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Yıl:2014; Cilt: 1; Sayı: 1>> Özet
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Türk Uyku Tıbbı Dergisi; 2014;1(1):22-27
Tedavi Öncesi ve Sonrası Dönemde Akromegalide Obstruktif Uyku Apne Sendromu
S Korkmaz, İ Çakır, F Bayram, Z Karaca, S İsmailoğulları, M Aksu
Acıbadem Üniversitesi, Kayseri
Giriş: Obstruktif uyku apne sendromu (OUAS), akromegalik hastalarda genel popülasyon ile karşılaştırıldığında oldukça sıktır. Akromegalik hastalardaki OUAS’nin bu hasta grubunda gözlenen geri dönüşümlü ya da geri dönüşsüz anatomik değişiklikler ile ilişkili olduğu düşünülmektedir. Bu anatomik değişikliklerin nedeni tam olarak bilinmemekle birlikte, serum Growth hormon (GH) ve insülin benzeri growth faktör-1 (IGF- 1) seviyelerinin önemli olduğu düşünülmektedir. Bu çalışmanın amacı, akromegalik hastalardaki OUAS sıklığını belirlemek ve hastalık aktivitesi ile OUAS arasındaki ilişkiyi saptamaktır. Gereç ve Yöntem: Çalışmaya 15 yeni tanı almış ve tedavi başlanmamış akromegali hastası alındı. Hastaların polisomnografi (PSG) kayıtları yapıldı ve bazal hormon değerleri belirlendi. OUAS tanısı alan hastalara sürekli hava yolu basınç (CPAP) tedavisi başlandı. CPAP tedavisi alan hastalarda PSG ve hormonal çalışmalar tekrarlandı. Bulgular: Akromegalik hastalarda OUAS, genel polasyona göre daha sık bulundu. Ancak hem bazal hem de tedavi sonrası yapılan değerlendirmelerde hastalardaki OUAS şiddeti ile hormonal aktivite arasında bir ilişki saptanmadı. Sonuç: OUAS, akromegalik hastalarda mortalite ve morbiditeyi artıran bir durumdur. Akromegali tanısının erken konması, OUAS gelişiminde rol oynayan geri dönüşsüz anatomik değişikliklerin oluşumunu engelleyeceğinden dolayı önemlidir. OUAS varlığı saptandığında uygulanacak CPAP tedavisi akromegalik hastalardaki morbidite ve mortaliteyi azaltıcı etki gösterecektir.
Obstructive Sleep Apnea Syndrome in Acromegaly Before and After Treatment
Introduction: Obstructive sleep apnea syndrome (OSAS) prevalence in acromegaly patients is very common compared with general population. It is thought that OSAS in acromegaly patients evolve because of reversible and irreversible anatomical changes. However, reason of anatomical changes has not been known in present. Maybe, Growth Hormone (GH) and insulin-like growth factor 1 (IGF-I) levels could be an important factor in the development of anatomical changes. In this study, we aimed to determine the prevalence of OSAS in acromegaly and to show the correlation between disease activity and OSAS in acromegalic patients. Materials and Methods: Newly diagnosed and treatment naive 15 acromegaly patients were included into the study. Patients were evaluated by polysomnography (PSG) recordings and hormone levels at baseline and 6 months after treatment. Results: Present study showed that OSAS is more common in patients with acromegaly than general population. Moreover, there is no correlation between GH, IGF-I level and apnea-hipopnea index (AHI) both at baseline and 6 months after treatment. Discussion: OSAS is a condition increased morbidity and mortality associated with acromegaly. Early diagnosis and treatment of acromegaly is important in order to prevent progression of anatomical changes leading to OSAS to an irreversible state. If OSAS and its complications had been prevented, morbidity and mortality in acromegaly patients would have been decreased.

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