Sleep apnoea syndrome in acromegaly
H. Khemiri1, Z. Turki1, M. Yazidi1, I. Kammoun1, M. Turki2, L. Ben Salem1 & C. Ben Slama1
Sleep apnoea syndrome (SAS) is common in acromegaly and both diseases are independently associated with hypertension and insulin resistance contributing to increased morbidity and mortality.
The aim of this study was to assess the prevalence and risk factors of SAS in acromegaly, to study clinical and polysomnographic particularities of SAS in acromegaly and to analyze the effects of acromegaly treatment on SAS.
Its a retrospective study on fifteen patients (nine women and six men). The mean age was 53.6 years (3271). All patients had newly diagnosed acromegaly. All patients had biochemical assessment (IGF1, GH, fasting blood glucose). The overnight respiratory polygraphy was performed only before acromegaly treatment in three patients, in ten before and after treatment, and in two it was just performed after treatment. Echocardiographic parameters were measured before acromegaly treatment in twelve patients.
Among the thirteen patients tested before acromegaly treatment, ten had SAS (76.9%). In a multivariate analysis only age was associated with SAS. The values of GH and nadir of GH were associated to the severe cases of SAS. Diabetes, high blood pressure, goiter and left ventricular hypertrophy were more prevalent in patients with SAS, especially in severe cases. Among the patients from whom acromegaly was cured 40% recovered of SAS.
The prevalence of SAS in acromegaly is high especially in older patients. SAS can persist after recovery of acromegaly in several patients. Respiratory polygraphy or polysomnography should be included as routine procedure in the work up of acromegaly. Appropriate intensive treatment should be implemented to minimize the clinical impact of SAS in acromegaly.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.