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Muscle strength in patients with acromegaly at diagnosis and during long-term follow-up

Journal article
Authors Laila Fuchtbauer
Daniel S Olsson
Bengt-Åke Bengtsson
L. L. Norrman
Katharina S Sunnerhagen
Gudmundur Johannsson
Published in European Journal of Endocrinology
Volume 177
Issue 2
Pages 217-226
ISSN 0804-4643
Publication year 2017
Published at Institute of Neuroscience and Physiology, Department of Clinical Neuroscience
Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
Pages 217-226
Language en
Links dx.doi.org/10.1530/eje-17-0120
Keywords quality-of-life, gh-deficient adults, growth-hormone replacement, body-composition, skeletal-muscle, resistance exercise, grip strength, performance, men, adenomectomy, Endocrinology & Metabolism
Subject categories Neuroscience

Abstract

Objective: 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. Methods: Patients with acromegaly underwent measurements of muscle strength (dynamometers) and body composition (four-compartment model) at diagnosis (n = 48), 1 year after surgery (n = 29) and after long-term follow-up (median 11 years) (n = 24). Results were compared to healthy subjects. Results: 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. Conclusions: 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.

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