Osteosarcopenia in acromegaly: reduced muscle quality and increased vertebral fat deposition

• Published in: Journal of endocrinological investigation Vol. 46; no. 12; pp. 2573 - 2582
• Main Authors: Eroğlu, İ., İremli, B. G., Erkoç, A., Idilman, I. S., Yuce, D., Calik-Kutukcu, E., Akata, D., Erbas, T.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.12.2023; Springer Nature B.V
• Subjects: Acromegaly; Adipose tissue; Body composition; Body fat; Body mass index; Bone mineral density; Comorbidity; Dual energy X-ray absorptiometry; Endocrinology; Internal Medicine; Magnetic resonance imaging; Medicine; Medicine & Public Health; Metabolic Diseases; Muscle strength; Musculoskeletal diseases; Musculoskeletal system; Original Article; Skeletal muscle; Spine; Vertebrae; Acromegaly; Sarcopenia; Bone mineral density; Vertebral MRI-PDFF; Osteosarcopenia
• ISSN: 1720-8386; 0391-4097; 1720-8386
• DOI: 10.1007/s40618-023-02114-3

Purpose Musculoskeletal disorders are among the most disabling comorbidities in patients with acromegaly. This study examined muscle and bone quality in patients with acromegaly. Methods Thirty-three patients with acromegaly and nineteen age- and body mass index-matched healthy controls were included in the study. Body composition was determined using dual-energy X-ray absorptiometry. The participants underwent abdominal magnetic resonance imaging (MRI) for cross-sectional evaluation of muscle area and vertebral MRI proton density fat fraction (MRI-PDFF). Muscular strength was measured using hand grip strength (HGS). Skeletal muscle quality (SMQ) was classified as weak, low, or normal, according to HGS/ASM (appendicular skeletal muscle mass) ratio. Results Groups had similar lean tissues, total body fat ratios, and total abdominal muscle areas. Acromegalic patients had lower pelvic BMD ( p  = 0.012) and higher vertebral MRI-PDFF ( p  = 0.014), while total and spine bone mineral densities (BMD) were similar between the groups. The SMQ score rate was normal only 57.5% in the acromegaly group, and 94.7% of the controls had a normal SMQ score ( p  = 0.01). Subgroup analysis showed that patients with active acromegaly (AA) had higher lean tissue and lower body fat ratios than controlled acromegaly (CA) and control groups. Vertebral MRI-PDFF was higher in the CA group than that in the AA and control groups ( p  = 0.022 and p  = 0.001, respectively). The proportion of participants with normal SMQ was lower in the AA and CA groups than that in the control group ( p  = 0.012 and p  = 0.013, respectively). Conclusion Acromegalic patients had reduced SMQ and pelvic BMD, but greater vertebral MRI-PDFF. Although lean tissue increases in AA, this does not affect SMQ. Therefore, increased vertebral MRI-PDFF in controlled acromegalic patients may be due to ectopic adiposity.