Prevalence of obstructive sleep apnea in patients with prolactinoma before and after treatment with dopamine agonists.
OBJECTIVE
Obesity is the main risk factor for the development of obstructive sleep apnea (OSA). Hyperprolactinemia has also been related to obesity. To determine the OSA prevalence in patients with prolactinoma before and after dopamine agonist (DA) and to evaluate the correlation between the apnea-hypopnea index (AHI) and prolactin levels, body mass index (BMI), waist circumference (WC), visceral fat volume (VFV), subcutaneous fat volume, and other metabolic parameters.


METHODS
Thirty-five patients with prolactinoma at baseline and twenty-one who completed the 6-month DA treatment were submitted to clinical/laboratorial evaluations, polysomnography and abdominal imaging.


RESULTS
Before treatment, the prevalence of obesity/overweight and OSA were, respectively, 68.5 and 34.2 %. We found a positive correlation between AHI and weight (r = 0.57; p < 0.001), BMI (r = 0.56; p < 0.001), WC (r = 0.61; p < 0.001), VFV (r = 0.55; p = 0.002), insulin levels (r = 0.57; p < 0.001), and HOMA-IR index (r = 0.57; p < 0.001); and a negative correlation between AHI and HDL-cholesterol (r = -0.47; p = 0.005). After multivariate analysis, VFV and insulin levels were the most important predictors for AHI (p = 0.001 and p = 0.02, respectively). After DA, the obesity/overweight and OSA prevalence did not change.


CONCLUSIONS
The OSA prevalence in patients with prolactinoma is similar to the obese subjects and did not change after treatment. Higher BMI and visceral obesity, but not prolactin levels, seem to be the major factor involved in the occurrence of OSA in these patients.
Department of Internal Medicine and Endocrine Unit, Medical School and Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco, 255, 9th Floor, Ilha do Fundão, Rio de Janeiro, 21941-913, Brazil.
Flávia Regina Pinho
FR
Barbosa
Cintia Marques dos Santos
CM
Silva
Giovanna Aparecida Balarini
GA
Lima
Giovanna Aparecida Balarinni
GA
Lima
Leila
L
Warszawski
Romeu Cortes
RC
Domingues
Michele
M
Dominic
Rosita
R
Fontes
Leonardo
L
Vieira Neto
Mônica Roberto
MR
Gadelha
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D018491:Dopamine Agonists / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000188:drug therapy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011388:Prolactin / Q000097:blood; D015175:Prolactinoma / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology*; D020181:Sleep Apnea, Obstructive / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology*; D055105:Waist Circumference / Q000187:drug effects; D055815:Young Adult
D018491:Dopamine Agonists; D011388:Prolactin