LDL cholesterol (without statistical significance). In patients with inactive acromegaly there was a statistically significant positive correlation between the concentration of acylated ghrelin and the concentration of triglycerides and a positive correlation between total ghrelin and triglycerides, but statistically insignificant. There were no differences in ghrelin levels depending on the insulin and glucose concentrations.
CONCLUSIONS: Some metabolic complications of the disease might result not only from GH hypersecretion but also from altered ghrelin secretion.