Akromegali hastalarında uyku apne sendromu sıklığının, uyku apne sendromu ile antropometrik ölçümler ve metabolik parametreler arasındaki ilişkinin değerlendirilmesi
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Date
2018
Authors
Biçer, Buket
Journal Title
Journal ISSN
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Publisher
Uludağ Üniversitesi
Abstract
Akromegali uzun süre aşırı büyüme hormonu (GH) salınımı sonucu gelişen, somatik ve metabolik etkileri olan nadir bir hastalıktır. Ortalama görülme yaşı 40-45 arasında olup insidansı milyonda 4-6 yeni vaka olarak bildirilmektedir. Klinik olarak yüzde kabalaşma, diş aralıklarında açılma, ellerde ve ayaklarda büyüme görülürken, kardiyovasküler sistem, kas-iskelet sistemi ve respiratuvar sistem tutulumu da görülebilmektedir. Akromegalinin metabolik etkileri arasında hiperglisemi, hipertrigliseridemi ve hiperkalsiüri yer almaktadır. Akromegali hastalarında yaklaşık %40-50 oranında obstrüktif uyku apne sendromu (OSAS) görülmektedir. Akromegali hastalarında görülen OSAS'ın obezite, bel çevresi, kalça çevresi ve vücut kitle indeksi ile ilişkisi ve ayrıca OSAS'ı olan akromegali hastalarında diyabet ve kardiyovasküler bozuklukların daha fazla görüldüğü çok sayıda çalışmayla gösterilmiştir. Çalışmamıza akromegali tanılı 28 hasta dâhil edildi. Hastalar polisomnografi sonuçlarına göre OSAS'ı olanlar ve olmayanlar olarak değerlendirildi. Tüm hastaların tanı anında ve polisomnografi yapıldığında bakılan GH, insülin benzeri büyüme faktörü-1 (IGF-1) ve diğer hipofiz hormon düzeyleri incelendi. Ayrıca tüm hastaların polisomnografi yapıldığında bakılan boy, kilo, vücut kitle indeksi (VKİ), bel çevresi (BÇ), kalça çevresi (KÇ), bel-kalça oranı (BKO), kan basıncı (KB) değerlendirildi ve açlık glukozu, tokluk glukozu, lipid profili incelendi. Hastalarda diyabetes mellitus (DM), hipertansiyon (HT) ve koroner arter hastalığı (KAH) sıklığı değerlendirildi. Hastalar OSAS'ı olanlar ve olmayanlar olarak iki grupta incelendi. OSAS'ı olan hasta grubunda vücut kitle indeksi, bel çevresi, bel/kalça oranı anlamlı olarak daha fazla bulundu. Ayrıca OSAS'ı olan hasta grubunda diyabetes mellitus'un ve hipertrigliserideminin anlamlı olarak fazla olduğu gösterildi. Akromegali hastalarında OSAS önemli bir klinik antite olup hastaların kardiyovasküler hastalık riskinde dolayısıyla mortalitede belirgin olarak artışa neden olan bir durumdur. OSAS'ı olan akromegali hastalarında diyabetes mellitus ve hipertrigliseridemi sık görülmektedir. Ayrıca vücut kitle indeksi ve bel/kalça oranı fazla olan akromegali hastalarında OSAS görülme riskinde artış görğlmektedir. Akromegali hastalarında OSAS'ı erken tanımak mortalite ve morbiditeye önemli katkı sağlayacaktır.
Acromegaly is a rare disease that has somatic and metabolic effects that develop as a result of long-term release of growth hormone. The mean age of onset is between 40 and 45 years and the incidence is reported as 4-6 million new cases. Clinically, the percentage of rash, opening in the teeth, growth in the hands and feet, cardiovascular system, musculoskeletal system and respiratory system involvement can be seen. Metabolic effects of acromegali include hyperglycaemia, hypertriglyceridemia and hypercalciuria. Approximately 40-50% of patients with acromegaly have obstructive sleep apnea syndrome. A number of studies have shown that sleep apnea syndrome in patients with acromegaly is associated with obesity, waist circumference, hip circumference and body mass index, as well as diabetes and cardiovascular disorders in acromegaly patients with sleep apnea syndrome. Twenty-eight patients with acromegaly diagnosed were included. Patients were evaluated as having and without obstructive sleep apnea syndrome (OSAS) according to polysomnography results. Growth hormone (GH), insülin like growth factor-1 (IGF-1) and other pituitary hormone levels were examined at the time of diagnosis and polysomnography of all patients. All patients were also evaluated for height, weight, body mass index (BMI), waist circumference, hip circumference, waist-to-hip ratio, blood pressure (BP) and fasting glucose, satiety glucose, lipid profile examined. Diabetes mellitus (DM), hypertension (HT) and coronary artery disease (CAD) frequency were evaluated in patients. Patients were divided into two groups as those with and without sleep apnea syndrome. Body mass index, waist circumference, waist / hip ratio were significantly higher in patients with sleep apnea syndrome. It was also shown that diabetes mellitus and hypertriglyceridemia were significantly higher in the patient group with sleep apnea syndrome. Sleep apnea syndrome is an important clinical entity in patients with acromegaly and is a condition that causes a significant increase in the risk of cardiovascular disease and therefore mortality. Diabetes mellitus and hypertriglyceridemia are common in acromegaly patients with sleep apnea syndrome. There is also an increased risk of sleep apnea syndrome in acromegaly patients with a higher body mass index and waist / hip ratio. Early recognition of OSAS in patients with acromegaly will contribute significantly to mortality and morbidity.
Acromegaly is a rare disease that has somatic and metabolic effects that develop as a result of long-term release of growth hormone. The mean age of onset is between 40 and 45 years and the incidence is reported as 4-6 million new cases. Clinically, the percentage of rash, opening in the teeth, growth in the hands and feet, cardiovascular system, musculoskeletal system and respiratory system involvement can be seen. Metabolic effects of acromegali include hyperglycaemia, hypertriglyceridemia and hypercalciuria. Approximately 40-50% of patients with acromegaly have obstructive sleep apnea syndrome. A number of studies have shown that sleep apnea syndrome in patients with acromegaly is associated with obesity, waist circumference, hip circumference and body mass index, as well as diabetes and cardiovascular disorders in acromegaly patients with sleep apnea syndrome. Twenty-eight patients with acromegaly diagnosed were included. Patients were evaluated as having and without obstructive sleep apnea syndrome (OSAS) according to polysomnography results. Growth hormone (GH), insülin like growth factor-1 (IGF-1) and other pituitary hormone levels were examined at the time of diagnosis and polysomnography of all patients. All patients were also evaluated for height, weight, body mass index (BMI), waist circumference, hip circumference, waist-to-hip ratio, blood pressure (BP) and fasting glucose, satiety glucose, lipid profile examined. Diabetes mellitus (DM), hypertension (HT) and coronary artery disease (CAD) frequency were evaluated in patients. Patients were divided into two groups as those with and without sleep apnea syndrome. Body mass index, waist circumference, waist / hip ratio were significantly higher in patients with sleep apnea syndrome. It was also shown that diabetes mellitus and hypertriglyceridemia were significantly higher in the patient group with sleep apnea syndrome. Sleep apnea syndrome is an important clinical entity in patients with acromegaly and is a condition that causes a significant increase in the risk of cardiovascular disease and therefore mortality. Diabetes mellitus and hypertriglyceridemia are common in acromegaly patients with sleep apnea syndrome. There is also an increased risk of sleep apnea syndrome in acromegaly patients with a higher body mass index and waist / hip ratio. Early recognition of OSAS in patients with acromegaly will contribute significantly to mortality and morbidity.
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Keywords
Akromegali, Uyku apne sendromu, Antropometrik ölçümler, Metabolik parametreler, Diyabetes mellitus, Koroner arter hastalığı, Acromegaly, Sleep apnea syndrome, Anthropometric measurements, Metabolic parameters, Diabetes mellitus, Coronary artery disease
Citation
Biçer, B. (2018). Akromegali hastalarında uyku apne sendromu sıklığının, uyku apne sendromu ile antropometrik ölçümler ve metabolik parametreler arasındaki ilişkinin değerlendirilmesi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.