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This Article Accepted manuscript (PDF) All Versions of this Article: EJE-08-0442v1 159/5/533    most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Davi', M. V. Articles by Francia, G. PubMed PubMed Citation Articles by Davi', M. V. Articles by Francia, G.

Sleep apnoea syndrome is highly prevalent in acromegaly and only partially reversible after biochemical control of the disease

m Davi', Biomedical and surgical science, Medicina interna D, Verona, 37134, Italy
l Dalle Carbonare, Biomedical and surgical sciences, Verona, Italy
a Giustina, Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy
m Ferrari, Biomedical and surgical sciences, Verona, Italy
a Frigo, Biomedical and surgical sciences, Verona, Italy
v Lo Cascio, Biomedical and surgical sciences, Verona, Italy
g Francia, Biomedical and surgical sciences, Verona, Italy

Correspondence: Maria Vittoria Davi', Email: mariavittoria.davi{at}azosp.vr.it

Abstract

Background: Whether sleep apnoea syndrome (SAS) subsides after biochemical and clinical remission of acromegaly is controversial.

Objective: To assess the presence of SAS in a cohort of acromegalic patients which included a subgroup with active disease and a subgroup in remission and to evaluate clinical and biochemical independent predictors of SAS.

Design: Cross-sectional and longitudinal study.

Setting: Italian university department of internal medicine.

Patients: 36 acromegalic patients: 18 active and 18 controlled.

Measurements: Polysomnography was performed in all patients and repeated in six with active acromegaly and SAS after achieving disease control. Echocardiographic parameters were also measured.

Results: The prevalence of SAS was 47% in the overall acromegalic population: 56% in the active group and 39% in the controlled one. In a multivariate analysis IGF-1, male gender, age, body mass index, disease duration were associated with SAS . Impaired glucose tolerance or diabetes were more prevalent in patients with SAS, particularly in the severe cases. Among the 6 patients of the longitudinal study, 5 showed improvement of SAS, but none recovered. No correlation was found between echocardiographic parameters and severity of SAS.

Conclusion: SAS can persist after recovery of acromegaly in several patients. Given the negative prognostic significance of this respiratory disorder, polysomnography should be included as routine procedure in the work-up of the acromegaly, even if in remission, being mandatory in those patients considered at high risk (elderly males, overweight, diabetic) Appropriate intensive treatment should be implemented to minimize the clinical impact of SAS in acromegaly.