Obstructive Sleep Apnea Syndrome Is Less Frequent in Patients With Well-Controlled Acromegaly Treated With Somatostatin Analogues, Pegvisomant or in Combination

摘要

Background: Obstructive sleep apnea (OSA) often occurs in patients with active acromegaly and improves after treatment. Less is known about the development of OSA in patients after a longer period of control treated with somatostatin analogues (SSA) and pegvisomant.Methods: Seventy-nine patients (12 females, 17 males; age 49 ± 14 years; body mass index 29.9 ± 5.4 kg/m2; IGF-1 184 ± 73 μg/L; disease duration 13 ± 8 years (mean ± standard deviation)) with well-controlled acromegaly treated with SSA (38%), pegvisomant (38%) or in combination (24%) who underwent ambulatory polygraphy were included in a prospective multicenter cross-sectional study.Results: Fourteen percent had OSA (range of apnea-hypopnea index (AHI) 5 - 15). Patients with OSA (AHI ? 5 vs. < 5) had a longer disease duration (16 ± 1 vs. 12 ± 8 years; P = 0.01) and were older (61 ± 9 vs. 47 ± 13 years; P = 0.037). The AHI of all patients correlated with age (P = 0.01; r = 0.44). No differences were seen in terms of BMI and Epworth sleepiness scale score. Previous transsphenoidal surgery and radiation had no impact of the detection of OSA. The duration of well-controlled acromegaly was 7 ± 3 years.Conclusion: OSA in patients with well-controlled acromegaly treated with SSA, pegvisomant or in combination is less frequent (14%) than previously described. Early treatment to reduce the active disease period should be aimed to prevent OSA.J Endocrinol Metab. 2017;7(5):141-145doi: https://doi.org/10.14740/jem455w