ECE2016 Guided Posters Pituitary - Clinical (10 abstracts)
1Laboratoire dEFCR et Laboratoire du Sommeil, Grenoble, France; 2Service dEndocrinologie, CHU Grenoble, Grenoble, France; 3Centre de Pneumologie, Bordeaux, France; 4Clinique Tessier, Valenciennes, France; 5Pneumologie, Grenoble, France; 6Service dEndocrinologie, CHU Larrey, Toulouse, France.
Introduction: Acromegaly is a rare disease (estimated prevalence 40125 cases per million) resulting from GH/IGF1 hypersecretion, mostly by pituitary adenomas. SAS has a prevalence of up to 80% in acromegalic patients. The high frequency of acromegaly-related comorbidities and delayed diagnosis although effective treatments exist, make it necessary a screening of acromegaly in at risk populations.
Aim: In a national multicenter study, to determine the prevalence of acromegaly in patients referred for SAS.
Patients and methods: Patients referred at Grenoble university hospital and in ten private practice centers for SAS suspicion were recruited consecutively from November 2013 to October 2014. Clinical data and co-morbidities were collected via an electronic case report form of French Sleep Observatory (OSFP). Patients had polysomnography/respiratory polygraphy and systematic serum IGF-1 determination. When serum IGF1 levels were elevated for age and sex, IGF1 level and GH during OGTT were performed and patients with GH/IGF1 hypersecretion had MRI of the pituitary and were examined by an endocrinologist for definite diagnosis of acromegaly.
Results: 873 patients with suspected SAS were included: 817 patients had IGF1 and 755 had polysomnography or respiratory polygraphy. SAS (Apnea/Hypopnea Index >15/h) was present in 567 patients and absent (AHI <15/h) in 188 patients. SAS patients were men (68%), older (54±12 vs 48±13 years, P<0.0001), had higher BMI (31.4±6.6 vs 29.0±6.0 kg/m2, P<0.0001) and lower IGF1 levels (142±63 vs 162±61 ng/ml, P<0.0001). 5 SAS patients had a 10% increase of IGF1 above the upper limit of normal and two SAS patients had acromegaly due to GH-secreting pituitary macroadenoma.
Conclusion: The prevalence of acromegaly is greater than 35/10 000 in our patients with SAS and higher than in the general population. Further studies are needed to evaluate the cost-effectiveness of IGF1 screening in patients with SAS.