Generic placeholder image

Endocrine, Metabolic & Immune Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5303
ISSN (Online): 2212-3873

Research Article

A New Device for Remote Monitoring of Vital Parameters in Acromegalic Patients: Pilot Study

Author(s): Denise Costa*, Tania D’Amico, Valeria Mercuri, Riccardo Schiaffini and Patrizia Gargiulo

Volume 22, Issue 14, 2022

Published on: 04 August, 2022

Page: [1410 - 1415] Pages: 6

DOI: 10.2174/1871530322666220516161753

Price: $65

Abstract

Introduction: Acromegaly is a rare disease that results from growth hormone (GH) excess. Diabetes mellitus, hypertension,cardiomyopathy, and obstructive sleep apnoea syndrome( OSAS) are frequent complications.

Aim of the study: Identify a useful system to obtain a reliable remote monitoring of glucose and the most important vital parameters in the acromegalic subjects.

Patients and Methods: Sixteen acromegalic patients (from 30 to 73 years old) were enrolled. We provided health monitor devices to the patients for continuous acquisition of physiological signals including twelve-lead electrocardiography (EKG) and nocturnal SpO2. At the same time, we applied on the same patients the blinded continuous glucose monitoring system(CGMS).

Results: The lowest saturation peaks at night (<80%) were achieved in patients with a known diagnosis of OSAS. A positive correlation was demonstrated between the lowest oxygen saturation values and the CGM peaks (pV <0,0001) and between the average values of oxygen saturation and CGM (pV<0,0003). Patients with a previous diagnosis of OSAS, obtained by polysomnography, showed on the multiparametric monitor recordings superimposable to their known condition. Instead we noticed a discordance in the two EKG recording: the wireless mode showed an irregular rhythm in 5/16 patients, which was not confirmed by the recording mode with cables.

Conclusion: The health monitor device associated with CGM may be a new useful and versatile tool for fragile patients who can self-manage remote monitoring, and for physicians who can obtain real-time information for the clinical and therapeutic management of patients. It is also a useful tool for the follow-up of patients with OSAS. Moreover, once the interference of the OSAS is excluded, the CGM allows us to obtain a more reliable and accurate diagnosis of DM.

Keywords: Acromegaly, self-monitoring, remote control, CGM, vital parameters, OSAS.

Graphical Abstract

[1]
Colao, A.; Ferone, D.; Marzullo, P.; Lombardi, G. Systemic complications of acromegaly: Epidemiology, pathogenesis, and management. Endocr. Rev., 2004, 25(1), 102-152.
[http://dx.doi.org/10.1210/er.2002-0022] [PMID: 14769829]
[2]
Adigun, O.O.; Nguyen, M.; Fox, T.J. Acromegaly; StatPearls, 2021.
[3]
Hannon, A.M. Diabetes in patients with acromegaly. Curr. Diab. Rep., 2017, 17(2), 8.
[http://dx.doi.org/10.1007/s11892-017-0838-7]
[4]
Biagetti, B.; Simó, R. Diabetes y HOMA-IRen la acromegalia. Endocrinol. Diabetes Nutr., 2021, 68, 1-2.
[5]
Fieffe, S. Diabetes in acromegaly, prevalence, risk factors, and evolution: Data from the French Acromegaly Registry. Eur. J. Endocrinol., 2011, 164(6), 877-884.
[http://dx.doi.org/10.1530/EJE-10-1050]
[6]
Holdaway, I.M.; Rajasoorya, R.C.; Gamble, G.D. Factors influencing mortality in acromegaly. J. Clin. Endocrinol. Metab., 2004, 89(2), 667-674.
[http://dx.doi.org/10.1210/jc.2003-031199] [PMID: 14764779]
[7]
Mercuri, V. Continuous glucose monitoring system in acromegalic patients: Possible role in the assessment of glycemia control. J. Diabetes Sci. Technol., 2021, 15(6), 1346-1351.
[PMID: 32787453]
[8]
Vannucci, L.; Luciani, P.; Gagliardi, E.; Paiano, S.; Duranti, R.; Forti, G.; Peri, A. Assessment of sleep apnea syndrome in treated acromegalic patients and correlation of its severity with clinical and laboratory parameters. J. Endocrinol. Invest., 2013, 36(4), 237-242.
[PMID: 22776855]
[9]
Berkmann, S.; Brun, J.; Schuetz, P.; Christ, E.; Mariani, L.; Mueller, B. Prevalence and outcome of comorbidities associated with acromegaly. Acta Neurochir. (Wien), 2021, 163(11), 3171-3180.
[http://dx.doi.org/10.1007/s00701-021-04846-8] [PMID: 33856552]
[10]
Fatti, L.M.; Scacchi, M.; Pincelli, A.I.; Lavezzi, E.; Cavagnini, F. Prevalence and pathogenesis of sleep apnea and lung disease in acromegaly. Pituitary, 2001, 4(4), 259-262.
[http://dx.doi.org/10.1023/A:1020702631793] [PMID: 12501976]
[11]
Rasche, K.; Keller, T.; Tautz, B.; Hader, C.; Hergenc, G.; Antosiewicz, J.; Di Giulio, C.; Pokorski, M. Obstructive sleep apnea and type 2 diabetes. Eur. J. Med. Res., 2010, 15(S2)(Suppl. 2), 152-156.
[http://dx.doi.org/10.1186/2047-783X-15-S2-152] [PMID: 21147644]
[12]
Cappellani, D.; Urbani, C.; Sardella, C.; Scattina, I.; Marconcini, G.; Isabella Lupi, I.; Manetti, L.; Marcocci, C.; Fausto Bogazzi, F. Diabetes mellitus induced by somatostatin analogue therapy is not permanent in acromegalic patients endocrinol. Diabetes Metab., 2019, 2(1), e00033.
[13]
Ajay, N. Sharma Acromegalic cardiomyopathy: Epidemiology, diagnosis, and management. Clin. Cardiol., 2018, 41(3), 419-425.
[14]
Hinojosa-Amaya, J.M.; Varlamov, E.V.; Yedinak, C.G.; Cetas, J.S.; McCartney, S.; Banskota, S.; Fleseriu, M. Echocardiographic findings in acromegaly: Prevalence of concentric left ventricular remodeling in a large single-center cohort. J. Endocrinol. Invest., 2021, 44(12), 2665-2674.
[http://dx.doi.org/10.1007/s40618-021-01579-4] [PMID: 33893617]
[15]
Mônica, R. Gadelha. Systemic complications of acromegaly and the impact of the current treatment landscape: An update. Endocr. Rev., 2019, 40(1), 268-332.
[16]
Mercuri, V.; D’Amico, T.; Gargiulo, P. Letter to the Editor: “COVID‐19 and the endocrine system: Exploring the unexplored”. Focus on acromegaly. J. Endocrinol. Invest., 2021, 44(3), 637-638.
[17]
Katznelson, L.; Laws, E.R., Jr; Melmed, S.; Molitch, M.E.; Murad, M.H.; Utz, A.; Wass, J.A. Acromegaly: An endocrine society clinical practice guideline. J. Clin. Endocrinol. Metab., 2014, 99(11), 3933-3951.
[http://dx.doi.org/10.1210/jc.2014-2700] [PMID: 25356808]
[18]
Giustina, A.; Barkan, A.; Beckers, A.; Biermasz, N.; Biller, B.M.K.; Boguszewski, C.; Bolanowski, M.; Bonert, V.; Bronstein, M.D.; Casanueva, F.F.; Clemmons, D.; Colao, A.; Ferone, D.; Fleseriu, M.; Frara, S.; Gadelha, M.R.; Ghigo, E.; Gurnell, M.; Heaney, A.P.; Ho, K.; Ioachimescu, A.; Katznelson, L.; Kelestimur, F.; Kopchick, J.; Krsek, M.; Lamberts, S.; Losa, M.; Luger, A.; Maffei, P.; Marazuela, M.; Mazziotti, G.; Mercado, M.; Mortini, P.; Neggers, S.; Pereira, A.M.; Petersenn, S.; Puig-Domingo, M.; Salvatori, R.; Shimon, I.; Strasburger, C.; Tsagarakis, S.; van der Lely, A.J.; Wass, J.; Zatelli, M.C.; Melmed, S. A consensus on the diagnosis and treatment of acromegaly comorbidities: An update. J. Clin. Endocrinol. Metab., 2020, 105(4), dgz096.
[http://dx.doi.org/10.1210/clinem/dgz096] [PMID: 31606735]
[19]
Klonoff, D.C.; Ahn, D.; Drincic, A. Continuous glucose monitoring: A review of the technology and clinical use. Diabetes Res. Clin. Pract., 2017, 133, 178-192.
[http://dx.doi.org/10.1016/j.diabres.2017.08.005] [PMID: 28965029]
[20]
American Diabetes Association. Classification and diagnosis of diabetes: Standards of medical care in diabetes-2019. Diabetes Care, 2019, 42(Suppl. 1), S13-S28.
[http://dx.doi.org/10.2337/dc19-S002] [PMID: 30559228]
[21]
Beumer, M.C.; Koch, R.M.; van Beuningen, D. OudeLashof, A.M.; van de Veerdonk, F.L.; Kolwijck, E.; van der Hoeven, J.G.; Bergmans, D.C.; Hoedemaekers, C.W.E. Influenza virus and factors that are associated with ICU admission, pulmonary co-infections and ICU mortality. J. Crit. Care, 2019, 50, 59-65.
[http://dx.doi.org/10.1016/j.jcrc.2018.11.013] [PMID: 30481669]
[22]
Mutti, C.; Azzi, N.; Soglia, M. ollara, I.; Alessandrini, F.; Parrino, L. Obstructive sleep apnea, cpap and COVID-19: a brief review. Acta Biomed., 2020, 91(4), e2020196.
[23]
De Menis, E.; Giustina, A.; Colao, A.; Degli Uberti, E.; Ghigo, E.; Minuto, F.; Bogazzi, F.; Drigo, R.; Cattaneo, A.; Aimaretti, G. Assessment of the awareness and management of sleep apnea syndrome in acromegaly. The COM. E. J. Endocrinol. Invest., 2011, 34(1), 60-64.
[http://dx.doi.org/10.1007/BF03346696] [PMID: 21406941]
[24]
Comunello, A.; Dassie, F.; Martini, C.; De Carlo, E.; Mioni, R.; Battocchio, M.; Paoletta, A.; Fallo, F.; Vettor, R.; Maffei, P. Heart rate variability is reduced in acromegaly patients and improved by treatment with somatostatin analogues. Pituitary, 2015, 18(4), 525-534.
[http://dx.doi.org/10.1007/s11102-014-0605-6] [PMID: 25261332]
[25]
Warszawski, L.; Kasuki, L.; Sá, R.; Dos Santos Silva, C.M.; Volschan, I.; Gottlieb, I.; Pedrosa, R.C.; Gadelha, M.R. Low frequency of cardniac arrhythmias and lack of structural heart disease in medically-naïve acromegaly patients: A prospective study at baseline and after 1 year of somatostatin analogs treatment. Pituitary, 2016, 19(6), 582-589.
[http://dx.doi.org/10.1007/s11102-016-0749-7] [PMID: 27591859]
[26]
Unubol, M.; Eryilmaz, U.; Guney, E.; Ture, M.; Akgullu, C. QT dispersion in patients with acromegaly. Endocrine, 2013, 43(2), 419-423.
[http://dx.doi.org/10.1007/s12020-012-9828-3] [PMID: 23149908]
[27]
Orosz, A.; Csajbók, É.; Czékus, C.; Gavallér, H.; Magony, S.; Valkusz, Z.; Várkonyi, T.T.; Nemes, A.; Baczkó, I.; Forster, T.; Wittmann, T.; Papp, J.G.; Varró, A.; Lengyel, C. Increased short-term beat-to-beat variability of QT interval in patients with acromegaly. PLoS One, 2015, 10(4), e0125639.
[http://dx.doi.org/10.1371/journal.pone.0125639] [PMID: 25915951]
[28]
Fatti, L.M.; Scacchi, M.; Lavezzi, E.; Pecori Giraldi, F.; De Martin, M.; Toja, P.; Michailidis, G.; Stramba-Badiale, M.; Cavagnini, F. Effects of treatment with somatostatin analogues on QT interval duration in acromegalic patients. Clin. Endocrinol. (Oxf.), 2006, 65(5), 626-630.
[http://dx.doi.org/10.1111/j.1365-2265.2006.02639.x] [PMID: 17054464]
[29]
Maffei, P.; Martini, C.; Milanesi, A.; Corfini, A.; Mioni, R.; de Carlo, E.; Menegazzo, C.; Scanarini, M.; Vettor, R.; Federspil, G.; Sicolo, N. Late potentials and ventricular arrhythmias in acromegaly. Int. J. Cardiol., 2005, 104(2), 197-203.
[http://dx.doi.org/10.1016/j.ijcard.2004.12.010] [PMID: 16168814]
[30]
Chemla, D.; Attal, P.; Maione, L.; Veyer, A.S.; Mroue, G.; Baud, D.; Salenave, S.; Kamenicky, P.; Bobin, S.; Chanson, P. Impact of successful treatment of acromegaly on overnight heart rate variability and sleep apnea. J. Clin. Endocrinol. Metab., 2014, 99(8), 2925-2931.
[http://dx.doi.org/10.1210/jc.2013-4288] [PMID: 24780045]
[31]
Parolin, M.; Dassie, F.; Vettor, R.; Steeds, R.P.; Maffei, P. Electrophysiological features in acromegaly: Re-thinking the arrhythmic risk? J. Endocrinol. Invest., 2021, 44(2), 209-221.
[http://dx.doi.org/10.1007/s40618-020-01343-0] [PMID: 32632903]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy