12571 Ultrasonography Is A Potential Cost-effective Tool To Evaluate Muscle Impairment In Patients With Controlled Cushing’S Disease And Acromegaly
Authors: Martel-Duguech Luciana , Bascuñana Helena , Webb Susan M , Valassi Elena 
Published: October 2024

Abstract
Disclosure: L. Martel-Duguech: None. H. Bascuñana: None. S. Webb: None. E. Valassi: None.
Myopathy is a frequent feature in patients with Cushing’s syndrome (CS) and in patients with acromegaly (ACRO) long-term after biochemical control is achieved. Although ultrasonography (US) is an easy and cost-effective tool to evaluate muscle impairment in the clinical setting, its usefulness in patients with “controlled” ACRO end CS patients has not been established The aim of our study was to evaluate muscle structure using US and assess the correlation between US parameters, muscle function and quality of life (QoL). We included 36 female patients with CS [mean (±SD) age, 50±12 years; mean (±SD) BMI, 26.7±3.8] and 36 age- and BMI-matched healthy women. Mean (±SD) duration of remission was 132±87 months. We also included 36 patients with ACRO [20 females and 16 males, mean (±SD) age, 53±9 years, BMI 27±4 Kg/m2 and duration of control 92±58 months], and 36 age, gender and BMI-matched controls. We obtained transverse ultrasound images of the rectus femoris and assessed muscle intensity at both the midpoint (QmitR) and the distal third (QtercR), between the anterior inferior iliac spine and the proximal end of the patella. We scored muscle intensity using the Heckmatt’s rating scale and classified our findings as follows: 1-normal, 2-mildy increased muscle echoes with normal bone reflection, 3-moderately increased muscle echoes with reduced bone, 4-severely increased muscle echoes with absent bone reflection. We found that mean US intensity score was increased in patients with CS (QmitR p&lt;0.001) and in patients with ACRO (QmitR p&lt;0.05; QtercR p&lt;0.001) vs. the controls, suggesting more impaired muscle architecture in the former, likely due to fibrosis/fatty infiltration. We also measured muscle function using the following tests: gait speed velocity (GS), timed up and go (TUG) and 30-second chair stand. QoL was assessed using both generic (SF-36) and disease-specific (CushingQoL and AcroQoL) questionnaires. US parameters, QoL and muscle function were correlated; in CS patients, higher QtercR was associated with slower GS (r=-0.421, p=0.041) and lower scores in social dimensions on CushingQoL ( friends/family , r=-0.510, p=0.013; and work/study, r=-0.523, p=0.010) . In ACRO patients, higher QmedR was associated with slower GS (r=-0.382, p=0.031) and decreased TUG (r=-0.497, p=0.004) and 30-second chair stand (r=-0.444, p=0.011) in all patients. Higher QmedR was also associated with lower score in physical function (ρ=-0.734, p=0.024), vitality (ρ=-0.728, p=0.026), and AcroQoL total score (ρ=-0.725, p=0.027), in male patients only. Conclusion: muscle US architectural parameters are impaired in “controlled” CS and ACRO patients, and are correlated with muscle function and QoL in both groups of patients. US may be a useful technique to identify, in a clinical setting, those CS and ACRO patients showing residual myopathy. This work was supported by PI17/00749 and PI21/01223 and FEDER funds
Presentation: 6/3/2024