Original Articles
Acromegaly and Sleep Apnea
J.J. Blanco Péreza, M.A. Blanco-Ramosb,
, C. Zamarrón Sanzc, A. Souto Fernándeza, A. Mato Matod, J. Lamela Lópeza
Corresponding author
xosej@tiscali.es
Correspondence: Dr. J.J. Blanco Pérez. Servicio de Neumología. Complexo Hospitalario Ourense. C/ Ramón Puga, 52-56. 32005 Ourense. España
Correspondence: Dr. J.J. Blanco Pérez. Servicio de Neumología. Complexo Hospitalario Ourense. C/ Ramón Puga, 52-56. 32005 Ourense. España
a Servicio de Neumología, Complexo Hospitalario Ourense, Ourense, Spain
b Unidad de Investigación, Complexo Hospitalario Ourense, Ourense, Spain
c Servicio de Neumología, Hospital Clínico Universitario, Santiago de Compostela, A Coruña, Spain
d Servicio de Endocrinología, Complexo Hospitalario Ourense, Ourense, Spain
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Blanco Pérez, M.A. Blanco-Ramos, C. Zamarrón Sanz, A. Souto Fernández, A. Mato Mato, J. Lamela López" "autores" => array:6 [ 0 => array:3 [ "nombre" => "J.J." "apellidos" => "Blanco Pérez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 1 => array:5 [ "preGrado" => "Dr." "nombre" => "M.A." "apellidos" => "Blanco-Ramos" "email" => array:1 [ 0 => "xosej@tiscali.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 2 => array:3 [ "nombre" => "C." "apellidos" => "Zamarrón Sanz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] ] 3 => array:3 [ "nombre" => "A." "apellidos" => "Souto Fernández" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 4 => array:3 [ "nombre" => "A." "apellidos" => "Mato Mato" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff4" ] ] ] 5 => array:3 [ "nombre" => "J." "apellidos" => "Lamela López" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Servicio de Neumología, Complexo Hospitalario Ourense, Ourense, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Unidad de Investigación, Complexo Hospitalario Ourense, Ourense, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Clínico Universitario, Santiago de Compostela, A Coruña, Spain" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] 3 => array:3 [ "entidad" => "Servicio de Endocrinología, Complexo Hospitalario Ourense, Ourense, Spain" "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff4" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. J.J. Blanco Pérez. Servicio de Neumología. Complexo Hospitalario Ourense. C/ Ramón Puga, 52-56. 32005 Ourense. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2003-11-11" "fechaAceptado" => "2004-02-17" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key Words" "identificador" => "xpalclavsec153573" "palabras" => array:3 [ 0 => "Sleep apnea-hypopnea syndrome" 1 => "Cephalometry" 2 => "Acromegaly" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec153574" "palabras" => array:2 [ 0 => "Síndrome de apnea-hipopnea del sueño" 1 => "Cefalometría. Acromegalia." ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">Acromegaly is often associated with sleep apnea-hypopnea syndrome (SAHS). The purpose of this study was to understand the prevalence of SAHS in patients with acromegaly and define the characteristics of acromegalic patients with and without SAHS.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">The study enrolled 17 patients (11 women and 6 men) residing in the province of Ourense, Spain, who were diagnosed with acromegaly. All patients underwent overnight polysomnography in a sleep laboratory. In addition, growth hormone and insulin-like growth factor 1 levels were assessed. Sixteen of the patients underwent cephalometric study.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">The average age of the patients was 58 years (95% confidence interval [CI], 52-63). The average body mass index was 31 (95% CI, 29-34) and average neck circumference was 41 (95% CI, 39-43). Ten patients (58.8%) had an apnea-hypopnea index (AHI) greater than 10. Nine had obstructive apnea and one had central apnea. Seven (5 with an AHI>10 and 2 with an AHI<10) reported excessive daytime sleepiness with Epworth scores greater than 10 (41.2%). Five patients (29.4%) were diagnosed with SAHS (AHI>10 and Epworth>10). No correlation was found between an AHI greater than 10 and hormonal activity (<span class="elsevierStyleItalic">P</span> = .082). The mean growth hormone level for patients with an AHI greater than 10 was 4.8 (95% CI, 0.5-9) and the mean for those with an AHI less than 10 was 12 (95% CI, 2-27). Fifty percent of the patients were treated with a somatostatin analog and half of those treated exhibited apnea (<span class="elsevierStyleItalic">P</span> = .302). No cephalometric differences related to the presence of apneas were found.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">We found a high prevalence of sleep apneas (58.8%) and SAHS (29.4%), and central apneas were rare. We found no correlation between hormone activity level and the presence of SAHS. The incidence of SAHS was the same in somatostatin analog treated and untreated patients. Cephalometric variables did not distinguish between acromegalic patients with and without SAHS.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">La acromegalia se relaciona frecuentemente con el síndrome de apnea-hipopnea del sueño (SAHS). El propósito de este trabajo es conocer la prevalencia del SAHS en los pacientes con acromegalia y definir las características de esta población con y sin SAHS.</p> <span class="elsevierStyleSectionTitle">Pacientes Y Métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se estudió a 17 pacientes diagnosticados de acromegalia en la provincia de Ourense (11 mujeres y 6 varones). A todos ellos se les realizó polisomnografía nocturna diagnóstica en el laboratorio del sueño, además de una determinación de hormona de crecimiento y de factor 1 de crecimiento insulina-<span class="elsevierStyleItalic">like</span>, y a 16 se les efectuó un estudio cefalométrico.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">La edad media de los pacientes era de 58 años (intervalo de confianza [IC] del 95%, 52-63). La media del índice de masa corporal era de 31 (IC del 95%, 29-34) y la del perímetro del cuello, de 41 (IC del 95%, 39-43). Diez pacientes (58,8%) tenían un índice de apnea-hipopnea (IAH) mayor de 10; 9 presentaban apnea obstructiva y 1, central. Del total de pacientes, 7 (5 con IAH > 10 y 2 con IAH < 10) presentaban somnolencia diurna excesiva, con un índice de Epworth superior a 10 (41,2%). Presentaban SAHS (IAH > 10 y Epworth > 10) 5 pacientes (29,4%). No se encontró relación entre un IAH mayor de 10 y actividad hormonal (p = 0,082). Los sujetos con IAH mayor de 10 presentaban un valor medio de hormona de crecimiento de 4,8 (IC del 95%, 0,5-9) y en aquellos con IAH menor de 10 dicho valor era de 12 (IC del 95%, 2-27). Estaban tratados con análogos de la somatostatina el 50% de los pacientes, de los cuales la mitad presentaba apnea (p = 0,302). El estudio completo de las cefalometrías no evidenció diferencia en relación con la presencia de apneas.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Encontramos una alta prevalencia de apnea del sueño (58,8%) y de síndrome de apnea del sueño (29,4%), y fue una rareza la presencia de apneas centrales. No encontramos relación entre actividad hormonal y la presencia de SAHS. Los pacientes tratados con análogos de la somatostatina presentaban la misma incidencia de SAHS que los no tratados. Ningún parámetro de cefalometría resultó discriminador.</p>" ] ] "NotaPie" => array:1 [ 0 => array:1 [ "nota" => "<p class="elsevierStyleNotepara">Cephalometric study financed by GASMEDI, S. A.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:22 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The occurrence of sleep-disordered breathing among middle-aged adults" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "T Young" 1 => "M Palta" 2 => "J Dempsey" 3 => "J Skratrud" 4 => "S Weber" 5 => "S Badr" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "N Engl J Med" "fecha" => "1993" "volumen" => "328" "paginaInicial" => "1230" "paginaFinal" => "1235" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Obstructive sleep apnea hypopnea and related clinical features in a population-based sample of subjects 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 2 | 6 |
| 2024 October | 29 | 15 | 44 |
| 2024 September | 26 | 19 | 45 |
| 2024 August | 52 | 49 | 101 |
| 2024 July | 28 | 20 | 48 |
| 2024 June | 36 | 25 | 61 |
| 2024 May | 56 | 28 | 84 |
| 2024 April | 31 | 25 | 56 |
| 2024 March | 25 | 15 | 40 |
| 2024 February | 24 | 15 | 39 |
| 2023 August | 0 | 4 | 4 |
| 2023 March | 5 | 2 | 7 |
| 2023 February | 19 | 19 | 38 |
| 2023 January | 19 | 27 | 46 |
| 2022 December | 18 | 23 | 41 |
| 2022 November | 28 | 22 | 50 |
| 2022 October | 21 | 31 | 52 |
| 2022 September | 11 | 18 | 29 |
| 2022 August | 22 | 33 | 55 |
| 2022 July | 17 | 39 | 56 |
| 2022 June | 13 | 31 | 44 |
| 2022 May | 20 | 24 | 44 |
| 2022 April | 21 | 28 | 49 |
| 2022 March | 39 | 40 | 79 |
| 2022 February | 20 | 24 | 44 |
| 2022 January | 36 | 19 | 55 |
| 2021 December | 17 | 42 | 59 |
| 2021 November | 20 | 38 | 58 |
| 2021 October | 20 | 38 | 58 |
| 2021 September | 25 | 42 | 67 |
| 2021 August | 13 | 35 | 48 |
| 2021 July | 16 | 29 | 45 |
| 2021 June | 15 | 30 | 45 |
| 2021 May | 10 | 32 | 42 |
| 2021 April | 29 | 50 | 79 |
| 2021 March | 17 | 18 | 35 |
| 2021 February | 12 | 14 | 26 |
| 2021 January | 9 | 14 | 23 |
| 2020 December | 10 | 11 | 21 |
| 2020 November | 9 | 13 | 22 |
| 2020 October | 14 | 9 | 23 |
| 2020 September | 5 | 10 | 15 |
| 2020 August | 8 | 16 | 24 |
| 2020 July | 15 | 18 | 33 |
| 2020 June | 22 | 7 | 29 |
| 2020 May | 21 | 22 | 43 |
| 2020 April | 19 | 7 | 26 |
| 2020 March | 16 | 13 | 29 |
| 2020 February | 22 | 10 | 32 |
| 2020 January | 13 | 10 | 23 |
| 2019 December | 14 | 14 | 28 |
| 2019 November | 5 | 8 | 13 |
| 2019 October | 10 | 7 | 17 |
| 2019 September | 9 | 8 | 17 |
| 2019 August | 14 | 3 | 17 |
| 2019 July | 6 | 16 | 22 |
| 2019 June | 10 | 6 | 16 |
| 2019 May | 14 | 9 | 23 |
| 2019 April | 44 | 13 | 57 |
| 2019 March | 16 | 20 | 36 |
| 2019 February | 12 | 12 | 24 |
| 2019 January | 4 | 11 | 15 |
| 2018 December | 9 | 15 | 24 |
| 2018 November | 13 | 7 | 20 |
| 2018 October | 15 | 6 | 21 |
| 2018 September | 10 | 20 | 30 |
| 2018 May | 2 | 0 | 2 |
| 2018 April | 22 | 13 | 35 |
| 2018 March | 1 | 4 | 5 |
| 2018 February | 7 | 10 | 17 |
| 2018 January | 5 | 16 | 21 |
| 2017 December | 8 | 10 | 18 |
| 2017 November | 3 | 10 | 13 |
| 2017 October | 3 | 6 | 9 |
| 2017 September | 3 | 12 | 15 |
| 2017 August | 7 | 7 | 14 |
| 2017 July | 2 | 15 | 17 |
| 2017 June | 7 | 16 | 23 |
| 2017 May | 5 | 12 | 17 |
| 2017 April | 4 | 8 | 12 |
| 2017 March | 1 | 4 | 5 |
| 2017 February | 2 | 3 | 5 |
| 2017 January | 1 | 2 | 3 |
| 2016 December | 11 | 7 | 18 |
| 2016 November | 22 | 11 | 33 |
| 2016 October | 23 | 13 | 36 |
| 2016 September | 9 | 10 | 19 |
| 2016 August | 5 | 4 | 9 |
| 2016 July | 10 | 7 | 17 |
| 2016 March | 1 | 0 | 1 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 48 | 1 | 49 |
| 2015 September | 43 | 24 | 67 |
| 2015 August | 38 | 9 | 47 |
| 2015 July | 32 | 14 | 46 |
| 2015 June | 32 | 13 | 45 |
| 2015 May | 42 | 27 | 69 |
| 2015 April | 40 | 20 | 60 |
| 2015 March | 28 | 19 | 47 |
| 2015 February | 27 | 6 | 33 |
| 2015 January | 34 | 12 | 46 |
| 2014 December | 48 | 30 | 78 |
| 2014 November | 32 | 24 | 56 |
| 2014 October | 49 | 24 | 73 |
| 2014 September | 47 | 27 | 74 |
| 2014 August | 39 | 24 | 63 |
| 2014 July | 57 | 16 | 73 |
| 2014 June | 42 | 16 | 58 |
| 2014 May | 36 | 10 | 46 |
| 2014 April | 37 | 9 | 46 |
| 2014 March | 46 | 11 | 57 |
| 2014 February | 46 | 8 | 54 |
| 2014 January | 32 | 7 | 39 |
| 2013 December | 39 | 9 | 48 |
| 2013 November | 36 | 10 | 46 |
| 2013 October | 49 | 9 | 58 |
| 2013 September | 31 | 11 | 42 |
| 2013 August | 58 | 13 | 71 |
| 2013 July | 47 | 14 | 61 |
| 2013 June | 28 | 9 | 37 |
| 2013 May | 27 | 11 | 38 |
| 2013 April | 15 | 7 | 22 |
| 2013 March | 5 | 1 | 6 |
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