Skip to main content
Erschienen in: Sleep and Breathing 3/2022

12.08.2021 | Basic Science • Original Article

Densely granulated adenoma pattern is associated with an increased risk of obstructive sleep apnea in patients with acromegaly

verfasst von: Xianchao Zhao, Lijun Heng, Yan Qu, Dong Jia, Jiafeng Ren, Shuyu Sun, Jian Qiu, Jinxiang Cheng, Ting Yang, Junying Zhou, Changjun Su

Erschienen in: Sleep and Breathing | Ausgabe 3/2022

Einloggen, um Zugang zu erhalten

Abstract

Objectives

To explore the prevalence of obstructive sleep apnea (OSA) and the association between the adenoma granulation patterns and OSA in patients with acromegaly.

Methods

An overnight polysomnography (PSG) assessment was carried out on participants with acromegaly. Results classified participants into a non-OSA group, mild to moderate OSA group, and severe OSA group. Morphological and biochemical analyses were performed. Demographic, clinical, biochemical, and polysomnographic data were compared among the three groups. Using logistic regression models, the risk of OSA in acromegalic subjects was estimated.

Results

OSA was reported in 36 of 49 patients (74%) with acromegaly. Contrasted with the non-OSA group, OSA patients had a larger proportion of the densely granulated (DG) pattern. The OSA groups with DG acromegaly had a smaller maximum tumor diameter and Vol/2 than those with the sparsely granulated (SG) pattern. Furthermore, a higher growth hormone (GH) level (45.0 ± 36.9 vs 18.6 ± 15.8, P = 0.047) and GH index (28.4 ± 13.8 vs 6.6 ± 8.2, P = 0.003) were found in DG acromegaly patients with severe OSA. Additionally, there was a trend toward higher standardized insulin-like growth factor 1 (IGF-1) in patients with DG acromegaly than in those with SG acromegaly in the severe OSA group. After adjusting for potential confounding variables, the DG pattern was correlated with the risk of OSA (OR = 14.84, 95%CI 1.36–162.20, P = 0.027) in patients with acromegaly.

Conclusions

The findings indicate that a high prevalence of OSA exists in patients with acromegaly, and the DG pattern may be a risk factor for OSA in acromegaly.
Literatur
3.
Zurück zum Zitat Guo X et al (2018) Characteristics of the upper respiratory tract in patients with acromegaly and correlations with obstructive sleep apnoea/hypopnea syndrome. Sleep Med 48:27–34PubMedCrossRef Guo X et al (2018) Characteristics of the upper respiratory tract in patients with acromegaly and correlations with obstructive sleep apnoea/hypopnea syndrome. Sleep Med 48:27–34PubMedCrossRef
4.
Zurück zum Zitat Rodrigues MP et al (2008) Craniofacial abnormalities, obesity, and hormonal alterations have similar effects in magnitude on the development of nocturnal hypoxemia in patients with acromegaly. J Endocrinol Invest 31(12):1052–1057PubMedCrossRef Rodrigues MP et al (2008) Craniofacial abnormalities, obesity, and hormonal alterations have similar effects in magnitude on the development of nocturnal hypoxemia in patients with acromegaly. J Endocrinol Invest 31(12):1052–1057PubMedCrossRef
5.
Zurück zum Zitat Kashine S et al (2012) Characteristics of sleep-disordered breathing in Japanese patients with acromegaly. Endocr J 59(1):31–38PubMedCrossRef Kashine S et al (2012) Characteristics of sleep-disordered breathing in Japanese patients with acromegaly. Endocr J 59(1):31–38PubMedCrossRef
6.
Zurück zum Zitat Kaw R et al (2012) Postoperative complications in patients with obstructive sleep apnea. Chest 141(2):436–441PubMedCrossRef Kaw R et al (2012) Postoperative complications in patients with obstructive sleep apnea. Chest 141(2):436–441PubMedCrossRef
7.
Zurück zum Zitat Apnea ASOA (2014) Practice guidelines for the perioperative management of patients with obstructive sleep apnea: an updated report by the American Society of Anesthesiologists Task Force on Perioperative Management of patients with obstructive sleep apnea. Anesthesiology 120(2):268–286CrossRef Apnea ASOA (2014) Practice guidelines for the perioperative management of patients with obstructive sleep apnea: an updated report by the American Society of Anesthesiologists Task Force on Perioperative Management of patients with obstructive sleep apnea. Anesthesiology 120(2):268–286CrossRef
8.
Zurück zum Zitat Franklin KA, Lindberg E (2015) Obstructive sleep apnea is a common disorder in the population-a review on the epidemiology of sleep apnea. J Thorac Dis 7(8):1311–1322PubMedPubMedCentral Franklin KA, Lindberg E (2015) Obstructive sleep apnea is a common disorder in the population-a review on the epidemiology of sleep apnea. J Thorac Dis 7(8):1311–1322PubMedPubMedCentral
9.
Zurück zum Zitat Vannucci L et al (2013) Assessment of sleep apnea syndrome in treated acromegalic patients and correlation of its severity with clinical and laboratory parameters. J Endocrinol Invest 36(4):237–242PubMed Vannucci L et al (2013) Assessment of sleep apnea syndrome in treated acromegalic patients and correlation of its severity with clinical and laboratory parameters. J Endocrinol Invest 36(4):237–242PubMed
10.
Zurück zum Zitat Castellani C et al (2016) Morphological study of upper airways and long-term follow-up of obstructive sleep apnea syndrome in acromegalic patients. Endocrine 51(2):308–316PubMedCrossRef Castellani C et al (2016) Morphological study of upper airways and long-term follow-up of obstructive sleep apnea syndrome in acromegalic patients. Endocrine 51(2):308–316PubMedCrossRef
11.
Zurück zum Zitat Davi MV, Giustina A (2012) Sleep apnea in acromegaly: a review on prevalence, pathogenetic aspects and treatment. Expert Rev Endocrinol Metab 7(1):55–62PubMedCrossRef Davi MV, Giustina A (2012) Sleep apnea in acromegaly: a review on prevalence, pathogenetic aspects and treatment. Expert Rev Endocrinol Metab 7(1):55–62PubMedCrossRef
12.
Zurück zum Zitat Wagenmakers MA et al (2015) Three-dimensional facial analysis in acromegaly: a novel tool to quantify craniofacial characteristics after long-term remission. Pituitary 18(1):126–134PubMedCrossRef Wagenmakers MA et al (2015) Three-dimensional facial analysis in acromegaly: a novel tool to quantify craniofacial characteristics after long-term remission. Pituitary 18(1):126–134PubMedCrossRef
13.
Zurück zum Zitat Wolters TLC et al (2020) The course of obstructive sleep apnea syndrome in patients with acromegaly during treatment. J Clin Endocrinol Metab 105(1):290–304CrossRef Wolters TLC et al (2020) The course of obstructive sleep apnea syndrome in patients with acromegaly during treatment. J Clin Endocrinol Metab 105(1):290–304CrossRef
15.
Zurück zum Zitat Kiseljak-Vassiliades K et al (2015) Growth hormone tumor histological subtypes predict response to surgical and medical therapy. Endocrine 49(1):231–241PubMedCrossRef Kiseljak-Vassiliades K et al (2015) Growth hormone tumor histological subtypes predict response to surgical and medical therapy. Endocrine 49(1):231–241PubMedCrossRef
16.
Zurück zum Zitat Bakhtiar Y et al (2010) Relationship between cytokeratin staining patterns and clinico-pathological features in somatotropinomae. Eur J Endocrinol 163(4):531–539PubMedCrossRef Bakhtiar Y et al (2010) Relationship between cytokeratin staining patterns and clinico-pathological features in somatotropinomae. Eur J Endocrinol 163(4):531–539PubMedCrossRef
17.
Zurück zum Zitat Fougner SL et al (2012) Adenoma granulation pattern correlates with clinical variables and effect of somatostatin analogue treatment in a large series of patients with acromegaly. Clin Endocrinol 76(1):96–102CrossRef Fougner SL et al (2012) Adenoma granulation pattern correlates with clinical variables and effect of somatostatin analogue treatment in a large series of patients with acromegaly. Clin Endocrinol 76(1):96–102CrossRef
18.
Zurück zum Zitat Roemmler J et al (2012) Elevated incidence of sleep apnoea in acromegaly—correlation to disease activity. Sleep Breath 16(4):1247–1253PubMedCrossRef Roemmler J et al (2012) Elevated incidence of sleep apnoea in acromegaly—correlation to disease activity. Sleep Breath 16(4):1247–1253PubMedCrossRef
19.
Zurück zum Zitat Guo X et al (2018) The posterior pharyngeal wall thickness is associated with OSAHS in patients with acromegaly and correlates with IGF-1 levels. Endocrine 61(3):526–532PubMedCrossRef Guo X et al (2018) The posterior pharyngeal wall thickness is associated with OSAHS in patients with acromegaly and correlates with IGF-1 levels. Endocrine 61(3):526–532PubMedCrossRef
20.
Zurück zum Zitat Parolin M et al (2020) Obstructive sleep apnea in acromegaly and the effect of treatment: a systematic review and meta-analysis. J Clin Endocrinol Metab 105(3):dgz116PubMedCrossRef Parolin M et al (2020) Obstructive sleep apnea in acromegaly and the effect of treatment: a systematic review and meta-analysis. J Clin Endocrinol Metab 105(3):dgz116PubMedCrossRef
21.
Zurück zum Zitat Katznelson L et al (2014) Acromegaly: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 99(11):3933–3951PubMedCrossRef Katznelson L et al (2014) Acromegaly: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 99(11):3933–3951PubMedCrossRef
22.
23.
Zurück zum Zitat Bonneville JF (2016) Magnetic resonance imaging of pituitary tumors. Front Horm Res 45:97–120PubMedCrossRef Bonneville JF (2016) Magnetic resonance imaging of pituitary tumors. Front Horm Res 45:97–120PubMedCrossRef
24.
Zurück zum Zitat Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep 14(6):540–545PubMedCrossRef Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep 14(6):540–545PubMedCrossRef
25.
Zurück zum Zitat Berry R, Rita B, Charlene G (2017) AASM scoring manual updates for 2017 (Version 2.4). J Clin Sleep Med 5(13):665–666CrossRef Berry R, Rita B, Charlene G (2017) AASM scoring manual updates for 2017 (Version 2.4). J Clin Sleep Med 5(13):665–666CrossRef
26.
Zurück zum Zitat Annamalai AK et al (2013) A Comprehensive study of clinical, biochemical, radiological, vascular, cardiac, and sleep parameters in an unselected cohort of patients with acromegaly undergoing presurgical somatostatin receptor ligand therapy. J Clin Endocrinol Metab 98(3):1040–1050PubMedCrossRef Annamalai AK et al (2013) A Comprehensive study of clinical, biochemical, radiological, vascular, cardiac, and sleep parameters in an unselected cohort of patients with acromegaly undergoing presurgical somatostatin receptor ligand therapy. J Clin Endocrinol Metab 98(3):1040–1050PubMedCrossRef
27.
Zurück zum Zitat Tsoy UA et al (2015) Clinical features of sleep-related breathing disorders in patients with acromegaly. Ter Arkh 87(4):47PubMedCrossRef Tsoy UA et al (2015) Clinical features of sleep-related breathing disorders in patients with acromegaly. Ter Arkh 87(4):47PubMedCrossRef
28.
Zurück zum Zitat Senaratna CV et al (2017) Prevalence of obstructive sleep apnea in the general population: a systematic review. Sleep Med Rev 34:70–81PubMedCrossRef Senaratna CV et al (2017) Prevalence of obstructive sleep apnea in the general population: a systematic review. Sleep Med Rev 34:70–81PubMedCrossRef
30.
Zurück zum Zitat Turan O et al (2018) Airway and sleep disorders in patients with acromegaly. Clin Respir J 12(3):1003–1010PubMedCrossRef Turan O et al (2018) Airway and sleep disorders in patients with acromegaly. Clin Respir J 12(3):1003–1010PubMedCrossRef
31.
Zurück zum Zitat Pivonello R et al (2017) Complications of acromegaly: cardiovascular, respiratory and metabolic comorbidities. Pituitary 20(1):46–62PubMedCrossRef Pivonello R et al (2017) Complications of acromegaly: cardiovascular, respiratory and metabolic comorbidities. Pituitary 20(1):46–62PubMedCrossRef
32.
Zurück zum Zitat Davi’ MV et al (2008) Sleep apnoea syndrome is highly prevalent in acromegaly and only partially reversible after biochemical control of the disease. Eur J Endocrinol 159(5):533–540PubMedCrossRef Davi’ MV et al (2008) Sleep apnoea syndrome is highly prevalent in acromegaly and only partially reversible after biochemical control of the disease. Eur J Endocrinol 159(5):533–540PubMedCrossRef
33.
Zurück zum Zitat Bruwier A et al (2011) Acromegaly and sleep apnea: Cephalometric evaluations. Ann Endocrinol 72(3):211–217CrossRef Bruwier A et al (2011) Acromegaly and sleep apnea: Cephalometric evaluations. Ann Endocrinol 72(3):211–217CrossRef
34.
Zurück zum Zitat Chennaoui M, Leger D, Gomez-Merino D (2020) Sleep and the GH/IGF-1 axis: consequences and countermeasures of sleep loss/disorders. Sleep Med Rev 49:101223PubMedCrossRef Chennaoui M, Leger D, Gomez-Merino D (2020) Sleep and the GH/IGF-1 axis: consequences and countermeasures of sleep loss/disorders. Sleep Med Rev 49:101223PubMedCrossRef
35.
Zurück zum Zitat Weiss V et al (2000) Prevalence of the sleep apnea syndrome in acromegaly population. J Endocrinol Invest 23(8):515–519PubMedCrossRef Weiss V et al (2000) Prevalence of the sleep apnea syndrome in acromegaly population. J Endocrinol Invest 23(8):515–519PubMedCrossRef
36.
37.
Zurück zum Zitat Hochban W et al (1999) Obstructive sleep apnoea in acromegaly: the role of craniofacial changes. Eur Respir J 14(1):196PubMedCrossRef Hochban W et al (1999) Obstructive sleep apnoea in acromegaly: the role of craniofacial changes. Eur Respir J 14(1):196PubMedCrossRef
38.
Zurück zum Zitat Cadieux RJ et al (1982) Endoscopic findings in sleep apnea associated with acromegaly. J Clin Endocrinol Metab 55(1):18–22PubMedCrossRef Cadieux RJ et al (1982) Endoscopic findings in sleep apnea associated with acromegaly. J Clin Endocrinol Metab 55(1):18–22PubMedCrossRef
39.
Zurück zum Zitat Akkoyunlu ME et al (2013) Does hormonal control obviate positive airway pressure therapy in acromegaly with sleep-disordered breathing? Respir Med 107(11):1803–1809PubMedCrossRef Akkoyunlu ME et al (2013) Does hormonal control obviate positive airway pressure therapy in acromegaly with sleep-disordered breathing? Respir Med 107(11):1803–1809PubMedCrossRef
40.
Zurück zum Zitat Wennberg A et al (2019) Sleep disorders and cognitive dysfunction in acromegaly. Endocrine 66(3):634–641PubMedCrossRef Wennberg A et al (2019) Sleep disorders and cognitive dysfunction in acromegaly. Endocrine 66(3):634–641PubMedCrossRef
41.
Zurück zum Zitat Choi E et al (2016) The severity of sleep disordered breathing induces different decrease in the oxygen saturation during rapid eye movement and non-rapid eye movement sleep. Psychiatry Investig 13(6):652PubMedPubMedCentralCrossRef Choi E et al (2016) The severity of sleep disordered breathing induces different decrease in the oxygen saturation during rapid eye movement and non-rapid eye movement sleep. Psychiatry Investig 13(6):652PubMedPubMedCentralCrossRef
42.
Zurück zum Zitat Sharma SK et al (2007) Obesity, and not obstructive sleep apnea, is responsible for metabolic abnormalities in a cohort with sleep-disordered breathing. Sleep Med 8(1):12–17PubMedCrossRef Sharma SK et al (2007) Obesity, and not obstructive sleep apnea, is responsible for metabolic abnormalities in a cohort with sleep-disordered breathing. Sleep Med 8(1):12–17PubMedCrossRef
43.
Zurück zum Zitat Leistner SM et al (2015) Reduced sleep quality and depression associate with decreased quality of life in patients with pituitary adenomas. Eur J Endocrinol 172(6):733–743PubMedCrossRef Leistner SM et al (2015) Reduced sleep quality and depression associate with decreased quality of life in patients with pituitary adenomas. Eur J Endocrinol 172(6):733–743PubMedCrossRef
Metadaten
Titel
Densely granulated adenoma pattern is associated with an increased risk of obstructive sleep apnea in patients with acromegaly
verfasst von
Xianchao Zhao
Lijun Heng
Yan Qu
Dong Jia
Jiafeng Ren
Shuyu Sun
Jian Qiu
Jinxiang Cheng
Ting Yang
Junying Zhou
Changjun Su
Publikationsdatum
12.08.2021
Verlag
Springer International Publishing
Erschienen in
Sleep and Breathing / Ausgabe 3/2022
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-021-02468-z

Weitere Artikel der Ausgabe 3/2022

Sleep and Breathing 3/2022 Zur Ausgabe

Sleep Breathing Physiology and Disorders • Review

Association between YKL-40 and asthma: a systematic meta-analysis

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.