Effect of Sandostatin LAR on sleep apnoea in acromegaly: correlation with computerized tomographic cephalometry and hormonal activity.


OBJECTIVES:Sleep apnoea has been reported to occur in subjects with acromegaly. This study evaluates the relationship among biochemical activity, sleep apnoeic activity and upper airway anatomic profile in acromegaly, and the effect of Sandostatin LAR, a long-acting somatostatin analogue, on these parameters. PATIENTS:Fourteen subjects with acromegaly were recruited. MEASUREMENTS:Subjects were assessed at baseline and those with apnoea-hypopnoea index (AHI) > or = 5 were reassessed after 6 months of treatment with Sandostatin LAR 20-30 mg IMI 4-weekly. Biochemical activity was assessed with levels of GH and IGF-1. Sleep disordered breathing was assessed with overnight polysomnography. Upper airway anatomic profile was defined with computerized tomographic cephalometry. RESULTS:Of 14 subjects (age 42.0 +/- 8.1 years, mean +/- SD; 11 men) at baseline, there was a positive correlation between GH and tongue length (VT; P = 0.004), and between AHI and cephalometric indices: length of soft palate (PMU; P = 0.002); mandibular plane-hyoid bone distance (MPH; P = 0.017), maximum thickness of soft palate (Max-SP; P = 0.018) and VT (P = 0.027). Eight patients had sleep disordered breathing (AHI > or = 5) which was predominantly obstructive in nature (AHI = 29.4 +/- 22.6). After treatment, there were significant improvements in hormonal profile: GH, mU/l (before, 51.5 +/- 27.8; after, 8.0 +/- 7.4; P = 0.017) and IGF-1, nmol/l (before, 95.5 +/- 23.4; after, 35.0 +/- 12.4; P = 0.012); sleep-disordered breathing: AHI (before, 29.4 +/- 22.6; after, 13.4 +/- 11.12; P = 0.025), snoring episodes (before, 486 +/- 240; after, 165 +/- 170; P = 0.05); cephalometric indices, mm: MPH (before, 18.8 +/- 12.1; after, 14.8 +/- 8.4; P = 0.018), VT (before, 72.3 +/- 4.4; after, 69.7 +/- 4.3; P = 0.05). There was a positive correlation between the reduction in GH and AHI (r = 0.738, P = 0.037). CONCLUSIONS:The findings demonstrated that there was correlation between sleep apnoea severity and soft tissue overgrowth at the upper airway region in acromegaly. They also suggest that Sandostatin LAR improved obstructive sleep apnoea in acromegaly, and the effect might be partly mediated via a reduction in upper airway soft tissue, in particular that of the tongue, concomitant with a reduction in GH levels.


Clin Endocrinol (Oxf)


Clinical endocrinology


Ip MS,Tan KC,Peh WC,Lam KS





Has Abstract


2001-10-01 00:00:00














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    pub_type: 杂志文章


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    更新日期:2012-09-01 00:00:00

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    更新日期:2016-02-01 00:00:00

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    更新日期:1993-07-01 00:00:00

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    pub_type: 杂志文章


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    更新日期:2017-01-01 00:00:00

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    authors: Puig J,Blasco G,Daunis-I-Estadella J,Loshuertos E,Codina J,Cuba V,Ortiz R,Xifra G,Ricart W,Pedraza S,Federici M,Fernández-Real JM

    更新日期:2015-08-01 00:00:00

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    更新日期:2014-06-01 00:00:00

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    更新日期:2006-12-01 00:00:00

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    pub_type: 临床试验,杂志文章


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    更新日期:1982-04-01 00:00:00

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    pub_type: 杂志文章


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    更新日期:1997-08-01 00:00:00

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    更新日期:1984-05-01 00:00:00

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    journal_title:Clinical endocrinology

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    更新日期:2012-09-01 00:00:00

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    更新日期:2006-03-01 00:00:00

  • Serum and follicular fluid insulin like growth factors I and II during growth hormone co-treatment for in-vitro fertilization and embryo transfer.

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    pub_type: 临床试验,杂志文章,随机对照试验


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    pub_type: 临床试验,杂志文章


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    更新日期:1995-05-01 00:00:00

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    pub_type: 杂志文章


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    pub_type: 临床试验,杂志文章


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    pub_type: 杂志文章


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    journal_title:Clinical endocrinology

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Höybye C,Hilding A,Jacobsson H,Thorén M

    更新日期:2003-05-01 00:00:00

  • Absorption and tolerability of taste-masked hydrocortisone granules in neonates, infants and children under 6 years of age with adrenal insufficiency.

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    journal_title:Clinical endocrinology

    pub_type: 杂志文章


    authors: Neumann U,Whitaker MJ,Wiegand S,Krude H,Porter J,Davies M,Digweed D,Voet B,Ross RJ,Blankenstein O

    更新日期:2018-01-01 00:00:00

  • Pyridostigmine fails to increase either spontaneous or GHRH-stimulated GH secretion during day or night in growth hormone-insufficient children.

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    journal_title:Clinical endocrinology

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Kirk JM,Ross RJ,Trainer PJ,Froud AL,Davies SC,Savage MO,Besser GM

    更新日期:1991-05-01 00:00:00

  • Binding of immunoglobulin-G from patients with thyroid autoimmune disease to normal T lymphocytes.

    abstract::Sera from patients with Graves' disease and Hashimoto's thyroiditis were reacted with normal T lymphocyte preparations in an attempt to detect binding of immunoglobulin G (IgG) to T cells. Sera from normal subjects and patients with toxic adenomas served as controls. Each serum was reacted with at least three differen...

    journal_title:Clinical endocrinology

    pub_type: 杂志文章


    authors: Pacini F,Sridama V,Pressendo J,DeGroot LJ,Medof ME

    更新日期:1983-07-01 00:00:00

  • Effects of insulin and glucocorticoids on the leptin system are mediated through free leptin.

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    journal_title:Clinical endocrinology

    pub_type: 临床试验,杂志文章


    authors: Lewandowski K,Randeva HS,O'Callaghan CJ,Horn R,Medley GF,Hillhouse EW,Brabant G,O'Hare P

    更新日期:2001-04-01 00:00:00