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Elevated incidence of sleep apnoea in acromegaly—correlation to disease activity

Purpose An elevated prevalence of sleep apnoea (SA) in patients with acromegaly has been suggested. Methods We performed polysomnographies in 52 patients with acromegaly (25 m, 27 f, age 51 years, range 19-82 years). Patients were defined having SA if they had more than five apnoeas or hypopnoeas pe...

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Published in:Sleep & breathing 2012-12, Vol.16 (4), p.1247-1253
Main Authors: Roemmler, J., Gutt, B., Fischer, R., Vay, S., Wiesmeth, A., Bidlingmaier, M., Schopohl, J., Angstwurm, M.
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creator Roemmler, J.
Gutt, B.
Fischer, R.
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Wiesmeth, A.
Bidlingmaier, M.
Schopohl, J.
Angstwurm, M.
description Purpose An elevated prevalence of sleep apnoea (SA) in patients with acromegaly has been suggested. Methods We performed polysomnographies in 52 patients with acromegaly (25 m, 27 f, age 51 years, range 19-82 years). Patients were defined having SA if they had more than five apnoeas or hypopnoeas per hour (respiratory disturbance index = RDI). The type of SA was divided into obstructive (OSA), central (CSA) or mixed (OSA+CSA). Seventeen patients had newly diagnosed disease, and 18 patients were treated with somatostatin analogues. Results Twenty-three patients had controlled disease activity (mean GH levels
doi_str_mv 10.1007/s11325-011-0641-7
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Methods We performed polysomnographies in 52 patients with acromegaly (25 m, 27 f, age 51 years, range 19-82 years). Patients were defined having SA if they had more than five apnoeas or hypopnoeas per hour (respiratory disturbance index = RDI). The type of SA was divided into obstructive (OSA), central (CSA) or mixed (OSA+CSA). Seventeen patients had newly diagnosed disease, and 18 patients were treated with somatostatin analogues. Results Twenty-three patients had controlled disease activity (mean GH levels &lt;1 μg/l during a 3-h profile and normalised IGF-1 levels). Twelve had active acromegaly despite medical treatment. Thirty patients (58%) had SA. Twenty-five of those had OSA, three had CSA, and two had mixed. Of the patients with active disease, 66% had SA, compared to 48% in the cured group. Significantly more patients with hypertension ( n  = 18) than without hypertension ( n  = 12, p  = 0.041) had SA. Basal glucose was not significantly different between patients with (100 mg/dl, range 75–207 mg/dl) and without SA (92 mg/dl, range 74–120 mg/dl), but HbA1c was significantly higher in patients with SA (5.9% (4.9–9.0%) vs. 5.4% (4.3–6.1%), p  = 0.001). A positive correlation between RDI and BMI ( p  = 0.04), RDI and age ( p  = 0.013) and RDI and disease activity ( p  = 0.014) was seen. No major correlation could be found between RDI and the duration of disease activity nor between RDI and GH levels. Conclusion RDI correlates positively with disease activity but not with the duration of the disease. The parameters of the metabolic syndrome are positively associated to the degree of SA in acromegalic patients.</description><identifier>ISSN: 1520-9512</identifier><identifier>EISSN: 1522-1709</identifier><identifier>DOI: 10.1007/s11325-011-0641-7</identifier><identifier>PMID: 22241151</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Acromegaly - diagnosis ; Acromegaly - epidemiology ; Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Body mass index ; Cross-Sectional Studies ; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases ; Dentistry ; Disease ; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes ; Female ; Fundamental and applied biological sciences. Psychology ; Germany ; Growth hormones ; Humans ; Incidence ; Internal Medicine ; Male ; Medical sciences ; Medicine ; Medicine &amp; Public Health ; Middle Aged ; Nervous system (semeiology, syndromes) ; Neurology ; Original Article ; Otorhinolaryngology ; Pediatrics ; Pituitary gland ; Pneumology/Respiratory System ; Polysomnography ; Risk Factors ; Sleep apnea ; Sleep Apnea, Obstructive - diagnosis ; Sleep Apnea, Obstructive - epidemiology ; Sleep. 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Methods We performed polysomnographies in 52 patients with acromegaly (25 m, 27 f, age 51 years, range 19-82 years). Patients were defined having SA if they had more than five apnoeas or hypopnoeas per hour (respiratory disturbance index = RDI). The type of SA was divided into obstructive (OSA), central (CSA) or mixed (OSA+CSA). Seventeen patients had newly diagnosed disease, and 18 patients were treated with somatostatin analogues. Results Twenty-three patients had controlled disease activity (mean GH levels &lt;1 μg/l during a 3-h profile and normalised IGF-1 levels). Twelve had active acromegaly despite medical treatment. Thirty patients (58%) had SA. Twenty-five of those had OSA, three had CSA, and two had mixed. Of the patients with active disease, 66% had SA, compared to 48% in the cured group. Significantly more patients with hypertension ( n  = 18) than without hypertension ( n  = 12, p  = 0.041) had SA. Basal glucose was not significantly different between patients with (100 mg/dl, range 75–207 mg/dl) and without SA (92 mg/dl, range 74–120 mg/dl), but HbA1c was significantly higher in patients with SA (5.9% (4.9–9.0%) vs. 5.4% (4.3–6.1%), p  = 0.001). A positive correlation between RDI and BMI ( p  = 0.04), RDI and age ( p  = 0.013) and RDI and disease activity ( p  = 0.014) was seen. No major correlation could be found between RDI and the duration of disease activity nor between RDI and GH levels. Conclusion RDI correlates positively with disease activity but not with the duration of the disease. The parameters of the metabolic syndrome are positively associated to the degree of SA in acromegalic patients.</description><subject>Acromegaly - diagnosis</subject><subject>Acromegaly - epidemiology</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Body mass index</subject><subject>Cross-Sectional Studies</subject><subject>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</subject><subject>Dentistry</subject><subject>Disease</subject><subject>Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Germany</subject><subject>Growth hormones</subject><subject>Humans</subject><subject>Incidence</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Middle Aged</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Original Article</subject><subject>Otorhinolaryngology</subject><subject>Pediatrics</subject><subject>Pituitary gland</subject><subject>Pneumology/Respiratory System</subject><subject>Polysomnography</subject><subject>Risk Factors</subject><subject>Sleep apnea</subject><subject>Sleep Apnea, Obstructive - diagnosis</subject><subject>Sleep Apnea, Obstructive - epidemiology</subject><subject>Sleep. 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Methods We performed polysomnographies in 52 patients with acromegaly (25 m, 27 f, age 51 years, range 19-82 years). Patients were defined having SA if they had more than five apnoeas or hypopnoeas per hour (respiratory disturbance index = RDI). The type of SA was divided into obstructive (OSA), central (CSA) or mixed (OSA+CSA). Seventeen patients had newly diagnosed disease, and 18 patients were treated with somatostatin analogues. Results Twenty-three patients had controlled disease activity (mean GH levels &lt;1 μg/l during a 3-h profile and normalised IGF-1 levels). Twelve had active acromegaly despite medical treatment. Thirty patients (58%) had SA. Twenty-five of those had OSA, three had CSA, and two had mixed. Of the patients with active disease, 66% had SA, compared to 48% in the cured group. Significantly more patients with hypertension ( n  = 18) than without hypertension ( n  = 12, p  = 0.041) had SA. Basal glucose was not significantly different between patients with (100 mg/dl, range 75–207 mg/dl) and without SA (92 mg/dl, range 74–120 mg/dl), but HbA1c was significantly higher in patients with SA (5.9% (4.9–9.0%) vs. 5.4% (4.3–6.1%), p  = 0.001). A positive correlation between RDI and BMI ( p  = 0.04), RDI and age ( p  = 0.013) and RDI and disease activity ( p  = 0.014) was seen. No major correlation could be found between RDI and the duration of disease activity nor between RDI and GH levels. Conclusion RDI correlates positively with disease activity but not with the duration of the disease. The parameters of the metabolic syndrome are positively associated to the degree of SA in acromegalic patients.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>22241151</pmid><doi>10.1007/s11325-011-0641-7</doi><tpages>7</tpages></addata></record>
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subjects Acromegaly - diagnosis
Acromegaly - epidemiology
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Body mass index
Cross-Sectional Studies
Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases
Dentistry
Disease
Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes
Female
Fundamental and applied biological sciences. Psychology
Germany
Growth hormones
Humans
Incidence
Internal Medicine
Male
Medical sciences
Medicine
Medicine & Public Health
Middle Aged
Nervous system (semeiology, syndromes)
Neurology
Original Article
Otorhinolaryngology
Pediatrics
Pituitary gland
Pneumology/Respiratory System
Polysomnography
Risk Factors
Sleep apnea
Sleep Apnea, Obstructive - diagnosis
Sleep Apnea, Obstructive - epidemiology
Sleep. Vigilance
Statistics as Topic
Vertebrates: nervous system and sense organs
Young Adult
title Elevated incidence of sleep apnoea in acromegaly—correlation to disease activity
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