Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Suita, Japan.
Endocr J. 2012;59(1):31-8. doi: 10.1507/endocrj.ej11-0171. Epub 2011 Oct 12.
Sleep-disordered breathing (SDB), especially sleep apnea-hypopnea syndrome (SAS), is often observed in patients with active acromegaly. This complication is a risk factor for cardiovascular disease and associated with increased morbidity and mortality in acromegaly. However there is little information on SDB in Japanese patients with acromegaly. We investigated the prevalence of SDB and association between the severity of SDB and various features and biomarkers in Japanese patients with acromegaly. Twenty-four Japanese patients with active acromegaly underwent overnight cardiorespiratory monitoring, hormonal assays and cephalometric measurements on X-ray. A high prevalence of SDB was detected in acromegaly (87.5%). Log apnea-hypopnea index (AHI) correlated positively with soft palate length / body height (X-ray) (r=0.44, p=0.043), but not with log growth hormone levels and insulin-like growth factor type-1 standard deviation scores, size of pituitary adenoma, disease duration, body mass index, waist circumference, estimated visceral fat area, heel pad thickness / height, tongue thickness/ height, or oropharyngeal dimension/ height. In conclusion, our study demonstrated a high prevalence of SDB in Japanese patients with acromegaly, and its severity correlated with soft palate length. Based on the high incidence of SDB identified in the present study, we recommend that all patients with acromegaly are routinely screened for SDB for early diagnosis and treatment.
睡眠呼吸障碍(SDB),尤其是睡眠呼吸暂停低通气综合征(SAS),在活动期肢端肥大症患者中经常观察到。这种并发症是心血管疾病的危险因素,并与肢端肥大症患者的发病率和死亡率增加相关。然而,关于日本肢端肥大症患者 SDB 的信息很少。我们研究了日本肢端肥大症患者 SDB 的患病率以及 SDB 严重程度与各种特征和生物标志物之间的关系。24 例活动期肢端肥大症患者接受了整夜心肺监测、激素检测和 X 射线头影测量。肢端肥大症患者 SDB 的患病率很高(87.5%)。Log 呼吸暂停低通气指数(AHI)与软腭长度/身高(X 射线)呈正相关(r=0.44,p=0.043),但与 Log 生长激素水平和胰岛素样生长因子 1 标准差评分、垂体腺瘤大小、疾病持续时间、体重指数、腰围、估计内脏脂肪面积、足跟垫厚度/身高、舌厚度/身高或口咽尺寸/身高无关。总之,我们的研究表明,日本肢端肥大症患者 SDB 的患病率很高,其严重程度与软腭长度有关。基于本研究中确定的 SDB 高发病率,我们建议所有肢端肥大症患者常规筛查 SDB,以便早期诊断和治疗。