A Swedish nationwide study reveals that patients with acromegaly-related diabetes face a significantly higher cardiovascular burden than those with type 2 diabetes alone, highlighting the need for targeted risk management.
People with acromegaly-associated diabetes appear to face a heavier cardiovascular burden than those with type 2 diabetes alone, according to a Swedish nationwide study published in The Journal of Clinical Endocrinology & Metabolism.
The research, led by Angelo Milioto of the University of Gothenburg, linked national health and administrative registries to compare 348 patients with acromegaly and diabetes with 3,480 matched patients with type 2 diabetes. The groups were similar in age, sex and follow-up time, allowing investigators to examine whether the endocrine disorder changed cardiovascular risk patterns.
Overall cardiovascular disease was more common in the acromegaly group, with higher rates of hypertension, heart failure, arrhythmia and stroke. The study found that patients with acromegaly-associated diabetes had a 55% higher adjusted risk of cardiovascular morbidity, and their first cardiovascular event tended to occur sooner than in the comparison group. The excess risk was driven mainly by venous thromboembolism, pulmonary embolism and arrhythmia. Cardiovascular mortality, however, was not significantly different between the two groups.
The findings add to earlier Swedish research showing that type 2 diabetes in acromegaly is linked to higher overall mortality, cardiovascular mortality and cardiovascular morbidity. Other reviews and cohort studies have also described acromegaly as a condition associated with substantial cardiovascular risk, particularly when the disease is not well controlled.
Treatment patterns differed as well. Metformin was prescribed less often in the acromegaly-diabetes group than among patients with type 2 diabetes, a gap the authors did not explain in the summary. They said the results highlight the need to pay close attention to hypertension and other modifiable risk factors that can influence stroke and heart failure risk in this population. The study was retrospective and did not assess the effect of growth hormone or insulin-like growth factor 1 levels on outcomes.
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