Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, Genoa, 16132, Italy.
Endocrinology Unit, Department of Internal Medicine and Medical Specialties (DIMI), Centre of Excellence for Biomedical Research (CEBR), University of Genova, Genoa, Italy.
Pituitary. 2024 Oct;27(5):507-517. doi: 10.1007/s11102-024-01422-y. Epub 2024 Jul 5.
The impact of GH/IGF-1 levels on skeletal muscle in acromegaly is still controversial. Temporal (TMT) and masseter muscle (MMT) thickness has been recently demonstrated as a reliable measure of muscle mass. We aimed to investigate the relationship between TMT, MMT and clinical/biochemical characteristics in patients with acromegaly.
Single center retrospective longitudinal study including 69 patients with at least one available brain/sella turcica MRI and matched clinical data. TMT, MMT, and muscle fatty infiltration (modified Goutallier score) were evaluated in all patients at baseline (first available MRI) and over time (182 MRIs analyzed).
At baseline, both TMT and MMT were higher in males than females (p = 0.001 and p = 0.016, respectively). TMT and MMT were positively associated (β 0.508, p < 0.001), and they were positively correlated with IGF-1 xULN (TMT, p = 0.047; MMT, p = 0.001). MMT had a positive correlation with patients' weight (p = 0.015) and height (p = 0.006). No correlation was found between TMT, MMT and the presence of hypogonadism. Considering all available MRIs, sex and IGF-1 xULN were significant determinants of TMT and MMT at multivariable analysis (female sex: β -0.345/-0.426, p < 0.001; IGF-1 xULN: β 0.257/0.328, p < 0.001). At longitudinal evaluation, uncontrolled patients at baseline showed a significant reduction of MMT over time (p = 0.044). Remarkable fatty infiltration was observed in 34-37% of MRIs; age was the main determinant (temporal muscle: OR 1.665; p = 0.013; masseter muscle: OR 1.793; p = 0.009).
Male patients with higher IGF-1 values have thicker temporal and masseter muscles, suggesting that sex and IGF-1 have a significant impact on muscle mass in acromegaly.
生长激素/胰岛素样生长因子-1（GH/IGF-1）水平对肢端肥大症患者骨骼肌的影响仍存在争议。颞肌（TMT）和咬肌（MMT）厚度最近被证明是肌肉质量的可靠测量指标。我们旨在研究肢端肥大症患者的 TMT、MMT 与临床/生化特征之间的关系。
本研究为单中心回顾性纵向研究，纳入了 69 例至少有一次脑/蝶鞍 MRI 及匹配临床数据的患者。所有患者在基线（首次获得 MRI 时）和随访时（共分析了 182 次 MRI）评估 TMT、MMT 和肌肉脂肪浸润（改良 Goutallier 评分）。
基线时，男性的 TMT 和 MMT 均高于女性（p=0.001 和 p=0.016）。TMT 和 MMT 呈正相关（β=0.508，p<0.001），且与 IGF-1 xULN 呈正相关（TMT，p=0.047；MMT，p=0.001）。MMT 与患者的体重（p=0.015）和身高（p=0.006）呈正相关。TMT 和 MMT 与性腺功能减退的发生无相关性。在考虑所有可用 MRI 时，性别和 IGF-1 xULN 是多变量分析中 TMT 和 MMT 的显著决定因素（女性：β-0.345/-0.426，p<0.001；IGF-1 xULN：β=0.257/0.328，p<0.001）。在纵向评估中，基线时未控制的患者 MMT 随时间显著下降（p=0.044）。34%-37%的 MRI 中可见明显的脂肪浸润；年龄是主要决定因素（颞肌：OR 1.665；p=0.013；咬肌：OR 1.793；p=0.009）。
IGF-1 水平较高的男性肢端肥大症患者颞肌和咬肌较厚，提示性别和 IGF-1 对肢端肥大症患者的肌肉质量有显著影响。
