Sarcopenic obesity and physical function in acromegaly: impact of disease control and evaluation using dual X-ray absorptiometry and multifrequency bioelectrical impedance analysis.

Purpose: To assess sarcopenia, sarcopenic obesity, physical performance in patients with acromegaly and compare the diagnostic performance of dual-energy X-ray absorptiometry (DXA) and multifrequency bioelectrical impedance analysis (BIA).

Methods: This cross-sectional study included 27 patients with acromegaly and 27 age-, sex-, and BMI-matched patients without acromegaly. Body composition was assessed using BIA and DXA. Lean mass indices included fat-free mass index (FFMI) and skeletal muscle index (SMI) via BIA, and the Baumgartner (BMG) and Foundation for the National Institutes of Health indices via DXA. Obesity parameters included fat mass index (FMI) and body fat percentage via BIA. Physical performance was evaluated using handgrip strength (HGS), Timed Up and Go (TUG), 4-m gait speed (4MGS), and the Short Physical Performance Battery (SPPB) tests. The strength, assistance in walking, rising from a chair, climbing stair and falls (SARC-F) questionnaire was also performed.

Results: Strong correlations were observed between BIA and DXA body composition measures (r = 0.83, p < 0.01 for %BIA fat mass vs. %DXA fat mass; r = 0.80, p < 0.01 for SMI vs. BMG and r = 0.80, p < 0.01 for FFMI vs. BMG). Patients with acromegaly had significantly higher FFMI than patients without the disease (p = 0.03), but no difference in sarcopenic obesity prevalence (p = 0.50). Patients with acromegaly performed worse in the TUG and 4MGS tests, even after adjustment for confounders (p < 0.01 for both). No significant associations were found between SARC-F scores and lean mass or physical performance.

Conclusion: Patients with acromegaly showed impaired physical performance despite higher FFMI, with no differences in sarcopenic obesity. The SARC-F questionnaire showed limited diagnostic value in this population.