ORIGINAL ARTICLE

Pulmonary Function and Serum Carboxymethyl- Lysine Level Evaluation in Acromegaly Patients
Akromegali Hastalarında Solunum Fonksiyonu ve Serum Karboksimetil-Lizin Seviyesinin Değerlendirilmesi
Received Date : 02 Dec 2020
Accepted Date : 25 May 2021
Available Online : 08 Jun 2021
Doi: 10.25179/tjem.2020-80353 - Makale Dili: EN
Turk J Endocrinol Metab. 2021;25:151-157
Bu makale, CC BY-NC-SA altında lisanslanmış açık erişim bir makaledir.
ABSTRACT
Objective: We aimed to evaluate the pulmonary function tests (PFTs) and serum carboxymethyl-lysine (CML) level and their association with the disease activity in patients with acromegaly. Material and Methods: This cross-sectional study included 65 acromegalic patients (F/M:28/37) and 52 controls ( F/M:23/29). PFTs such as spirometry and diffusing capacity of the lungs for carbon monoxide (DLCO) were performed to determine the lungs’ ability to exchange gases. Serum CML levels were measured with the enzyme-linked immunosorbent assay. Basal and nadir growth hormone (GH), hemoglobin A1c (HbA1c), and insulin-like growth factor- 1 (IGF-1) were also assessed. Results: Serum CML levels were significantly higher in acromegalic patients (208.1±80 ng/mL) than in controls (174.2±11 ng/mL), (p=0.02). The evaluated PFTs were expressed as predicted values [forced expiratory volume in the 1st second % (p=0.01), forced vital capacity % (p=0.007), functional residual capacity % (p=0.03), residual volume % (p=0.03), vital capacity % (p=0.007), total lung capacity % (p=0.01), and DLCO% (p=0.02)] that were found to be elevated in acromegalic patients than in controls. CML levels positively correlated with HbA1c (r=0.53, p=0.02) but did not correlate with basal GH levels (r=0.35, p=0.06). GH and IGF-1 levels positively correlated with lung volume in acromegalic patients. Conclusion: Serum CML levels increased in acromegaly patients but had no association with the PFTs results. Increased lung volume was the most prominent lung function alteration in acromegalic patients; relevantly, we found elevated GH and IGF-1 levels to be associated with the increased lung volumes. Future studies need to evaluate the association between the advanced glycation end-products and complications of acromegaly.
ÖZET
Amaç: Bu çalışmada akromegali hastalarında solunum fonksiyonları, serum karboksimetil-lizin [carboxymethyl-lysine (CML)] seviyeleri ve hastalık aktiviyeleriyle ilişkilerini değerlendirmeyi amaçladık. Gereç ve Yöntemler: Bu kesitsel çalışmaya 65 akromegali hastası (K/E:28/37) ve 52 kontrol (K/E:23/29) olgusu dâhil edilmistir. Solunum fonksiyon testleri (SFT) spirometri ile gaz değişimi ise karbon monoksit difüzyon kapasitesi [diffusing capacity of the lungs for carbon monoxide (DLCO)] ile değerlendirilmiştir. Serum CML düzeyi enzim bağımlı immünosorbent ölçüm metoduyla ölçülmüştür. Hemoglobin A1c (HbA1c), insülin benzeri büyüme faktörü-1 [insulin-like growth factor-1 (IGF-1)], bazal ve nadir büyüme hormonu (BH) düzeyleri ölçülmüştür. Bulgular: Serum CML seviyeleri akromegali hastalarında (208,1±80 ng/mL), kontrol hastalarına göre (174,2±11 ng/mL) belirgin olarak daha yüksekti (p=0,02). SFT ve DLCO; akromegali hastalarında kontrol grubuna göre anlamlı olarak daha yüksek saptandı [% birinci saniyedeki zorlu ekspiratuar volüm (p=0,01), % zorlu vital kapasite (p=0,007), % fonksiyonel rezidüel kapasite (p=0,03), % kalıntı hacim (p=0,03), % vital kapasite (p=0,007), % total akciğer kapasitesi (p=0,01) ve %DLCO (p=0,02)]. CML düzeyi; HbA1c ile pozitif korelasyon gösterirken, (r=0.53, p=0.02), bazal BH ile korelasyon mevcut değildi (r=0.35, p=0.06). Akromegali hastalarında BH ve IGF-1 düzeyleriyle akciğer kapasitesi arasında pozitif korelasyon mevcuttu. Sonuç: Serum CML düzeyleri akromegali hastalarında yükselmiştir, ancak SFT ile arasında bir ilişki gösterilememiştir. Artmış akciğer kapasitesi akromegali hastalarında en sık görülen solunum fonksiyon değişikliğidir ve artmış BH ve IGF-1 düzeyleriyle arasında bir ilişki mevcuttu. İleri glikasyon son ürünleri ve akromegali komplikasyonları arasındaki ilişkinin gösterilebilmesi için daha fazla çalışmaya ihtiyaç vardır.
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