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Prevalence of sleep apnea and metabolic abnormalities in patients with acromegaly and analysis of cephalometric parameters by magnetic resonance imaging.

¹ Hospital Universitário Clementino Fraga Filho, Serviço de Endocrinologia, Universidade Federal do Rio de Janeiro, 21941-913 Rio de Janeiro, Brazil² Laboratório Diagnósticos da América, 20020-022 Rio de Janeiro, Brazil³ Instituto Estadual de Diabetes e Endocrinologia Luis Capriglione, 20211-340 Rio de Janeiro, Brazil⁴ Clínica Radiológica LABS-Serviço de Radiologia, 22281-100 Rio de Janeiro, Brazil⁵ Clínica Neurológica Professor Fernando Pompeu-Laboratório do Sono, 22640-102 Rio de Janeiro, Brazil

(Correspondence should be addressed to M R Gadelha who is now at Rua Nascimento Silva, 555/101, Ipanema, 22421-020 Rio de Janeiro, Brazil; Email: mgadelha{at}hucff.ufrj.br)

Objectives: 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.

Design and 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 µg/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.

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