Impact of obstructive sleep apnea on cardiovascular risk in patients with acromegaly

Respiratory complications represented by obstructive sleep apnea (OSA), cardiovascular disease (CVD), and metabolic disorders including insulin resistance (IR) are common in patients with acromegaly. OSA is further associated with a higher risk of IR and CVD in the general population. However, significant information on the effect of OSA on IR and CVD risk for patients with acromegaly remains to be scarce.

This retrospective study included 125 patients with active acromegaly. Medical history, anthropometric parameters, polysomnographic and fasting biochemical measurements were collected. Ten-year Framingham CVD risk scores were calculated and categorized as low, moderate, and high. IR was assessed using the homeostasis model assessment (HOMA-IR).

OSA was confirmed in two thirds of the enrolled patients. Compared with patients without OSA, patients with both OSA and acromegaly were found to have higher proportion of HOMA-IR and moderate-to-high 10-year CVD risk. Logistic regression analysis showed that OSA, HOMA-IR, and low-density lipoprotein cholesterol were all risk factors for moderate-to-high CVD risk. Meanwhile, no mediating effect of HOMA-IR in the association between OSA and Framingham CVD risk was observed in patients with acromegaly.

The coexistence of OSA might increase the CVD risk for patients with acromegaly, and IR might independently contribute to CVD risk in acromegalic patients with OSA.