title: Airway and sleep disorders in patients with acromegaly.
abstract: OBJECTIVE
  Acromegaly is a multisystemic disorder caused by excessive secretion of growth hormone (GH). Sleep-disordered breathing (SDB) such as sleep apnea syndrome (SAS) may occur in acromegaly. The aim of study was to assess the presence of sleep disorders and evaluate the systemic complications on respiratory, cardiovascular, and upper airway systems in acromegalic patients.
  
  
  METHODS
  The study group consisted of 30 acromegaly outpatients. GH and insulin-like growth factor 1 (IGF-1) measurements were obtained; body pletysmography, arterial blood gas analysis, tissue-doppler imaging, echocardiography, polysomnography, otorhinolaryngologic examination, and head-neck computed tomography were performed.
  
  
  RESULTS
  Sixteen female (53.3%) and 14 male (46.7%) acromegalic patients had a mean age of 51.1 ± 13.2. GH was supressed in 19 patients (63.3%) when 11 had active acromegaly (36.7%). There were 17 patients with SAS (62.9%) (7: mild, 3:intermediate, 7:severe SAS) and average AHI was 16/h. Sixteen patients had predominantly obstructive SAS while one patient had predominantly central SAS. SAS was statistically more frequent in males than females (P = .015). The mean neck circumference was significantly longer in patients with SAS (P = .048). In SAS patients,the soft palate was elongated and thickened,which was statistically significant (P = .014 and P = .05).Vallecula-to-tongue distance was statistically longer in acromegalic patients with SAS (P = .007).There was a positive correlation between tonsil size,vallecula-to-tongue distance and AHI (r = 0.432, P = .045 and r = 0.512, P = .021, respectively).
  
  
  CONCLUSIONS
  SDB seems to be common and clinically important in patients with acromegaly, particularly in men. The most frequent type of apnea in acromegalics is obstructive. Hormonal activity of acromegaly does not seem to have an effect on the development of SAS. Despite its high prevalence, SAS is frequently under-assessed in patients with acromegaly. Systemic complications and SDB should be researched in acromegalics.
authors.affiliation: Division of Chest Diseases, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
authors.forename: Onur
authors.identifier: http://orcid.org/0000-0001-6320-0470
authors.initials: O
authors.lastname: Turan
authors.affiliation: Division of Endocrinology and Metabolism, Dokuz Eylul University, Izmir, Turkey.
authors.forename: Barış
authors.initials: B
authors.lastname: Akinci
authors.affiliation: Division of Otolaryngology, Dokuz Eylul University, Izmir, Turkey.
authors.forename: Ahmet Omer
authors.initials: AO
authors.lastname: Ikiz
authors.affiliation: Division of Chest Diseases, Dokuz Eylul University, Izmir, Turkey.
authors.forename: Oya
authors.initials: O
authors.lastname: Itil
authors.affiliation: Division of Neurology, Dokuz Eylul University, Izmir, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Oztura
authors.affiliation: Division of Radiodiagnostics, Dokuz Eylul University, Izmir, Turkey.
authors.forename: Emel
authors.initials: E
authors.lastname: Ada
authors.affiliation: Division of Cardiology, Dokuz Eylul University, Izmir, Turkey.
authors.forename: Bahri
authors.initials: B
authors.lastname: Akdeniz
authors.affiliation: Division of Endocrinology and Metabolism, Dokuz Eylul University, Izmir, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Yener
authors.affiliation: Division of Chest Diseases, Alanya Anatolia Hospital, Antalya, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Kaya
authors.affiliation: Division of Endocrinology and Metabolism, Ağrı State Hospital, Ağrı, Turkey.
authors.forename: Arzu
authors.initials: A
authors.lastname: Gedik
authors.affiliation: Division of Endocrinology and Metabolism, Dokuz Eylul University, Izmir, Turkey.
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Comlekci
mesh_terms: D000172:Acromegaly / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D015995:Prevalence; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D014057:Tomography, X-Ray Computed; D014421:Turkey / Q000453:epidemiology
keywords: acromegaly; growth hormone; sleep apnea syndrome; sleep disorders