Prevalence of acromegaly in patients with symptoms of sleep apnea
Por:
Sesmilo G, Resmini E, Sambo M, Blanco C, Calvo F, Pazos F, Fernández-Catalina P, Martínez de Icaya P, Páramo C, Fajardo C, Marazuela M, Álvarez-Escolá C, Díez JJ and Perea V
Publicada:
12 sep 2017
Resumen:
Acromegaly is a rare disease with nonspecific symptoms with acral enlargement being almost universally present at diagnosis. The estimated prevalence is 40-125 cases/million but targeted universal screening studies have found a higher prevalence (about 10 fold). The aim of the ACROSAHS study was to investigate the prevalence of acromegaly and acromegaly comorbidities in patients with sleep apnea symptoms and acral enlargement. ACROSAHS was a Spanish prospective non-interventional epidemiological study in 13 Hospital sleep referral units. Facial and acral enlargement symptoms including: ring size and shoe size increase, tongue, lips and jaws enlargement, paresthesia or carpal tunnel syndrome and widening of tooth spaces, as well as other typical acromegaly comorbidities were recorded with a self-administered questionnaire of patients who attended a first visit for sleep apnea symptoms between 09/2013 and 07/2014. Serum insulin-like growth factor type 1 (IGF1) was measured in patients with >= 1 acral symptom to determine the prevalence of acromegaly. Of the 1557 patients enrolled, 1477 with complete data (72% male) were analyzed. 530 patients (36%) reported at least 1 acral enlargement symptom and were tested for IGF-1, 41 were above range, persisted in 7, and among those, 2 cases of acromegaly were diagnosed (prevalence of at least 1.35 cases/1000). Overall, 1019 patients (69%) had >= 2 acromegaly symptoms and should have been screened according to guidelines; moreover 373 patients (25%) had >= 1 symptom of acral enlargement plus >= 3 other acromegaly symptoms. In conclusion, in patients with sleep apnea symptoms and acral enlargement, we found an acromegaly prevalence of at least 1.35 cases per 1000 and a high prevalence of typical acromegaly symptoms. It is important that sleep specialists are aware of acromegaly symptoms to aid with acromegaly diagnosis.
Filiaciones:
Sesmilo G:
Servicio de endocrinología, Hospital Quirón-Dexeus/Clínica del Sueño Estivill, Barcelona, Spain
Resmini E:
IIB- Sant Pau y Servicio de Endocrinología, Departamento de Medicina, Centro de Investigación Biomédica en Enfermedades Raras (CIBER-ER Unidad 747), Hospital Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
Sambo M:
Servicio de endocrinología, Hospital Universitario Gregorio Marañón, Madrid, Spain
Blanco C:
Servicio de endocrinología, Hospital Universitario Príncipe de Asturias, Madrid, Spain
Calvo F:
Servicio de endocrinología, Hospital Clínico Universitario Lozano-Blesa, Zaragoza, Spain
Pazos F:
Servicio de endocrinología, Hospital Universitario Marqués de Valdecilla, Santander, Spain
Fernández-Catalina P:
Servicio de endocrinología, Complexo Hospitalario de Pontevedra, Pontevedra, Spain
Martínez de Icaya P:
Servicio de endocrinología, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
Páramo C:
Servicio de endocrinología, Complexo Hospitalario Universitario De Vigo, Vigo, Spain
:
Servicio de endocrinología, Hospital Universitario de la Ribera, Alzira, Spain
Marazuela M:
Servicio de endocrinología, Hospital de La Princesa, Madrid, Spain
Álvarez-Escolá C:
Servicio de endocrinología, Hospital Universitario la Paz, Madrid, Spain
Díez JJ:
Servicio de endocrinología, Hospital Universitario Ramón y Cajal, Madrid, Spain
Perea V:
Servicio de endocrinología, Hospital Quirón-Dexeus/Clínica del Sueño Estivill, Barcelona, Spain
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