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IGF-1-based screening reveals a low prevalence of acromegaly in patients with obstructive sleep apnea

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Abstract

Purpose

Recent epidemiologic studies suggest a high prevalence of acromegaly. The prevalence of obstructive sleep apnea syndrome (OSAS) in acromegaly patients ranges from 47 to 70%. A recent study identified 2 patients with acromegaly among 567 OSAS patients. However, it remains unclear whether screening for acromegaly among OSAS patients is necessary. The aim was to screen for acromegaly among OSAS patients by measuring IGF-1 levels and performing confirmatory tests if necessary.

Methods

We performed a prospective cross-sectional diagnostic study on the prevalence of acromegaly in patients with OSAS. A total of 507 patients with a confirmed diagnosis of OSAS (357 male, 150 female) were screened.

Results

Seven male and three female patients (1.97% of total) were positively screened for elevated IGF-1 levels. Nine out of ten patients suppressed growth hormone levels during OGTT excluding acromegaly, whereas one individual was identified to have acromegaly according to established criteria (1/507, prevalence 0.2%). Analysis of the data showed no correlation between elevated IGF-1 values and the severity of OSAS or BMI.

Conclusions

Our data demonstrate a low prevalence of acromegaly in patients with OSAS. Until data from population-based studies is available we suggest restricting screening for acromegaly in OSAS to those patients who have additional clinical features of acromegaly.

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Acknowledgements

We thank Sandra Rutz for helping to organize and coordinate the research study.

Funding

The study was supported by a research grant from Pfizer.

Author contributions

D.H. analyzed the data and wrote the manuscript. C.R. performed the research and analyzed the data. M.B. and A.T. helped to conceptualize the structure of the study and helped to perform the study. R.F. contributed to the execution of the research. M.B. supervised laboratory analysis. R.P.K. contributed to writing the manuscript. J.S. and M.R. helped to conceptualize the structure of the study. H.J.S. acted in an advisory role, designed the research study, helped analyze the data and contributed to writing the manuscript. All authors revised it critically for important intellectual content and gave final approval for publication.

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Authors and Affiliations

  1. Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ziemssenstraße 1, 80331, München, Germany

    Daniel A. Heinrich, Claudia Reinholz, Richard Frohner, Jochen Schopohl, Martin Bidlingmaier, Robert P. Kosilek, Martin Reincke & Harald J. Schneider

  2. Asklepios Fachkliniken München-Gauting, Lehrklinik der LMU München, Robert-Koch-Allee 2, 82131, Gauting, Germany

    Maximilian Bauer & Amanda Tufman

  3. Medizinische Klinik und Poliklinik V, Klinikum der Universität München, Ziemssenstraße 1, 80331, München, Germany

    Amanda Tufman

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  1. Daniel A. Heinrich
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  2. Claudia Reinholz
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  3. Maximilian Bauer
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  8. Robert P. Kosilek
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  9. Martin Reincke
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  10. Harald J. Schneider
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Corresponding author

Correspondence to Daniel A. Heinrich.

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Conflict of interest

H.J.S. received research grants, speaker fees, and travel grants from Pfizer, and speaker fees and travel grants from Novartis. M.R. received speaker fees from Pfizer, Ipsen, and Novartis. J.S. has received research grants, lecture fees and travel/accommodation/meeting expenses from Ipsen, Novartis, and Pfizer. The remaining authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Heinrich, D.A., Reinholz, C., Bauer, M. et al. IGF-1-based screening reveals a low prevalence of acromegaly in patients with obstructive sleep apnea. Endocrine 60, 317–322 (2018). https://doi.org/10.1007/s12020-018-1538-z

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  • DOI: https://doi.org/10.1007/s12020-018-1538-z

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