Introduction: Multiple endocrine neoplasia type 1 (MEN 1) is an autosomal dominant condition classically presenting with multiple endocrinopathies. However, MEN 1 is also associated with early onset cardiovascular disease and this is a major cause of premature mortality. The prevalence of traditional modifiable cardiovascular risk factors in MEN 1 has not be systematically assessed.
Methods: Retrospective cohort analysis of patients with MEN 1 who attended the Royal Hobart Hospital between 1997 and 2024. Cardiovascular risk factors assessed included total cholesterol (n=63), LDL (n=58), blood pressure (BP) (n=67), smoking status (n=73), HbA1c (n=56) and BMI (n=31). Hypertension was defined as office systolic BP ≥ 140mmHg and/or diastolic BP ≥ 90mmHg on three occasions or a history of treated hypertension. Total cholesterol and LDL were considered elevated at ≥ 5.5 and 3.5 mmol/L respectively.
Results: Seventy-five patients (n=48 female, 64%) with a median age of 55 years were included. Elevated total cholesterol and LDL occurred in 47 (74.6%) and 35 (60.3%) patients, respectively. One or more lipid abnormality occurred in 50 (79.3%) patients with a median age of onset of 50.4 years (IQR, 41.2 – 59.5). Hypertension occurred in 43 (64.1%) patients with a median age of 53.8 years (IQR, 46.8 – 65.7). Diabetes occurred in 34 (80%) patients with a median age of 34 years (IQR,49.6 – 67.3) and median HbA1C of 7.3% (IQR,6.4 – 9.2). Obesity was present in 22 (70.1%) patients. Thirty-three (45.2%) patients were either an ex-smoker or active-smoker.
Conclusion: Modifiable cardiovascular risk factors occurred with high prevalence and early onset in patients with MEN 1. These may contribute to the high burden of early cardiovascular disease and mortality seen in MEN 1 and be target for intervention.