Milioto Angelo, Corica Giuliana, Nista Federica, Wildemberg Luiz Eduardo Armondi, Rossi Federica, Bignotti Bianca, Gadelha Mônica R, Ferone Diego, Tagliafico Alberto Stefano, Gatto Federico
Endocrinology Unit, Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, Genoa 16138, Italy.
Neuroendocrinology Research Center/Endocrinology Division, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-913, Brazil.
J Endocr Soc. 2024 Feb 18;8(4):bvae032. doi: 10.1210/jendso/bvae032. eCollection 2024 Feb 19.
Patients with acromegaly are characterized by chronic exposure to high growth hormone (GH) and insulin-like growth factor-1 levels, known for their anabolic effect on skeletal muscle. Therefore, an increased skeletal muscle mass could be hypothesized in these individuals. Herein, we have performed a systematic revision of published evidence regarding skeletal muscle mass, quality, and performance in patients with acromegaly.
A systematic review of the literature in the PubMed database up to September 1, 2023, was conducted with the following query: acromegaly AND ("muscle mass" OR "skeletal muscle"). We excluded studies that did not compare different disease states or used nonradiological methods for the skeletal muscle analyses, except for bioelectrical impedance analysis.
Fifteen studies met the inclusion criteria. A total of 360 patients were evaluated for skeletal muscle mass, 122 for muscle fatty atrophy, and 192 for muscle performance. No clear evidence of increased skeletal muscle mass in patients with active disease compared to control or healthy individuals emerged. As for skeletal muscle quality, we observed a trend toward higher fatty infiltration among patients with acromegaly compared to healthy participants. Likewise, patients with active disease showed consistently worse physical performance compared to control or healthy individuals.
Skeletal muscle in acromegaly has lower quality and performance compared to that of healthy individuals. The small number of published studies and multiple confounding factors (eg, use of different radiological techniques) contributed to mixed results, especially regarding skeletal muscle mass. Well-designed prospective studies are needed to investigate skeletal muscle mass in patients with acromegaly.
肢端肥大症患者的特征是长期暴露于高水平的生长激素（GH）和胰岛素样生长因子-1，它们对骨骼肌具有合成代谢作用。因此，可以推测这些个体的骨骼肌质量会增加。在此，我们对已发表的关于肢端肥大症患者骨骼肌质量、质量和功能的证据进行了系统综述。
截至2023年9月1日，在PubMed数据库中对文献进行了系统综述，查询如下：肢端肥大症AND（“肌肉质量”或“骨骼肌”）。我们排除了未比较不同疾病状态或使用非放射学方法进行骨骼肌分析的研究，但生物电阻抗分析除外。
15项研究符合纳入标准。共评估了360例患者的骨骼肌质量，122例患者的肌肉脂肪萎缩情况，以及192例患者的肌肉功能。与对照组或健康个体相比，未发现活动期疾病患者骨骼肌质量增加的明确证据。至于骨骼肌质量，我们观察到与健康参与者相比，肢端肥大症患者的脂肪浸润有增加的趋势。同样，与对照组或健康个体相比，活动期疾病患者的身体功能始终较差。
与健康个体相比，肢端肥大症患者的骨骼肌质量和功能较低。已发表研究数量较少以及多种混杂因素（例如，使用不同的放射学技术）导致结果不一，尤其是在骨骼肌质量方面。需要设计良好的前瞻性研究来调查肢端肥大症患者的骨骼肌质量。
