Coagulation parameters and platelet function analysis in patients with acromegaly

Objective Acromegaly is associated with increased cardiovascular morbidity and mortality. The data about the evaluation of coagulation and fibrinolysis in acromegalic patients are very limited and to our knowledge, platelet function analysis has never been investigated. So, we aimed to investigate t...

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Published in:	Journal of endocrinological investigation Vol. 39; no. 1; pp. 97 - 101
Main Authors:	Colak, A., Yılmaz, H., Temel, Y., Demirpence, M., Simsek, N., Karademirci, İ., Bozkurt, U., Yasar, E.
Format:	Journal Article
Language:	English
Published:	Cham Springer International Publishing 01.01.2016
Subjects:	Acromegaly - blood Acromegaly - epidemiology Adult Aged Blood Coagulation - physiology Blood Coagulation Tests Blood Platelets - physiology Case-Control Studies Endocrinology Female Hemostasis - physiology Humans Male Medicine Medicine & Public Health Metabolic Diseases Middle Aged Original Article Platelet Function Tests Acromegaly Coagulation Platelet function analysis
ISSN:	1720-8386, 1720-8386
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Abstract	Objective Acromegaly is associated with increased cardiovascular morbidity and mortality. The data about the evaluation of coagulation and fibrinolysis in acromegalic patients are very limited and to our knowledge, platelet function analysis has never been investigated. So, we aimed to investigate the levels of protein C, protein S, fibrinogen, antithrombin 3 and platelet function analysis in patients with acromegaly. Methods Thirty-nine patients with active acromegaly and 35 healthy subjects were included in the study. Plasma glucose and lipid profile, fibrinogen levels, GH and IGF-1 levels and protein C, protein S and antithrombin III activities were measured in all study subjects. Also, platelet function analysis was evaluated with collagen/ADP and collagen–epinephrine-closure times. Results Demographic characteristics of the patient and the control were similar. As expected, fasting blood glucose levels and serum GH and IGF-1 levels were significantly higher in the patient group compared with the control group (pglc: 0.002, pGH: 0.006, pIGF-1: 0.001, respectively). But lipid parameters were similar between the two groups. While serum fibrinogen and antithrombin III levels were found to be significantly higher in acromegaly group ( p fibrinogen : 0.005 and pantithrombin III: 0.001), protein S and protein C activity values were significantly lower in the patient group ( p protein S : 0.001, p protein C : 0.001). Also significantly enhanced platelet function (measured by collagen/ADP- and collagen/epinephrine-closure times) was demonstrated in acromegaly ( p col-ADP : 0.002, p col-epinephrine : 0.002). The results did not change, when we excluded six patients with type 2 diabetes in the acromegaly group. There was a negative correlation between serum GH levels and protein S ( r : –0.25, p : 0.04)) and protein C ( r : –0.26, p : 0.04) values. Likewise, there was a negative correlation between IGF-1 levels and protein C values ( r : –0.39, p : 0.002), protein S values ( r : –0.39, p : 0.001), collagen/ADP-closure times ( r : –0.28, p : 0.02) and collagen/epinephrine-closure times ( r :-0.26, p : 0.04). Also, we observed a positive correlation between IGF-1 levels and fibrinogen levels ( r : 0.31, p : 0.01). Conclusion Acromegaly was found to be associated with increased tendency to coagulation and enhanced platelet activity. This hypercoagulable state might increase the risk for cardiovascular and cerebrovascular events in acromegaly.
AbstractList	Acromegaly is associated with increased cardiovascular morbidity and mortality. The data about the evaluation of coagulation and fibrinolysis in acromegalic patients are very limited and to our knowledge, platelet function analysis has never been investigated. So, we aimed to investigate the levels of protein C, protein S, fibrinogen, antithrombin 3 and platelet function analysis in patients with acromegaly. Thirty-nine patients with active acromegaly and 35 healthy subjects were included in the study. Plasma glucose and lipid profile, fibrinogen levels, GH and IGF-1 levels and protein C, protein S and antithrombin III activities were measured in all study subjects. Also, platelet function analysis was evaluated with collagen/ADP and collagen-epinephrine-closure times. Demographic characteristics of the patient and the control were similar. As expected, fasting blood glucose levels and serum GH and IGF-1 levels were significantly higher in the patient group compared with the control group (pglc: 0.002, pGH: 0.006, pIGF-1: 0.001, respectively). But lipid parameters were similar between the two groups. While serum fibrinogen and antithrombin III levels were found to be significantly higher in acromegaly group (p fibrinogen: 0.005 and pantithrombin III: 0.001), protein S and protein C activity values were significantly lower in the patient group (p protein S: 0.001, p protein C: 0.001). Also significantly enhanced platelet function (measured by collagen/ADP- and collagen/epinephrine-closure times) was demonstrated in acromegaly (p col-ADP: 0.002, p col-epinephrine: 0.002). The results did not change, when we excluded six patients with type 2 diabetes in the acromegaly group. There was a negative correlation between serum GH levels and protein S (r: -0.25, p: 0.04)) and protein C (r: -0.26, p: 0.04) values. Likewise, there was a negative correlation between IGF-1 levels and protein C values (r: -0.39, p: 0.002), protein S values (r: -0.39, p: 0.001), collagen/ADP-closure times (r: -0.28, p: 0.02) and collagen/epinephrine-closure times (r:-0.26, p: 0.04). Also, we observed a positive correlation between IGF-1 levels and fibrinogen levels (r: 0.31, p: 0.01). Acromegaly was found to be associated with increased tendency to coagulation and enhanced platelet activity. This hypercoagulable state might increase the risk for cardiovascular and cerebrovascular events in acromegaly. Objective Acromegaly is associated with increased cardiovascular morbidity and mortality. The data about the evaluation of coagulation and fibrinolysis in acromegalic patients are very limited and to our knowledge, platelet function analysis has never been investigated. So, we aimed to investigate the levels of protein C, protein S, fibrinogen, antithrombin 3 and platelet function analysis in patients with acromegaly. Methods Thirty-nine patients with active acromegaly and 35 healthy subjects were included in the study. Plasma glucose and lipid profile, fibrinogen levels, GH and IGF-1 levels and protein C, protein S and antithrombin III activities were measured in all study subjects. Also, platelet function analysis was evaluated with collagen/ADP and collagen–epinephrine-closure times. Results Demographic characteristics of the patient and the control were similar. As expected, fasting blood glucose levels and serum GH and IGF-1 levels were significantly higher in the patient group compared with the control group (pglc: 0.002, pGH: 0.006, pIGF-1: 0.001, respectively). But lipid parameters were similar between the two groups. While serum fibrinogen and antithrombin III levels were found to be significantly higher in acromegaly group ( p fibrinogen : 0.005 and pantithrombin III: 0.001), protein S and protein C activity values were significantly lower in the patient group ( p protein S : 0.001, p protein C : 0.001). Also significantly enhanced platelet function (measured by collagen/ADP- and collagen/epinephrine-closure times) was demonstrated in acromegaly ( p col-ADP : 0.002, p col-epinephrine : 0.002). The results did not change, when we excluded six patients with type 2 diabetes in the acromegaly group. There was a negative correlation between serum GH levels and protein S ( r : –0.25, p : 0.04)) and protein C ( r : –0.26, p : 0.04) values. Likewise, there was a negative correlation between IGF-1 levels and protein C values ( r : –0.39, p : 0.002), protein S values ( r : –0.39, p : 0.001), collagen/ADP-closure times ( r : –0.28, p : 0.02) and collagen/epinephrine-closure times ( r :-0.26, p : 0.04). Also, we observed a positive correlation between IGF-1 levels and fibrinogen levels ( r : 0.31, p : 0.01). Conclusion Acromegaly was found to be associated with increased tendency to coagulation and enhanced platelet activity. This hypercoagulable state might increase the risk for cardiovascular and cerebrovascular events in acromegaly. OBJECTIVEAcromegaly is associated with increased cardiovascular morbidity and mortality. The data about the evaluation of coagulation and fibrinolysis in acromegalic patients are very limited and to our knowledge, platelet function analysis has never been investigated. So, we aimed to investigate the levels of protein C, protein S, fibrinogen, antithrombin 3 and platelet function analysis in patients with acromegaly.METHODSThirty-nine patients with active acromegaly and 35 healthy subjects were included in the study. Plasma glucose and lipid profile, fibrinogen levels, GH and IGF-1 levels and protein C, protein S and antithrombin III activities were measured in all study subjects. Also, platelet function analysis was evaluated with collagen/ADP and collagen-epinephrine-closure times.RESULTSDemographic characteristics of the patient and the control were similar. As expected, fasting blood glucose levels and serum GH and IGF-1 levels were significantly higher in the patient group compared with the control group (pglc: 0.002, pGH: 0.006, pIGF-1: 0.001, respectively). But lipid parameters were similar between the two groups. While serum fibrinogen and antithrombin III levels were found to be significantly higher in acromegaly group (p fibrinogen: 0.005 and pantithrombin III: 0.001), protein S and protein C activity values were significantly lower in the patient group (p protein S: 0.001, p protein C: 0.001). Also significantly enhanced platelet function (measured by collagen/ADP- and collagen/epinephrine-closure times) was demonstrated in acromegaly (p col-ADP: 0.002, p col-epinephrine: 0.002). The results did not change, when we excluded six patients with type 2 diabetes in the acromegaly group. There was a negative correlation between serum GH levels and protein S (r: -0.25, p: 0.04)) and protein C (r: -0.26, p: 0.04) values. Likewise, there was a negative correlation between IGF-1 levels and protein C values (r: -0.39, p: 0.002), protein S values (r: -0.39, p: 0.001), collagen/ADP-closure times (r: -0.28, p: 0.02) and collagen/epinephrine-closure times (r:-0.26, p: 0.04). Also, we observed a positive correlation between IGF-1 levels and fibrinogen levels (r: 0.31, p: 0.01).CONCLUSIONAcromegaly was found to be associated with increased tendency to coagulation and enhanced platelet activity. This hypercoagulable state might increase the risk for cardiovascular and cerebrovascular events in acromegaly.
Author	Colak, A. Karademirci, İ. Demirpence, M. Yasar, E. Yılmaz, H. Bozkurt, U. Simsek, N. Temel, Y.
Author_xml	– sequence: 1 givenname: A. surname: Colak fullname: Colak, A. organization: Department of Biochemistry, Tepecik Research and Training Hospital – sequence: 2 givenname: H. surname: Yılmaz fullname: Yılmaz, H. email: drhamiyetyilmaz@yahoo.com organization: Department of Endocrinology, Tepecik Research and Training Hospital – sequence: 3 givenname: Y. surname: Temel fullname: Temel, Y. organization: Department of Biochemistry, Tepecik Research and Training Hospital – sequence: 4 givenname: M. surname: Demirpence fullname: Demirpence, M. organization: Department of Endocrinology, Tepecik Research and Training Hospital – sequence: 5 givenname: N. surname: Simsek fullname: Simsek, N. organization: Department of Biochemistry, Tepecik Research and Training Hospital – sequence: 6 givenname: İ. surname: Karademirci fullname: Karademirci, İ. organization: Department of Biochemistry, Tepecik Research and Training Hospital – sequence: 7 givenname: U. surname: Bozkurt fullname: Bozkurt, U. organization: Department of Biochemistry, Tepecik Research and Training Hospital – sequence: 8 givenname: E. surname: Yasar fullname: Yasar, E. organization: Department of Anaesthesiology, Bozyaka Research and Training Hospital
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Cites_doi	10.1055/s-2000-8145 10.1210/er.2002-0022 10.1161/01.ATV.0000181762.31694.da 10.1111/j.1365-2265.1994.tb03789.x 10.1007/s40618-014-0147-9 10.3324/haematol.2010.027102 10.1067/mlc.2001.117406 10.1016/j.febslet.2005.03.001 10.1161/01.CIR.0000141575.92958.9C 10.1210/jc.2014-2700 10.1097/00062752-200209000-00004 10.4158/EP.13.4.363 10.1007/s12020-008-9088-4 10.1111/j.1365-2265.2008.03181.x 10.1046/j.1365-2265.2001.01218.x 10.1023/A:1020750514954 10.1097/01.mbc.0000187252.09759.ba 10.1530/eje.0.1510439 10.1055/s-0029-1211774 10.1046/j.1365-2265.1997.d01-1743.x 10.1530/EJE-12-0084
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Snippet	Objective Acromegaly is associated with increased cardiovascular morbidity and mortality. The data about the evaluation of coagulation and fibrinolysis in... Acromegaly is associated with increased cardiovascular morbidity and mortality. The data about the evaluation of coagulation and fibrinolysis in acromegalic... OBJECTIVEAcromegaly is associated with increased cardiovascular morbidity and mortality. The data about the evaluation of coagulation and fibrinolysis in...
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SubjectTerms	Acromegaly - blood Acromegaly - epidemiology Adult Aged Blood Coagulation - physiology Blood Coagulation Tests Blood Platelets - physiology Case-Control Studies Endocrinology Female Hemostasis - physiology Humans Male Medicine Medicine & Public Health Metabolic Diseases Middle Aged Original Article Platelet Function Tests
Title	Coagulation parameters and platelet function analysis in patients with acromegaly
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