Sleep disorders and cognitive dysfunction in acromegaly
Sleep disorders and cognitive dysfunction in acromegaly
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DOI：
10.1007/s12020-019-02061-1
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发表时间：
2019-12-01
期刊：
影响因子：
3.7
通讯作者：
Maffei, P.
中科院分区：
文献类型：
--
作者：
Wennberg, A.;Lorusso, R.;Maffei, P.
目的在一般人群中，睡眠障碍与认知障碍的风险增加有关。肢端肥大症患者睡眠障碍（如睡眠呼吸暂停）的患病率高于一般人群，并且由于肢端肥大症治疗和合并症，他们可能有额外的认知障碍风险。我们的目的是研究一组肢端肥大症患者的睡眠障碍和认知功能障碍之间的关系。我们进行了神经认知评估和患者完成了肢端肥大症生活质量问卷（AcroQoL），埃普沃思嗜睡量表，匹兹堡睡眠质量指数。结果在67肢端肥大症患者的研究中，38.8%是男性和中位年龄在神经系统检查为56（IQR 48，65）。大约6-10%的患者有认知评估受损，这取决于测试。在校正了年龄、性别、BMI、疾病持续时间和疾病活动度的线性回归模型中，较差的睡眠质量与较低的总体认知z评分相关（B=-0.03，95% CI-0.06，-0.002）。日间嗜睡与身体AcroQoL分项评分较差相关（B=-0.04，95% CI-0.08，-0.002）。睡眠质量与总体AcroQoL较差相关（B=-0.03，95% CI-0.05，-0.006），身体AcroQoL（B=-0.04，95% CI-0.07，-0.005），心理AcroQoL（B=-0.02，95% CI-0.04，-0.001）和社会AcroQoL（B=-0.02，95% CI-0.04，-0.0009）。结论在肢端肥大症患者中，我们发现了强有力的证据表明睡眠质量差与生活质量差相关，一些证据表明它与认知功能较差有关。
Purpose In the general population, sleep disorders are associated with an increased risk of cognitive impairment. The prevalence of sleep disorders, such as sleep apnea, in acromegalic patients is higher than in the general population, and they may have additional risk of cognitive impairment due to acromegaly treatment and comorbidities. We aim to study the relationship between sleep disturbances and cognitive dysfunction in a group of acromegalic patients.Methods We studied 67 consecutive acromegalic patients. We performed a neurocognitive assessment and patients completed the Acromegaly Quality of Life Questionnaire (AcroQoL), Epworth Sleepiness Scale, and Pittsburgh Sleep Quality Index.Results Of the 67 acromegaly patients in the study, 38.8% were male and median age at the neurological examination was 56 (IQR 48, 65). Approximately 6-10% of patients had impaired cognitive assessment, depending on the test. In linear regression models adjusted for age, sex, BMI, disease duration, and disease activity, poorer sleep quality was associated with lower global cognitive z-score (B=-0.03, 95% CI -0.06, -0.002). Daytime somnolence was associated with poorer physical AcroQoL sub-score (B=-0.04, 95% CI -0.08, -0.002). Sleep quality was associated with poorer overall AcroQoL (B=-0.03, 95% CI -0.05, -0.006), physical AcroQoL (B=-0.04, 95% CI -0.07, -0.005), psychological AcroQoL (B=-0.02, 95% CI -0.04, -0.001), and social AcroQoL (B=-0.02, 95% CI -0.04, -0.0009).Conclusions In acromegaly patients, we found robust evidence that poor sleep quality is associated with poorer quality of life, and some evidence that it is associated with poorer cognitive function.