ELEVATED FIBRINOGEN LEVELS DECREASE FOLLOWING TREATMENT OF ACROMEGALY

OBJECTIVE Acromegaly is associated with increased morbidity and mortal ity from cardiovascular disease and from stroke in particular, Fibrino gen is an established risk factor for stroke and myocardial infarction and high levels of plasminogen activator inhibitor-1 (PAI-1) activity were predictive of a recurrent myocardial infarction, The aim of this study was to analyse fibrinogen and PAI-1 activity in patients with a cromegaly before and after treatment, PATIENTS Twenty patients with ac romegaly were compared with healthy controls matched for sex (12 men, 8 women), age (mean 53 +/- 7 years), body mass index (mean 26.5 +/- 2. 5 kg/m(2)) and smoking. Fibrinogen was also compared with a random pop ulation sample of men and women (n = 392), aged 25-64 years, from the WHO's MONICA Project, Goteborg, Sweden, RESULTS The acromegalic patien ts had a higher lean body mass of 65 +/- 11 vs 59 +/- 11 kg (P < 0.05) , lower body fat of 17 +/- 8 vs 25 +/- 10 kg (P < 0.01), higher plasma fibrinogen of 4.0 +/- 0.9 vs 2.4 +/- 0.5 g/l (P < 0.001) and plasma i nsulin of 15 +/- 14 vs 7 +/- 2 mU/I (P < 0.01), serum triglycerides of 1.5 +/- 0.5 vs 1.2 +/- 0.5 mmol/l (P < 0.05), as well as serum insuli n-like growth factor-I (IGF-I) levels of 742 +/- 271 vs 168 +/- 51 mu g/l (P < 0.001) compared with the matched controls, PAI-1 activity was similar, as was total cholesterol, high-density lipoprotein cholester ol, low-density lipoprotein cholesterol, fasting blood glucose and blo od pressure for acromegalic patients compared with controls, All the a cromegalic patients had higher fibrinogen levels (p < 0.001) than the population mean, Plasma fibrinogen correlated positively with serum IG F-I in acromegaly (r = 0.55, P < 0.05), Fibrinogen decreased to a mean value of 3.2 +/- 0.3 g/l on treatment, CONCLUSION Acromegaly is assoc iated with high fibrinogen levels which may be one explanation for the increased risk of cardiovascular events, and stroke in particular, in this disease, Fibrinogen levels decreased following treatment of acro megaly.