title: Sleep apnoea syndrome is highly prevalent in acromegaly and only partially reversible after biochemical control of the disease.
abstract: BACKGROUND
  Whether sleep apnoea syndrome (SAS) subsides after biochemical and clinical remission of acromegaly is controversial.
  
  
  OBJECTIVE
  To assess the presence of SAS in a cohort of acromegalic patients, which included a subgroup with active disease and a subgroup in remission, and to evaluate clinical and biochemical independent predictors of SAS.
  
  
  METHODS
  Cross-sectional and longitudinal study.
  
  
  METHODS
  Italian university department of internal medicine.
  
  
  METHODS
  About 36 acromegalic patients: 18 active and 18 controlled.
  
  
  METHODS
  Polysomnography was performed in all patients and repeated in six with active acromegaly and SAS after achieving disease control. Echocardiographic parameters were also measured.
  
  
  RESULTS
  The prevalence of SAS was 47% in the overall acromegalic population: 56% in the active group and 39% in the controlled one. In a multivariate analysis IGF1, male gender, age, body mass index, and disease duration were associated with SAS. Impaired glucose tolerance or diabetes was more prevalent in patients with SAS, particularly in the severe cases. Among the six patients of the longitudinal study, five showed improvement of SAS, but none recovered. No correlation was found between echocardiographic parameters and severity of SAS.
  
  
  CONCLUSIONS
  SAS can persist after recovery of acromegaly in several patients. Given the negative prognostic significance of this respiratory disorder, polysomnography should be included as routine procedure in the work-up of the acromegaly, even if in remission, being mandatory in those patients considered at high risk (elderly males, overweight, diabetic). Appropriate intensive treatment should be implemented to minimize the clinical impact of SAS in acromegaly.
authors.affiliation: Clinic of Internal Medicine D, Department of Biomedical and Surgical Sciences, University of Verona, Policlinico GB Rossi, Verona, Italy. mariavittoria.davi@azosp.vr.it
authors.forename: Maria Vittoria
authors.initials: MV
authors.lastname: Davi'
authors.forename: Luca
authors.initials: L
authors.lastname: Dalle Carbonare
authors.forename: Andrea
authors.initials: A
authors.lastname: Giustina
authors.forename: Marcello
authors.initials: M
authors.lastname: Ferrari
authors.forename: Anna
authors.initials: A
authors.lastname: Frigo
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Lo Cascio
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Francia