Serum Lipidomic Profile Signature of Active Acromegaly and Relationships to Cardiovascular Disease

Acromegaly is a rare endocrine disease characterized by multiple metabolic abnormalities and high cardiovascular risk. This cross-sectional study evaluated the lipidomic serum profile of 109 participants (59 acromegaly patients versus 50 healthy controls) via high-performance liquid chromatography combined with mass spectrometry (HPLC-MS). The lipidomic profile that differentiated acromegaly from controls included sphingomyelins (SMs), glycerophospholipids, glycerolipids, ceramides, fatty acids, wax esters (WEs), carnitines, and sterol (ST) lipids. SM 34:0;O2 and phosphorylcholine best distinguished acromegaly patients from controls (VIP > 2.49). SM 34:0;O2 levels were significantly elevated in treatment-naïve versus uncontrolled patients (<i>p</i> < 0.0001). Furthermore, SM 34:0;O2 positively correlated with random GH and IGF-1. Lack of therapy predicted SM 34:0;O2 serum titers in acromegaly. Profound alterations of glycerophospholipids and sphingolipids were detected in acromegaly patients with cardiovascular complications. ST 24:1;O3, ceramide (Cer) 38:0;O4, and WE 34:1 were significantly increased in both hypertensive acromegaly patients and those with heart failure in comparison to patients without cardiovascular impairment. In conclusion, SM 34:0;O2 and phosphorylcholine emerged as potential lipidomic biomarkers in acromegaly. Moreover, SM 34:0;O2 potentially reflects disease severity. Identifying lipidomic profile alterations in acromegaly patients with cardiac involvement may provide a basis for further insights into the cardiovascular pathogenesis of the disease.