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

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Abstract

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.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request. The data are not publicly available due to privacy or ethical restrictions.

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Funding

This research was supported by the Hacettepe University Scientific Research Projects Coordination Unit (Project number TTU-2021-19463).

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Authors and Affiliations

  1. Department of Internal Medicine, School of Medicine, Hacettepe University, Sıhhıye, 06100, Ankara, Turkey

    İ. Eroğlu, B. G. İremli & T. Erbas

  2. Department of Endocrinology and Metabolism, School of Medicine, Hacettepe University, Ankara, Turkey

    B. G. İremli & T. Erbas

  3. Department of Cardiorespiratory Physiotherapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey

    A. Erkoç & E. Calik-Kutukcu

  4. Department of Radiology, School of Medicine, Hacettepe University, Ankara, Turkey

    I. S. Idilman & D. Akata

  5. Department of Preventive Oncology, School of Medicine, Hacettepe University, Ankara, Turkey

    D. Yuce

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  1. İ. Eroğlu
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  3. A. Erkoç
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Corresponding author

Correspondence to İ. Eroğlu.

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Conflict of interest

İmdat Eroğlu, Burçin Gönül İremli, Aysegul Erkoç, Ilkay S. Idilman, Deniz Yuce, Ebru Calik-Kutukcu, Deniz Akata, and Tomris Erbas declare that they have no conflict of interest.

Ethical approval and consent to participate

This study was approved by the Ethics Committee of Hacettepe University (Project Number: GO 21/166, Decision Number:2021/05-38). The study was performed in accordance with the Declaration of Helsinki.

Informed consent

Written informed consent was obtained from all of the subjects.

Research involving human participants and/or animals

All procedures followed were in accordance with the ethical standards of the Helsinki Declaration of 1964 and later versions.

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Eroğlu, İ., İremli, B.G., Erkoç, A. et al. Osteosarcopenia in acromegaly: reduced muscle quality and increased vertebral fat deposition. J Endocrinol Invest 46, 2573–2582 (2023). https://doi.org/10.1007/s40618-023-02114-3

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