Prevalence of acromegaly in patients with symptoms of sleep apnea
Sesmilo, Gemma (Hospital Universitari Dexeus (Barcelona, Catalunya))
Resmini, Eugenia (Institut d'Investigació Biomèdica Sant Pau)
Sambo, Marcel (Hospital General Universitario Gregorio Marañón)
Blanco, Concepción (Hospital Universitario Príncipe de Asturias (Alcalá de Henares, Madrid))
Calvo, Fernando (Hospital Clínico Universitario "Lozano Blesa" de Zaragoza)
Pazos, Fernando (Hospital Universitario Marqués de Valdecilla (Santander, Cantabria))
Fernández-Catalina, Pablo (Complejo Hospitalario Universitario de Pontevedra)
Martínez de Icaya, Purificación (Hospital Universitario Severo Ochoa)
Páramo, Concepción (Complexo Hospitalario Universitario de Vigo)
Fajardo, Carmen (Hospital Universitari de la Ribera (València))
Marazuela, Mónica (Hospital Universitario de la Princesa (Madrid))
Álvarez-Escolá, Cristina (Hospital Universitario La Paz (Madrid))
Díez, Juan Jose (Hospital Universitario Ramón y Cajal (Madrid))
Perea, Verónica (Hospital Universitari Dexeus (Barcelona, Catalunya))
Universitat Autònoma de Barcelona

Data:	2017
Resum:	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.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Publicat a:	PloS one, Vol. 12 (september 2017) , ISSN 1932-6203

DOI: 10.1371/journal.pone.0183539
PMID: 28898247

11 p, 1.3 MB

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