A retrospective study of the role of hypercapnia in patients with acromegaly
Abstract Background Acromegaly is a multisystemic disease characterized by an excessive release of growth hormone (GH) and insulin-like growth factor-1. Obstructive sleep apnea (OSA) is a common consequence of acromegaly, and hypercapnia is frequently observed in patients with acromegaly, OSA, and o...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-05-01
|
| Series: | BMC Pulmonary Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12890-023-02488-3 |
| _version_ | 1827940136695889920 |
|---|---|
| author | Junwei Guo Wenhao Cao Jinmei Luo Rong Huang Yi Xiao |
| author_facet | Junwei Guo Wenhao Cao Jinmei Luo Rong Huang Yi Xiao |
| author_sort | Junwei Guo |
| collection | DOAJ |
| description | Abstract Background Acromegaly is a multisystemic disease characterized by an excessive release of growth hormone (GH) and insulin-like growth factor-1. Obstructive sleep apnea (OSA) is a common consequence of acromegaly, and hypercapnia is frequently observed in patients with acromegaly, OSA, and obesity. However, the effects of hypercapnia on acromegaly remain unknown. This study was designed to investigate whether there are differences in clinical symptoms, sleep variables, and biochemical remission after surgery for acromegaly in patients with OSA with or without hypercapnia. Methods A retrospective analysis was conducted involving patients with acromegaly and OSA. The pharmacotherapy history for acromegaly before surgery, anthropometric measures, blood gas, sleep monitoring data, and biochemical assays of hypercapnic and eucapnic individuals were collected 1–2 weeks before surgery. Univariate and multivariate logistic regression analyses were performed to determine the risk factors for failed postoperative biochemical remission. Results In this study, 94 patients with OSA and acromegaly were included. Among them, 25 (26.6%) had hypercapnia. The hypercapnic group had higher body mass index (92% vs. 62.3%; p = 0.005) and poorer nocturnal hypoxemia index. No serological differences were found between the two groups. According to the post-surgery GH level, 52 patients (55.3%) reached biochemical remission. Univariate logistic regression analysis revealed that diabetes mellitus (odds ratio [OR], 2.59; 95% confidence interval [CI], 1.02–6.55), instead of hypercapnia (OR, 0.61; 95% CI, 0.24–1.58), was associated with lower remission rates. Patients who received pharmacotherapy for acromegaly before surgery (OR, 0.21; 95% CI, 0.06–0.79) and had higher thyroid-stimulating hormone levels (OR, 0.53; 95% CI, 0.32–0.88) were more likely to have biochemical remission after surgery. Multivariate analysis further showed that only diabetes mellitus (OR, 3.29; 95% CI, 1.15–9.46) and preoperative pharmacotherapy (OR, 0.21; 95% CI, 0.06–0.83) remained significant. Hypercapnia, hormone levels, and sleep indicators had no effect on biochemical remission after surgery. Conclusions Single-center evidence shows that hypercapnia alone may not be a risk factor for lower biochemical remission rates. Correcting hypercapnia does not appear to be required before surgery. More evidence is needed to further support this conclusion. |
| first_indexed | 2024-03-13T09:05:07Z |
| format | Article |
| id | doaj.art-b8d98ca6fd544d9c9a1c4fd5bf6bfb25 |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-03-13T09:05:07Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-b8d98ca6fd544d9c9a1c4fd5bf6bfb252023-05-28T11:07:28ZengBMCBMC Pulmonary Medicine1471-24662023-05-012311910.1186/s12890-023-02488-3A retrospective study of the role of hypercapnia in patients with acromegalyJunwei Guo0Wenhao Cao1Jinmei Luo2Rong Huang3Yi Xiao4Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeDepartment of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeDepartment of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeDepartment of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeDepartment of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical CollegeAbstract Background Acromegaly is a multisystemic disease characterized by an excessive release of growth hormone (GH) and insulin-like growth factor-1. Obstructive sleep apnea (OSA) is a common consequence of acromegaly, and hypercapnia is frequently observed in patients with acromegaly, OSA, and obesity. However, the effects of hypercapnia on acromegaly remain unknown. This study was designed to investigate whether there are differences in clinical symptoms, sleep variables, and biochemical remission after surgery for acromegaly in patients with OSA with or without hypercapnia. Methods A retrospective analysis was conducted involving patients with acromegaly and OSA. The pharmacotherapy history for acromegaly before surgery, anthropometric measures, blood gas, sleep monitoring data, and biochemical assays of hypercapnic and eucapnic individuals were collected 1–2 weeks before surgery. Univariate and multivariate logistic regression analyses were performed to determine the risk factors for failed postoperative biochemical remission. Results In this study, 94 patients with OSA and acromegaly were included. Among them, 25 (26.6%) had hypercapnia. The hypercapnic group had higher body mass index (92% vs. 62.3%; p = 0.005) and poorer nocturnal hypoxemia index. No serological differences were found between the two groups. According to the post-surgery GH level, 52 patients (55.3%) reached biochemical remission. Univariate logistic regression analysis revealed that diabetes mellitus (odds ratio [OR], 2.59; 95% confidence interval [CI], 1.02–6.55), instead of hypercapnia (OR, 0.61; 95% CI, 0.24–1.58), was associated with lower remission rates. Patients who received pharmacotherapy for acromegaly before surgery (OR, 0.21; 95% CI, 0.06–0.79) and had higher thyroid-stimulating hormone levels (OR, 0.53; 95% CI, 0.32–0.88) were more likely to have biochemical remission after surgery. Multivariate analysis further showed that only diabetes mellitus (OR, 3.29; 95% CI, 1.15–9.46) and preoperative pharmacotherapy (OR, 0.21; 95% CI, 0.06–0.83) remained significant. Hypercapnia, hormone levels, and sleep indicators had no effect on biochemical remission after surgery. Conclusions Single-center evidence shows that hypercapnia alone may not be a risk factor for lower biochemical remission rates. Correcting hypercapnia does not appear to be required before surgery. More evidence is needed to further support this conclusion.https://doi.org/10.1186/s12890-023-02488-3HypercapniaAcromegalyObstructive sleep apneaBiochemical remission |
| spellingShingle | Junwei Guo Wenhao Cao Jinmei Luo Rong Huang Yi Xiao A retrospective study of the role of hypercapnia in patients with acromegaly BMC Pulmonary Medicine Hypercapnia Acromegaly Obstructive sleep apnea Biochemical remission |
| title | A retrospective study of the role of hypercapnia in patients with acromegaly |
| title_full | A retrospective study of the role of hypercapnia in patients with acromegaly |
| title_fullStr | A retrospective study of the role of hypercapnia in patients with acromegaly |
| title_full_unstemmed | A retrospective study of the role of hypercapnia in patients with acromegaly |
| title_short | A retrospective study of the role of hypercapnia in patients with acromegaly |
| title_sort | retrospective study of the role of hypercapnia in patients with acromegaly |
| topic | Hypercapnia Acromegaly Obstructive sleep apnea Biochemical remission |
| url | https://doi.org/10.1186/s12890-023-02488-3 |
| work_keys_str_mv | AT junweiguo aretrospectivestudyoftheroleofhypercapniainpatientswithacromegaly AT wenhaocao aretrospectivestudyoftheroleofhypercapniainpatientswithacromegaly AT jinmeiluo aretrospectivestudyoftheroleofhypercapniainpatientswithacromegaly AT ronghuang aretrospectivestudyoftheroleofhypercapniainpatientswithacromegaly AT yixiao aretrospectivestudyoftheroleofhypercapniainpatientswithacromegaly AT junweiguo retrospectivestudyoftheroleofhypercapniainpatientswithacromegaly AT wenhaocao retrospectivestudyoftheroleofhypercapniainpatientswithacromegaly AT jinmeiluo retrospectivestudyoftheroleofhypercapniainpatientswithacromegaly AT ronghuang retrospectivestudyoftheroleofhypercapniainpatientswithacromegaly AT yixiao retrospectivestudyoftheroleofhypercapniainpatientswithacromegaly |