Decrease in sE-Selectin after Pituitary Surgery in Patients with Acromegaly

Adhesion of circulating leukocytes to endothelial cells is one of the initial events in the development of atherosclerosis (1). This process is mediated by cellular adhesion molecules such as sE-selectin, a specific product of endothelial cells. Circulating concentrations of soluble cell adhesion molecules may serve as surrogate markers for endothelial damage and early atherosclerosis (2)(3)(4). Increased serum concentrations of sE-selectin have been described in patients with insulin resistance (5)(6), diabetes mellitus (2)(7), hypertension(8), and sleep apnea syndrome (SAS) (9). In patients with acromegaly, impaired glucose tolerance, arterial hypertension, and SAS are frequent findings, and macrovascular disease is a common complication (10). The aim of this study was to measure sE-selectin in patients with acromegaly before and after pituitary surgery and to analyze whether sE-selectin concentrations are related to disease activity, insulin resistance, hypertension, or SAS in this particular group of patients. All consecutive patients with newly diagnosed acromegaly who had been referred to the Division of Endocrinology and Diabetes at the University Hospital in Zurich between November 1999 and December 2002 were included. Serum sE-selectin concentrations were measured at diagnosis of acromegaly and 2–4 months after pituitary surgery. The Ethics Committee of the University Hospital of Zurich was contacted and decided that formal approval to measure sE-selectin was not necessary. Oral informed consent to determine additional laboratory values was obtained from all patients. A diagnosis of SAS was established by the simultaneous presence of two criteria: subjective hypersomnolence, defined as >10 points on the Epworth sleepiness scale, and an increased apnea–hypopnea index, defined as more than five apnea or hypopnea episodes per hour of sleep during an overnight sleep …