Functional evaluation of the joints in acromegalic patients and associated factors

Abstract

Objective: This study aims to evaluate the presence of arthropathy in the large peripheral joints most commonly affected in acromegaly and to classify the severity according to the functional assessment of each joint to identify any factor that could predict the development of arthropathy and its level of severity. Seventy-one acromegalic patients were interviewed and underwent a physical examination of the knees, hips, and shoulders to identify the presence of arthropathy. The disease was functionally classified as more severe or less severe, according to a specific functional scale. We studied 21 males (29.5 %) and 50 females (70.5 %) with a mean age of 49.5± 14.5 years. Arthropathy in the studied joints was observed in 40 patients (prevalence of 56 %), and a statistically significant association with the presence of arthropathy was observed for three of the evaluated factors: increased body mass index (BMI), older age at diagnosis of acromegaly, and female gender. There was no association with disease control or other factors related to acromegaly. We classified 19 patients as having more functionally severe arthropathy and identified two factors associated with its development: increased BMI and lower levels of insulin-like growth factor type I. The relationship of factors such as female sex and BMI, which are also related to osteoarthritis, with arthropathy in acromegalic patients suggested a high prevalence of irreversible joint disease present at diagnosis of acromegaly. We highlight the BMI, which was associated with either the presence of arthropathy or more severe arthropathy, which demonstrates the importance of body weight control in the management of acromegalic patients.