Effects of Testosterone on Muscle Strength, Physical Function, Body Composition, and Quality of Life in Intermediate-Frail and Frail Elderly Men: A Randomized, Double-Blind, Placebo-Controlled Study

被引:462
作者
Srinivas-Shankar, Upendram
Roberts, Stephen A. [2 ]
Connolly, Martin J. [4 ]
Connell, Matthew D. L. O'
Adams, Judith E.
Oldham, Jackie A. [3 ]
Wu, Frederick C. W. [1 ]
机构
[1] Univ Manchester, Manchester Royal Infirm, Dept Med & Endocrinol, Androl Res Unit, Manchester M13 9WL, Lancs, England
[2] Univ Manchester, Hlth Methodol Res Grp, Manchester M13 9WL, Lancs, England
[3] Univ Manchester, Ctr Rehabil Sci, Manchester M13 9WL, Lancs, England
[4] Univ Auckland, Freemasons Dept Geriatr Med, Auckland 1142, New Zealand
关键词
SEX-HORMONE LEVELS; OLDER MEN; GROWTH-HORMONE; SERUM TESTOSTERONE; FAT MASS; PERFORMANCE; IMPROVES; SUPPLEMENTATION; RESISTANCE; MOBILITY;
D O I
10.1210/jc.2009-1251
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Context: Physical frailty is associated with reduced muscle strength, impaired physical function, and quality of life. Testosterone (T) increases muscle mass and strength in hypogonadal patients. It is unclear whether T has similar effects in intermediate-frail and frail elderly men with low to borderline-low T. Objective: Our objective was to determine the effects of 6 months T treatment in intermediate-frail and frail elderly men, on muscle mass and strength, physical function, and quality of life. Design and Setting: We conducted a randomized, double-blind, placebo-controlled, parallel-group, single-center study. Participants: Participants were community-dwelling intermediate-frail and frail elderly men at least 65 yr of age with a total T at or below 12 nmol/liter or free T at or below 250 pmol/liter. Methods: Two hundred seventy-four participants were randomized to transdermal T (50 mg/d) or placebo gel for 6 months. Outcome measures included muscle strength, lean and fat mass, physical function, and self-reported quality of life. Results: Isometric knee extension peak torque improved in the T group ( vs. placebo at 6 months), adjusted difference was 8.6 (95% confidence interval, 1.3-16.0; P = 0.02) Newton-meters. Lean body mass increased and fat mass decreased significantly in the T group by 1.08 +/- 1.8 and 0.9 +/- 1.6 kg, respectively. Physical function improved among older and frailer men. Somatic and sexual symptom scores decreased with T treatment; adjusted difference was -1.2 (-2.4 to -0.04) and -1.3 (-2.5 to -0.2), respectively. Conclusions: T treatment in intermediate-frail and frail elderly men with low to borderline-low T for 6 months may prevent age-associated loss of lower limb muscle strength and improve body composition, quality of life, and physical function. Further investigations are warranted to extend these results. ( J Clin Endocrinol Metab 95: 639- 50, 2010)
引用
收藏
页码:639 / 650
页数:12
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