Prevalence of sleep apnea and metabolic abnormalities in patients with acromegaly and analysis of cephalometric parameters by magnetic resonance imaging.
OBJECTIVE
To determine the prevalence of sleep apnea (SA) and SA syndrome (SAS) in patients with acromegaly and correlate SA with clinical, laboratory, and cephalometric parameters.


METHODS
Prospective and cross-sectional study of 24 patients with active acromegaly evaluated by clinical and laboratory (GH, IGF-I) parameters, polysomnography and magnetic resonance imaging (MRI) of the pharynx.


RESULTS
Out of 24 patients, 21 had SA (87.5%), of which 20 (95.3%) had the predominant obstructive type. Median age of these 21 patients was 54 years (range 23-75) and median estimated disease duration was 60 months (range 24-300). The frequency in SA patients of impaired glucose tolerance, diabetes mellitus (DM), and hypertension was 19, 33.3, and 71.4% respectively. Goiter was found in 10 patients (47.6%) and obesity in 18 (90%). Median GH level was 14 mug/l (1.4-198) and median %IGF-I (percentage above the upper limit of normal range of IGF-I) was 181% (-31.6 to 571.2). The prevalence of SAS was 52.4%. Apnea-hypopnea index (AHI) correlated significantly with age, waist circumference, body mass index, and hypopharynx area. The AHI was significantly higher in patients with hypertension and DM.


CONCLUSIONS
The prevalence of SA and SAS in acromegaly was similar to the one previously described in other series. Age was a significant risk factor, and hypertension and DM were significantly associated complications of SA. Obesity was also significantly related to SA, as a risk factor, a complication or both. Overall, cephalometric parameters by MRI did not correlate with SA.
van Haute
Flávia R B
FR
Hospital Universitário Clementino Fraga Filho, Serviço de Endocrinologia, Universidade Federal do Rio de Janeiro, 21941-913 Rio de Janeiro, Brazil.
Taboada
Giselle F
GF
Corrêa
Lívia L
LL
Lima
Giovanna A B
GA
Fontes
Rosita
R
Riello
Anna Patricia
AP
Dominici
Michele
M
Gadelha
Mônica R
MR
D000172:Acromegaly / Q000150:complications / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D002508:Cephalometry; D005260:Female; D006257:Head / Q000033:anatomy & histology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008659:Metabolic Diseases / Q000150:complications / Q000453:epidemiology*; D008875:Middle Aged; D010614:Pharynx / Q000033:anatomy & histology; D015995:Prevalence; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000453:epidemiology*