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

  • Basic Science • Original Article
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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.

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Acknowledgements

The authors thank the sleep technologists (Ruirui Yuan, Juan Wen and Xing Yang) at the Sleep Medicine Center, Tangdu Hospital of the Fourth Military Medical University.

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Authors and Affiliations

  1. Sleep Medicine Center, Tangdu Hospital of the Fourth Military Medical University, Xinsi Road 569#, Xi’an, 710038, China

    Xianchao Zhao, Jiafeng Ren, Shuyu Sun, Jian Qiu, Jinxiang Cheng, Ting Yang & Changjun Su

  2. Department of Neurosurgery, Tangdu Hospital of the Fourth Military Medical University, Xi’an, China

    Lijun Heng, Yan Qu & Dong Jia

  3. Sleep Medicine Center, West China Hospital of Sichuan University, Dian Xin Nan Jie 28#, Chengdu, 610041, China

    Junying Zhou

  4. Department of Neurology, West China Hospital, Sichuan University, Chengdu, China

    Junying Zhou

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  1. Xianchao Zhao
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  2. Lijun Heng
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  3. Yan Qu
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  10. Junying Zhou
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Correspondence to Junying Zhou or Changjun Su.

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The Tangdu Hospital Ethics Committee approved this study.

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Xianchao Zhao and Lijun Heng are co-first authors of the article.

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Zhao, X., Heng, L., Qu, Y. et al. Densely granulated adenoma pattern is associated with an increased risk of obstructive sleep apnea in patients with acromegaly. Sleep Breath 26, 1381–1387 (2022). https://doi.org/10.1007/s11325-021-02468-z

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  • DOI: https://doi.org/10.1007/s11325-021-02468-z

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