Article record

诊断延迟时长和疾病严重程度是肢端肥大症患者睡眠呼吸暂停的主要预测因素

Diagnostic delay length and disease severity are the main predictors of sleep apnea in acromegaly patients.

临床研究鼻科IF 6Q1

文献信息

PMID	42936300
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Rosa Pirchio 查看其他 9 位作者 Renata Simona Auriemma；Stefano Sanduzzi Zamparelli；Paola Bonavolontà；Claudia Merola；Angelo Canora；Claudia Pivonello；Alessandro Sanduzzi Zamparelli；Rosario Pivonello；Annamaria Colao
作者单位	Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Diabetologia, Andrologia e Nutrizione, Università Federico II di Napoli, Naples, Italy. 查看其他 7 条单位信息 Division of Pneumology and Semi‑Intensive Respiratory Therapy, A. Cardarelli Hospital, Naples, Italy.；Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy.；Istituti Clinici Scientifici Maugeri IRCCS, Pulmonary Rehabilitation Unit of Telese Terme Institute, Telese Terme, Italy.；Dipartimento di Sanità Pubblica, Università Federico II di Napoli, Naples, Italy.；Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy.；UNESCO Chair for Health Education and Sustainable Development, University of Naples "Federico II", Naples, Italy.；ERN Lung, Frankfurt am Main, Germany.
期刊	Frontiers in endocrinology
SCI 分区	Q1
IF	6
研究类型	临床研究 · 临床
所属专科	鼻科

中文摘要

背景： 阻塞性睡眠呼吸暂停（OSA）在肢端肥大症诊断时影响高达80%的患者，且尽管接受治疗仍常持续存在。目前建议识别有OSA风险的患者以提供多导睡眠图/呼吸监测评估。
目的： 研究肢端肥大症患者中OSA的患病率及危险因素。
方法： 前瞻性、单中心研究；对36例肢端肥大症患者（年龄54.1±12.9岁）进行呼吸监测。
结果： 17例患者（47.2%）发现OSA，多为轻度（64.7%）。OSA患者在诊断时（p=0.02）和呼吸监测时（p=0.008）年龄均较大，诊断延迟更长（p=0.003），BMI更高（p=0.03）。与疾病完全控制者相比，肢端肥大症未控制患者的呼吸暂停次数（p=0.02）和阻塞性呼吸暂停次数（p=0.04）显著更高，最低氧饱和度显著更低（p=0.02），氧饱和度<90%的时间百分比更高（p=0.03）。诊断延迟是呼吸暂停-低通气指数（AHI，p=0.04）和氧减饱和度指数（ODI，p=0.04）评分的最佳预测因素，且独立于BMI。与无OSA患者相比，OSA患者的胰岛素抵抗（p=0.05）、糖代谢谱受损（p=0.05）和STOP-Bang评分（p=0.001）显著更高，但Epworth嗜睡量表评分（p=0.96）无显著差异。
结论： 诊断延迟和患者年龄，而非疾病状态，似乎可预测OSA的发生并影响其严重程度。这些发现强调了早期识别OSA高风险患者的重要性。

英文摘要

CONTEXT: Obstructive sleep apnea (OSA) affects up to 80% of patients at diagnosis of acromegaly and often persists despite treatment. Currently, patients at risk for OSA are recommended to be identified to offer polygraphy evaluation.
PURPOSE: To study the prevalence and risk factors for OSA in patients with acromegaly.
METHODS: Prospective, single-center study; polygraphy was performed on 36 patients with acromegaly (age 54.1 ± 12.9 years).
RESULTS: OSA was found in 17 patients (47.2%), mostly mild (64.7%). Patients with OSA were older both at diagnosis (p = 0.02) and at polygraphy (p = 0.008), had a longer diagnostic delay (p = 0.003) and higher BMI (p = 0.03). Patients with uncontrolled acromegaly exhibited a significantly higher number of apneas (p=0.02) and obstructive apneas (p=0.04) and had significantly lower minimum oxygen saturations (p=0.02) and a higher percentage of time spent with oxygen saturation <90% (p=0.03) as compared to those with full disease control. Diagnostic delay was the best predictor of apnea-ipopnea index (AHI, p=0.04) and oxygen desaturation index (ODI, p=0.04) scores, independently on BMI. Insulin resistance (p = 0.05), glucose profile impairment (p = 0.05) and STOP-Bang score (p=0.001), but not Epworth Sleepiness Scale score (p = 0.96), were significantly higher in patients with OSA as compared to those without.
CONCLUSION: Diagnostic delay and patients' age, rather than disease status, appear to predict the development of OSA and influence its severity. These findings reinforce the importance of early identification of patients at higher risk for OSA.