Body Composition in Acromegaly According to Disease Activity – Performance of Dual X-Ray Absorptiometry and Multifrequency Bioelectrical Impedance Analysis

Abstract

Introductionthe present study aims to evaluate body composition and its relationship with hormonal control in acromegaly, also comparing the performance of Bioelectrical impedance analysis (BIA), a more accessible method, with dual X-ray absorptiometry (DXA), technology frequently used in current studies. Methodswe studied 28 patients (78% female) of whom 13 with active disease, mean age was 52.11 ± 12.53 years; 64% had high blood pressure (HBP) and 50% had type 2 diabetes (T2D).ResultsAlthough patients with controlled disease had lower serum GH (1.2 ± 1.68µg/L vs 6.61 ± 6.40µg/L, p=0.001) and IGF-1 (158.89 ± 54.53ng/mL and 503.31 ± 253.25ng/mL, p<0.001), they did not differ in body composition: percentage of fat mass: 36.13 ± 11.84% vs 37.73 ± 8.76%, p=0.691 for BIA and 37.10 ± 10.21% vs 37.89 ± 7.32%, p=0.819 for DXA; muscle mass parameters, BIA: FFMI 18.68 ± 2.38kg/m2vs 19.14 ± 1.59kg/m2, p=0.560; SMI 10.17 ± 1.39kg/m2vs 10.53 ± 1.01kg/m2, p=0.438; DXA: Baumgartner 7.99 ± 1.43kg/m2vs 8.02 ± 1.24kg/m2, p=0.947, respectively for controlled and active disease. Patients with controlled acromegaly had lower fasting glucose (110.33 ± 55.48mg/dL vs 129.77 ± 40.17mg/dL, p=0.033) and were less likely to have persistent T2D (28.6 vs 71.4%, p=0.008) and HBP (38.9 vs 61.1%, p=0.049). There were strong positive correlations between BIA and DXA for fat mass (r=0.929, p<0.001) and muscle mass parameters: SMI X Baumgartner: r=0.890, p<0.001; and FFMI X Baumgartner: r=0.868, p<0.001.Conclusionour data showed similar results in body composition assessment by BIA and DXA, with good correlation between the methods, regardless of the hormonal status of acromegaly. Furthermore, in patients with adequate hormonal control, there was preservation of muscle mass and a lower prevalence of metabolic comorbidities, such as T2D and HBP.

Bioimpedance and Dual-Energy X-ray Absorptiometry Are Not Equivalent Technologies: Comparing Fat Mass and Fat-Free Mass

“…In addition, for conclusive statements to be made about the accuracy and usefulness of BIA, studies would need to assess its reliability/repeatability and would need to compare it with other criterion measures, such as MRI or CT, or direct measures such as total body water or total body counting and neuron activation. In conclusion, although BIA technology has greatly improved during the last years, has become evident that further studies are needed with regard to this medical technology to demonstrate its effectiveness compared to other commonly used methods [ 32 ]. Some limitations should be assumed, such as the sample population’s reduced dimension and inhomogeneity, mainly in the sex distribution; also the cross-sectional design did not allow prospective body composition comparisons.…”

An Overview of Cardiovascular Risk in Pituitary Disorders

“…No differences have been detected in body composition between controlled and not controlled acromegalics by the means of bioimpedance or dual-energy X-ray absorptiometry (DEXA) analysis [54,55]. Interestingly, a type of lipodystrophy with reduced adipose mass centrally and intrahepatic lipid and a shift of excess lipid to intramuscular adipose tissue has been observed [55].…”