Sleeping apnea syndrome (SAS) in acromegaly and obesity
Daniela Amzar1, Stefan Mihaicuta2, Ioana Golu1, Melania Balas1 & Ioana Zosin1
The aim of the study: Acromegaly is associated with respiratory and cardiovascular morbidities and high mortality rate. The present study evaluates clinical aspects in acromegalic and obese patients with sleep apnea syndrome (SAS).
Material and method: The patients were diagnosed and followed-up in the Clinic of Endocrinology, Timisoara, in the period 20062009. All the cases were confirmed and investigated as present guidelines recommend. The polysomnographic investigated study group comprised 19 acromegalic patients and 13 obese subjects (BMI=42.6 kg/m2).
Results: The prevalence SAS in acromegaly group was 47.3% (9 out of 19 patients). The median of minimum GH level during OGTT was 8.9 ng/ml in apnea group and 5.3 ng/ml in nonapneic group (P>0.05). The mean age was 50±11.8 years (95%CI 40.9559.05), the neck circumference was 40.33±3.84 cm (95%CI 37.3843.29), the BMI was 34.66±5.77 kg/m2 and the waist circumference was 105.11±10.6 cm (95% CI 96.94113.3). A percent of 77.7% presented intense snoring, Epworth score 7.55±4.16 (215) (95%CI 4.3610.75). 47.3% presented SAS (12.5%- mild, 37.5%-moderate, 50%-severe form). The mean saturation was 94.77±1.20% (9397%) (95% CI 93.8595.70), the desaturation index was 8.22±6.78 per hour (95% CI 3.013.43) and the lowest desaturation was 85.22±5.29% (7693%) (95%CI 81.1689.29). CPAP was performed in only one patient, with normalization of the hypopnea-apnea index. Five cases presented stage II and III essential hypertension, pulse rate 78.4±14.1 beats/min (62110) (CI 95% 68.2988.51) and one case was diagnosed with coronary artery disease. SAS in obesity group was present in 3 out of 13 patients (23.7%).
Conclusion: The study confirms the high prevalence of SAS in acromegaly; half of the acromegaly cases showed severe forms of sleep apnea, with high cardiovascular impact, with daily somnolence, despite the fact that they are snoring and have quite normal neck circumference. GH serum level is not an indicator for the presence and severity of sleep apnea.