Prevalence and risk factors of sleep breathing disorders in patients with acromegaly from Moscow region

Yu A Kovaleva,I A Ilovayskaya,A V Dreval,N V Kulakov,S I Fedorova

doi:10.26442/terarkh201890104-70

Abstract

Aim. Assessment of prevalence and risk factors of sleep breathing disorders in patients with acromegaly from Moscow region. Materials and methods. Cardiorespiratory monitoring was executed to 55 patients with acromegaly (18 men and 37 women): 27 patients with de novo disease, 28 patients on treatment of acromegaly (including 18 patietns with uncontrolled and 10 - with controlled acromegaly). All subgroups did not differ on sex, BMI and age. Also 24-hour monitoring of arterial blood pressure was carried out in 39 patients (12 men and 27 women, 14 patients with de novo acromegaly, 15 and 10 patients with uncontrolled and controlled acromegaly, respectively). Results and discussion. The high prevalence of sleep breathing disorders (SBD) was revealed in patients with acromegaly from Moscow Region. SBD was found in 92.6%, 83.5% and 70.0% patients with newly diagnosed, uncontrolled and controlled acromegaly, respectively. The majority of patients had severe/moderate SBD in all subgroups (78.8%, 72.2% and 60.0%, respectively). In patients with newly diagnosed and uncontrolled acromegaly index of apnea-hypopnea (31 and 38.5 respectively), number of apnoe episodes (76 and 72) and saturation level (93% and 93.5%) did not differ significantly while these parameters were better in patients with a controlled acromegaly (apnea-hypopnea index 20, apnea episodes 45.5 and saturation level 95%). The peak of desaturation was subphysiological in 91.7%, 86.7% and 77.8% of patients with newly diagnosed, uncontrolled and controlled acromegaly, respectively. Severity of SBD did not depend on GH and IGF-1 levels as well as acromegaly duration. Such all-population risk factors of SBD as BMI and age were valuable for patients with acromegaly, however gender did not matter. SBD were associated with lack of physiological decrease of systolic and diastolic night BP. Conclusion. Acromegaly per se is a strong risk factor of sleep breathing disorders. The high prevalence of sleep breathing disorders in patients with acromegaly even after achievement of control over a disease emphasized need of specialized treatment of these violations.

Highlights

In patients with newly diagnosed and uncontrolled acromegaly index of apnea-hypopnea (31 and 38.5 respectively), number of apnoe episodes (76 and 72) and saturation level (93% and 93.5%) did not differ significantly while these parameters were better in patients with a controlled acromegaly
The peak of desaturation was subphysiological in 91.7%, 86.7% and 77.8% of patients with newly diagnosed, uncontrolled and controlled acromegaly, respectively
У пациентов с впервые выявленной и неконтролируемой акромегалией существенно не различались медианы показателей индекса апноэ-гипопноэ (ИАГ), числа эпизодов апноэ за период исследования и уровня сатурации, в то время как ИАГ и число эпизодов апноэ были ниже, а уровень сатурации – выше (95%) у пациентов с контролируемой акромегалией

Summary

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Обследовано 55 больных акромегалией: 18 мужчин (28,2%) и 37 женщин (67,38%), находившихся на стационарном лечении в отделении терапевтической эндокринологии МОНИКИ им. Е. когда уровень ИРФ находится в пределах половозрастной нормы и уровень СТГ 0,05); уровни СТГ и ИРФ-1 оказались выше, а длительность акромегалии – меньше у больных с впервые выявленным заболеванием.

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Findings

Длительность АГ