Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Emniyet Street, Yenimahalle, Ankara, 06100, Turkey.
Department of Radiology, Faculty of Medicine, Gazi University, Ankara, 06100, Turkey.
Pituitary. 2023 Dec;26(6):716-724. doi: 10.1007/s11102-023-01352-1. Epub 2023 Oct 30.
The effects of acromegaly on soft tissues, bones and joints are well-documented, but information on its effects on muscle mass and quality remains limited. The primary goal of this study is to assess the sonoelastographic features of forearm muscles in patients with acromegaly.
Forty-five patients with acromegaly and 45 healthy controls similar in terms of gender, age, and body mass index (BMI) were included in a single-center, multidisciplinary, cross-sectional study. The body composition was analyzed using bioelectrical impedance analysis (BIA), and height-adjusted appendicular skeletal muscle index (hSMI) was calculated. The dominant hand's grip strength was also measured. Two radiologists specialized in the musculoskeletal system employed ultrasound shear wave elastography (SWE) to assess the thickness and stiffness of brachioradialis and biceps brachii muscles.
The acromegaly group had significantly higher thickness of both the biceps brachii (p = 0.034) and brachioradialis muscle (p = 0.046) than the control group. However, the stiffness of the biceps brachii (p = 0.001) and brachioradialis muscle (p = 0.001) was lower in the acromegaly group than in the control group. Disease activity has not caused a significant difference in muscle thickness and stiffness in the acromegaly group (p > 0.05). The acromegaly group had a higher hSMI (p = 0.004) than the control group. The hand grip strength was similar between the acromegaly and control group (p = 0.594).
The patients with acromegaly have an increased muscle thickness but decreased muscle stiffness in the forearm muscles responsible for elbow flexion. Acromegaly can lead to a permanent deterioration of the muscular structure regardless of the disease activity.
肢端肥大症对软组织、骨骼和关节的影响已有充分的文献记载，但关于其对肌肉质量和功能的影响的信息仍然有限。本研究的主要目的是评估肢端肥大症患者前臂肌肉的超声弹性特征。
纳入了一项单中心、多学科、横断面研究中的 45 例肢端肥大症患者和 45 名性别、年龄和体重指数（BMI）与之相匹配的健康对照者。使用生物电阻抗分析（BIA）分析身体成分，并计算身高调整后的四肢骨骼肌指数（hSMI）。还测量了优势手的握力。两位专门从事肌肉骨骼系统的放射科医生使用超声剪切波弹性成像（SWE）评估肱二头肌和肱桡肌的厚度和硬度。
肢端肥大症组的肱二头肌（p=0.034）和肱桡肌（p=0.046）厚度明显大于对照组。然而，肱二头肌（p=0.001）和肱桡肌（p=0.001）的硬度在肢端肥大症组中低于对照组。疾病活动并未导致肢端肥大症组肌肉厚度和硬度出现显著差异（p＞0.05）。肢端肥大症组的 hSMI 高于对照组（p=0.004）。肢端肥大症组和对照组的手握力相似（p=0.594）。
患有肢端肥大症的患者在前臂负责肘屈的肌肉中出现肌肉厚度增加但肌肉硬度降低。无论疾病活动如何，肢端肥大症都会导致肌肉结构的永久性恶化。
