Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg and Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden.
Department of Internal Medicine, Södra Älvsborgs Sjukhus, Borås, Sweden.
Eur J Endocrinol. 2017 Aug;177(2):217-226. doi: 10.1530/EJE-17-0120. Epub 2017 May 31.
Patients with acromegaly have decreased body fat (BF) and increased extracellular water (ECW) and muscle mass. Although there is a lack of systematic studies on muscle function, it is believed that patients with acromegaly may suffer from proximal muscle weakness despite their increased muscle mass. We studied body composition and muscle function in untreated acromegaly and after biochemical remission.
Prospective observational study.
Patients with acromegaly underwent measurements of muscle strength (dynamometers) and body composition (four-compartment model) at diagnosis ( = 48), 1 year after surgery ( = 29) and after long-term follow-up (median 11 years) ( = 24). Results were compared to healthy subjects.
Untreated patients had increased body cell mass (113 ± 9% of predicted) and ECW (110 ± 20%) and decreased BF (67 ± 7.6%). At one-year follow-up, serum concentration of IGF-I was reduced and body composition had normalized. At baseline, isometric muscle strength in knee flexors and extensors was normal and concentric strength was modestly increased whereas grip strength and endurance was reduced. After one year, muscle strength was normal in both patients with still active disease and patients in remission. At long-term follow-up, all patients were in remission. Most muscle function tests remained normal, but isometric flexion and the fatigue index were increased to 153 ± 42% and 139 ± 28% of predicted values, respectively.
Patients with untreated acromegaly had increased body cell mass and normal or modestly increased proximal muscle strength, whereas their grip strength was reduced. After biochemical improvement and remission, body composition was normalized, hand grip strength was increased, whereas proximal muscle fatigue increased.
肢端肥大症患者的体脂（BF）减少，细胞外液（ECW）和肌肉量增加。尽管缺乏对肌肉功能的系统研究，但人们认为尽管肌肉量增加，肢端肥大症患者仍可能患有近端肌肉无力。我们研究了未经治疗的肢端肥大症和生化缓解后的身体成分和肌肉功能。
前瞻性观察研究。
肢端肥大症患者在诊断时（= 48），手术后 1 年（= 29）和长期随访后（中位数 11 年）（= 24）进行肌肉力量（测力计）和身体成分（四室模型）测量。将结果与健康受试者进行比较。
未经治疗的患者细胞内液量（113 ± 9%预测值）和 ECW（110 ± 20%）增加，体脂减少（67 ± 7.6%）。在一年随访时，IGF-I 血清浓度降低，身体成分正常化。基线时，膝关节屈肌和伸肌的等长肌肉力量正常，等速力量适度增加，而握力和耐力降低。一年后，仍处于活动期疾病和缓解期的患者的肌肉力量正常。在长期随访中，所有患者均处于缓解期。大多数肌肉功能测试仍正常，但等长屈曲和疲劳指数分别增加到 153 ± 42%和 139 ± 28%预测值。
未经治疗的肢端肥大症患者细胞内液量增加，近端肌肉力量正常或适度增加，而握力降低。生化改善和缓解后，身体成分正常化，手握力增加，而近端肌肉疲劳增加。
