Vascular reactivity in acromegalic patients: preliminary evidence for regional endothelial dysfunction and increased sympathetic vasoconstriction

• Published in: Clinical endocrinology (Oxford) 2000-10, Vol.53 (4), p.445-451
• Main Authors: Maison, Patrick, Démolis, Pierre, Young, Jacques, Schaison, Gilbert, Giudicelli, Jean-François, Chanson, Philippe
• Format: Article
• Language: English
• Subjects: Acromegaly - blood; Acromegaly - physiopathology; Adult; Biological and medical sciences; Case-Control Studies; Cold Temperature; Endocrinopathies; Endothelium, Vascular - physiopathology; Female; Growth Hormone - blood; Hand; Hot Temperature; Humans; Hypothalamus. Hypophysis. Epiphysis (diseases); Insulin-Like Growth Factor I - analysis; Laser-Doppler Flowmetry; Male; Medical sciences; Middle Aged; Non tumoral diseases. Target tissue resistance. Benign neoplasms; Regional Blood Flow; Skin - blood supply; Skin Temperature; Sympathetic Nervous System - physiopathology; Vasoconstriction
• ISSN: 0300-0664; 1365-2265
• DOI: 10.1046/j.1365-2265.2000.01127.x

BACKGROUND AND OBJECTIVES Hypertension is found in one‐third of acromegalic patients. An heterogenous distribution of cardiac output has been recently demonstrated in acromegalic patients with an increased blood flow at the level of the upper limb, suggesting that acromegalic patients may have some degree of endothelial dysfunction. Elsewhere, studies involving hypopituitary GH‐deficient adults have shown that GH and/or IGF‐I may have direct effect on endothelial function. SUBJECTS AND METHODS We thus compared cutaneous vasoreactivity responses in 10 normotensive patients with active acromegaly (A) (six women and four men) aged 25–59 (mean, 43.2 years), whose basal GH and IGF‐I levels ranged from 7.4 to 158 mU/l and from 401 to 1690 μg/l, respectively, and in 10 normal age‐ and sex‐matched controls (NC) by means of Laser Doppler flowmetry at the levels of the palm and the dorsum of the right hand. Circulatory skin velocities were studied basally and after increasing skin temperature to 44 °C (in order to study direct nonspecific vasodilatation response which is independent of endothelial or autonomous nervous system and reflects normal vascular muscle function), after shear‐stress (known to produce flow‐dependent vasodilatation, mediated by nitric oxyde (NO) originating from endothelial cells) and after cold‐stress applied on the opposite hand (known to produce vaso‐constriction mediated by the sympathetic nervous system). RESULTS The warm test induced a significant (P