Abstract：
UNASSIGNED: To identify a screening tool for obstructive sleep apnea (OSA) and evaluate the effects of endoscopic transsphenoidal surgery on improving OSA in patients with acromegaly.
UNASSIGNED: We prospectively enrolled adults with acromegaly scheduled for endoscopic transsphenoidal surgery. All measurements were conducted when participants were admitted for a baseline work-up for acromegaly before surgery and surveillance approximately 3 to 6 months after surgery. Respiratory event index (REI) was used as a surrogate for apnea-hypopnea index (Trial Registration: NCT03526016).
UNASSIGNED: Of the 35 patients with acromegaly (median age, 47 years; 40% men; median body mass index, 24.4 kg/m2), 24 (68.6%) had OSA (REI ≥5/hour), 15 (42.9%) had moderate-to-severe OSA (REI ≥15/hour). At baseline, serum insulin-like growth factor 1 (IGF-1) levels were positively correlated with the REI (ρ=0.53, P=0.001). The sensitivity and negative predictive value of a Snoring, Tiredness, Observed apnea, high blood Pressure-Body mass index, age, Neck circumference, and Gender (STOP-Bang) score ≥ 3 were 93.3% and 87.5%, respectively, detecting moderate-to-severe OSA. Biochemical acromegaly remission was achieved in 32 (91.4%) patients. The median difference in the REI was -9.5/hour (95% confidence interval, -13.3 to -5.3). Half of the 24 patients diagnosed with OSA preoperatively had REI <5/hour postoperatively. In a linear mixed-effects model, changes in the REI across surgery were related to changes in IGF-1 levels.
UNASSIGNED: The STOP-Bang questionnaire is a reliable tool for OSA among patients with acromegaly. Improvement in OSA severity after surgery is related to decreased IGF-1 levels.
UNASSIGNED: We prospectively enrolled adults with acromegaly scheduled for endoscopic transsphenoidal surgery. All measurements were conducted when participants were admitted for a baseline work-up for acromegaly before surgery and surveillance approximately 3 to 6 months after surgery. Respiratory event index (REI) was used as a surrogate for apnea-hypopnea index (Trial Registration: NCT03526016).
UNASSIGNED: Of the 35 patients with acromegaly (median age, 47 years; 40% men; median body mass index, 24.4 kg/m2), 24 (68.6%) had OSA (REI ≥5/hour), 15 (42.9%) had moderate-to-severe OSA (REI ≥15/hour). At baseline, serum insulin-like growth factor 1 (IGF-1) levels were positively correlated with the REI (ρ=0.53, P=0.001). The sensitivity and negative predictive value of a Snoring, Tiredness, Observed apnea, high blood Pressure-Body mass index, age, Neck circumference, and Gender (STOP-Bang) score ≥ 3 were 93.3% and 87.5%, respectively, detecting moderate-to-severe OSA. Biochemical acromegaly remission was achieved in 32 (91.4%) patients. The median difference in the REI was -9.5/hour (95% confidence interval, -13.3 to -5.3). Half of the 24 patients diagnosed with OSA preoperatively had REI <5/hour postoperatively. In a linear mixed-effects model, changes in the REI across surgery were related to changes in IGF-1 levels.
UNASSIGNED: The STOP-Bang questionnaire is a reliable tool for OSA among patients with acromegaly. Improvement in OSA severity after surgery is related to decreased IGF-1 levels.
摘要：
■确定阻塞性睡眠呼吸暂停（OSA）的筛查工具，并评估内镜经蝶入路手术对改善肢端肥大症患者OSA的影响。
■我们前瞻性招募了患有肢端肥大症的成年人，计划进行内镜经蝶入路手术。所有测量都是在参与者在手术前接受肢端肥大症的基线检查并在手术后约3至6个月进行监测时进行的。呼吸事件指数（REI）用作呼吸暂停低通气指数的替代指标（试验注册：NCT03526016）。
■在35例肢端肥大症患者中（中位年龄，47岁；40%男性；中位体重指数，24.4kg/m2),24（68.6%）有OSA（REI≥5/小时），15人（42.9%）患有中度至重度OSA（REI≥15/小时）。在基线,血清胰岛素样生长因子1(IGF-1)水平与REI呈正相关(ρ=0.53,P=0.001)。打鼾的敏感性和阴性预测值，疲倦,观察到的呼吸暂停，高血压-体重指数,年龄,颈围,性别(STOP-Bang)评分≥3分分别为93.3%和87.5%，分别,检测中度至重度OSA。32例（91.4％）患者的生化肢端肥大症得到缓解。REI的中位数差异为-9.5/小时(95%置信区间，-13.3至-5.3）。术前诊断为OSA的24例患者中，有一半患者术后REI<5/小时。在线性混合效应模型中，整个手术中REI的变化与IGF-1水平的变化有关.
■STOP-Bang问卷是肢端肥大症患者OSA的可靠工具。手术后OSA严重程度的改善与IGF-1水平降低有关。
■我们前瞻性招募了患有肢端肥大症的成年人，计划进行内镜经蝶入路手术。所有测量都是在参与者在手术前接受肢端肥大症的基线检查并在手术后约3至6个月进行监测时进行的。呼吸事件指数（REI）用作呼吸暂停低通气指数的替代指标（试验注册：NCT03526016）。
■在35例肢端肥大症患者中（中位年龄，47岁；40%男性；中位体重指数，24.4kg/m2),24（68.6%）有OSA（REI≥5/小时），15人（42.9%）患有中度至重度OSA（REI≥15/小时）。在基线,血清胰岛素样生长因子1(IGF-1)水平与REI呈正相关(ρ=0.53,P=0.001)。打鼾的敏感性和阴性预测值，疲倦,观察到的呼吸暂停，高血压-体重指数,年龄,颈围,性别(STOP-Bang)评分≥3分分别为93.3%和87.5%，分别,检测中度至重度OSA。32例（91.4％）患者的生化肢端肥大症得到缓解。REI的中位数差异为-9.5/小时(95%置信区间，-13.3至-5.3）。术前诊断为OSA的24例患者中，有一半患者术后REI<5/小时。在线性混合效应模型中，整个手术中REI的变化与IGF-1水平的变化有关.
■STOP-Bang问卷是肢端肥大症患者OSA的可靠工具。手术后OSA严重程度的改善与IGF-1水平降低有关。
