Acromegaly screening in patients with sleep apnea symptoms

Acromegaly is a rare disease with that usually takes years before the diagnosis. Prevalence is 40-125 cases per million, however, some screening studies have found a much higher prevalence, suggesting that acromegaly could be underestimated. Acromegaly symptoms are non-specific but acral enlargement is almost universally present at diagnosis. Aim: sleep apnea is present in about 40-80% of acromegaly patients. In this study we aims to investigate the presence of acromegaly in a selected population of patients suffering from snoring or suspected sleep apnea. Methods: multicenter Spanish study involving 14 hospital sleep referral units and Endocrinology Departments. Patients who were seen in first visit for sleep apnea symptoms and/or hoarseness were offered to participate. A questionnaire was designed to investigate the presence of symptoms consistent with a diagnosis of acromegaly including: increase in ring size or shoe size, enlargement of the tongue, lips or jaw, paresthesia in hands or carpal tunnel syndrome and widening of tooth spaces, in addition to a list of other typical symptoms. A serum IGF-1 was measured in case of positive signs of acromegaly and an oral glucose tolerance test was performed to confirm acromegaly. We present our preliminary data. Results: Only two acromegaly were diagnosed out of 965 patients screened. Conclusions: In a selected population of patient suffering from snoring or suspected sleep apnea we found an acromegaly prevalence of 2.1 cases per 1000 patients screened. It is important that sleep specialists beware of the disease and recognize its symptoms in order to perform an early diagnosis. Funding support: this investigator study has received a support from Ipsen.