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Ultrasound-based detection of glucocorticoid-induced impairments of muscle mass and structure in Cushing’s disease

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Abstract

Purpose

To investigate the glucocorticoid-induced impairments of muscle mass and structure in patients presenting different stages of steroid myopathy progression.

Methods

Thirty-three patients (28 women) affected by active (N = 20) and remitted (N = 13) Cushing’s disease were recruited and the following variables were assessed: walking speed, handgrip strength, total body and appendicular muscle mass by bioelectrical impedance analysis (BIA), thickness and echo intensity of lower limb muscles by ultrasonography.

Results

The two groups of patients showed comparable values of both handgrip strength [median (interquartile range) values: active disease: 27.4 (7.5) kg vs. remitted disease: 26.4 (9.4) kg; P = 0.58] and walking speed [active disease: 1.0 (0.2) m/s vs. remitted disease: 1.1 (0.3) m/s; P = 0.43]. Also, the thickness of the four muscles and all BIA-derived sarcopenic indices were comparable (P > 0.05 for all comparisons) between the two groups. On the contrary, the echo intensity of vastus lateralis, tibialis anterior (lower portion), and medial gastrocnemius was significantly (P < 0.05 for all comparisons) higher in patients with active disease compared to patients with remitted disease. Finally, significant negative correlations were found in the whole group of patients between muscle echo intensity and muscle function assessments.

Conclusions

We provided preliminary evidence that the ultrasound-derived measurements of muscle thickness and echo intensity can be useful to detect and track the changes of muscle mass and structure in patients with steroid myopathy and we suggest that the combined assessment of muscle mass, strength, and performance should be systematically applied in the routine examination of steroid myopathy patients.

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Authors and Affiliations

  1. Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy

    M. A. Minetto & N. E. Gorji

  2. Division of Physical Medicine and Rehabilitation, Department of Surgical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy

    M. A. Minetto

  3. Biolab, Department of Electronics and Telecommunications, Polytechnic University of Turin, Turin, Italy

    C. Caresio, M. Salvi & F. Molinari

  4. Oncological Endocrinology Unit, Department of Medical Sciences, University of Turin, Turin, Italy

    V. D’Angelo & E. Arvat

  5. Clinic of Endocrinology and Metabolic Diseases, Ospedali Riuniti di Ancona University Hospital, Ancona, Italy

    G. Arnaldi

  6. Department of Translational Neurosciences and Neurotherapeutics, John Wayne Cancer Institute and Pacific Neuroscience Institute, Santa Monica, CA, USA

    S. Kesari

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  1. M. A. Minetto
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  2. C. Caresio
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  3. M. Salvi
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  4. V. D’Angelo
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  7. G. Arnaldi
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  9. E. Arvat
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Correspondence to M. A. Minetto.

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The authors have no conflict of interest to disclosure.

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The study was approved by the local ethics committee. The study conformed with the guidelines in the Declaration of Helsinki and was approved by the local ethics committee.

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All patients received a detailed explanation of the study and gave written informed consent prior to participation.

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Minetto, M.A., Caresio, C., Salvi, M. et al. Ultrasound-based detection of glucocorticoid-induced impairments of muscle mass and structure in Cushing’s disease. J Endocrinol Invest 42, 757–768 (2019). https://doi.org/10.1007/s40618-018-0979-9

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  • DOI: https://doi.org/10.1007/s40618-018-0979-9

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