Effects of testosterone and progressive resistance training in eugonadal men with AIDS wasting - A randomized, controlled trial

Background: Substantial loss of muscle mass occurs among men with AIDS wasting. Objective: To investigate the independent effects of testosterone therapy and progressive resistance training in eugonadal men with AIDS wasting. Design: Randomized, controlled trial. Setting: University hospital. Patients: 54 eugonadal men with AIDS wasting (weight < 90% ideal body weight or weight loss > 10%). Intervention: In a 2 x 2 factorial design, patients were assigned to receive testosterone enanthate (200 mg/wk) or placebo injections and progressive resistance training (three times weekly) or no training for 12 weeks. Measurements: Cross-sectional muscle area and other indices of muscle mass. Results: Cross-sectional muscle area increased in response to training compared with nontraining (change in arm muscle mass, 499 +/- 349 mm(2) vs. 206 +/- 264 mm(2) [P = 0.004]; change in leg muscle mass, 1106 +/- 854 mm(2) vs. 523 +/- 872 mm(2) [P = 0.045]) and in response to testosterone therapy compared with placebo (change in arm muscle mass, 512 +/- 371 mm(2) vs. 194 +/- 215 mm(2) [P < 0.001]; change in leg muscle mass, 1236 +/- 881 mm(2) vs. 399 +/- 729 mm(2) [P = 0.002]). Levels of high-density lipoprotein cholesterol decreased in response to testosterone therapy compared with placebo (-0.03 +/- 0.13 mmol/L vs. 0.05 +/- 0.13 mmol/L [-1 +/- 5 mg/dL vs. 2 +/- 5 mg/dL]; P = 0.011) and increased in response to training compared with nontraining (0.05 +/- 0.13 mmol/L vs. 0.00 +/- 0.16 mmol/L [2 +/- 5 mg/dL vs. 0 +/- 6 mg/dL]; P = 0.052). Conclusions: In contrast to anabolic therapies that may have adverse effects on metabolic variables, supervised exercise effectively increases muscle mass and is associated with significant positive health benefits in eugonadal men with AIDS wasting.