THU065 Evaluation Of Sarcopenia And Bone Health In Patients With Acromegaly
Authors: Eroglu Imdat , Gonul İremli Burcin , Erkoc Aysegul , Idilman Ilkay S , Yuce Deniz , Kutukcu Ebru C , Akata Deniz , Erbas Tomris 
Published: October 2023

Disclosure: I. Eroglu: None. B. Gonul İremli: None. A. Erkoc: None. I. Idilman: None. D. Yuce: None. E. C. Kutukcu: None. D. Akata: None. T. Erbas: None.

Background: Although many complications related to high GH exposure develop in patients with acromegaly, musculoskeletal complications are among the most important complications that reduce the quality of life of patients. However, the effects of acromegaly on muscle and bone have not been adequately researched and are still not entirely understood. We aimed to investigate muscle and bone quality in acromegalic patients in this cross-sectional, case-controlled study. Methods: The study consisted of thirty-two (15F/17M) acromegalic patients (n=15 active acromegaly - AA and n=17 controlled acromegaly - CA) and 19 healthy controls (C). Dual energy X-ray absorptiometry (DXA) was used to determine body composition, appendicular skeletal muscle mass (ASM), relative skeletal muscle index (RSMI), and bone mineral density (BMD). The handgrip strength (HGS) and quadriceps muscle strength were measured by hand dynamometer. Magnetic resonans imaging at the L3 level was used to measure total abdominal muscle area (TAMA, cm2) and vertebral fat ratio (VFR). HGS adjusted by ASM (HGS/ASM) was used to define skeletal muscle quality (SMQ). SMQ was regarded “normal” when the HGS/ASM ratio was &gt;1.53, and “weak” when the ratio was ≤1.36 in males and ≤1.35 in women. The SMQ of those with HGS/ASM levels between these ranges was considered “low”. Results: Age, gender, and BMI were similar between groups. The GH and IGF-1 levels in AA was greater than in CA, and C (p&lt;0.001 for all). While lean tissue was higher in AA than CA and C (p=0.038 and p=0.041, resp.), body fat ratio was lower in AA than CA and C (p=0.04 and p=0.042 resp.). ASM, RSMI, TAMA, HGS and quadriceps strength were similar between groups. Median (IQR) HGS/ASM were 1.67 (1.15-1.9) in AA, 1.57 (1.36-1.79) in CA and 1.77 (1.67-1.93) in C. This difference was found to be significant between CA and C (p=0.008). According to skelatal muscle quality, 94.7% of the individuals in the C group were of normal SMQ, while this rate was 60% in the AA and 52.9% in CA. The ratio of those with low/weak SMQ was higher in the AA and CA compared to C (p=0.012 and p=0.013, resp.). Total and vertebra BMD were similar across groups. Pelvic BMD in CA was lower than C (p=0.02). VFR was higher in CA (56.5%) than in AA (43.75%) and C (42.6%) (p=0.04 and p=0.001 resp.). Conclusion: We showed for the first time that patients with acromegaly had lower muscle quality and pelvic BMD, while patients with controlled acromegaly had higher vertebral fat ratio. Even though lean tissue increased in AA patients, regional muscle distributions (ASM and TAMA) were shown to be similar. The increased muscle mass in acromegaly patients is not expressed as muscular strength, and muscle quality is low in these patients. The high vertebral fat ratio seen in patients with CA may be a result of ectopic adiposity with disease control, as well as the reason for the increased frequency of vertebral fractures seen in patients with acromegaly.

Presentation: Thursday, June 15, 2023