Sleep apnoea syndrome is highly prevalent in acromegaly and only partially reversible after biochemical control of the disease
Sleep apnoea syndrome is highly prevalent in acromegaly and only partially reversible after biochemical control of the disease
复制标题
DOI：
10.1530/eje-08-0442
复制
发表时间：
2008-11-01
影响因子：
5.8
通讯作者：
Francia, Giuseppe
中科院分区：
文献类型：
--
作者：
Davi, Maria Vittoria;Carbonare, Luca Dalle;Francia, Giuseppe
背景资料：睡眠呼吸暂停综合征（sleep apneea syndrome，SAS）在肢端肥大症（acromegaly）生物化学和临床症状缓解后是否消退仍存在争议。目的：探讨睡眠呼吸暂停综合征（sleep apneea syndrome，SAS）在肢端肥大症（acromegaly）患者中的存在情况。设计：横断面和纵向研究，地点：意大利大学内科学系，患者：约36例肢端肥大症患者：18例活动期和18例对照期，测量方法：对所有患者进行多导睡眠描记术，并在疾病控制后对6例活动期肢端肥大症和SAS患者重复进行多导睡眠描记术。结果：SAS在肢端肥大症患者中的患病率为47%，其中活动组为56%，对照组为39%。在多变量分析中，IGF1.男性年龄、体重指数和硬脑膜疾病与SAS相关。糖耐量减低或糖尿病是SAS患者的常见病。特别是在严重的情况下。在纵向研究的6例患者中。5例SAS改善。但没有一个恢复。超声心动图参数与SAS的严重程度之间无相关性。结论：SAS可以在一些患者的肢端肥大症恢复后持续存在。考虑到这种呼吸系统疾病的负面预后意义。多导睡眠图应作为肢端肥大症检查的常规程序。即使在缓解期，在被认为是疾病高风险的患者中也是强制性的（老年男性。超重糖尿病）。应实施适当的强化治疗，以尽量减少SAS对肢端肥大症的临床影响。
Background: Whether sleep apnoea syndrome (SAS) subsides after biochecmical and clinical remission of acromegaly is controversial.Objective: To assess the presence of SAS ill it cohort of acromegalic patients, which included it 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 intcrilal medicine.Patients: About 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 alsoResults: The prevalence of SAS was 47% in the overall acromegalic population: 56% in the active group mid 39% in the controlled one. In a multivariate analysis IGF1. male gender. age, body mass index, and disease dural ion were associated with SAS. Impaired glucose tolerance or diabetes,its wore prevalent ill Patients with SAS. particularly, in the severe cases. Among the six patients of the longitudinal study. five 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 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 ill high risk (elderly males. overweight. diabetic). Appropriate intensive treatment should be implemented to minimize the clinical impact of SAS in acromegaly.