1
|
Bhasin S, Thompson IM. Prostate Risk and Monitoring During Testosterone Replacement Therapy. J Clin Endocrinol Metab 2024; 109:1975-1983. [PMID: 38753865 DOI: 10.1210/clinem/dgae334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 05/09/2024] [Accepted: 05/13/2024] [Indexed: 05/18/2024]
Abstract
ABSTRACT Men with hypogonadism have reduced risk of prostate cancer mortality; whether testosterone treatment increases the risk of prostate safety events in men with hypogonadism remains controversial. Several studies including 4 larger randomized trials-the Testosterone Trials, TEstosterone and Atherosclerosis Progression in Aging Men (TEAAM) trial, Testosterone for Diabetes Mellitus trial, and Testosterone Replacement therapy for Assessment of long-term Vascular Events and efficacy ResponSE in hypogonadal men (TRAVERSE) trial-treated men with testosterone or placebo for 1 year or longer and reported prospectively ascertained prostate safety data. The TRAVERSE Trial, because of its large size, longer duration, and adjudication of prostate events, has provided comprehensive data on the risk of adverse prostate events during testosterone replacement therapy (TRT). Among men with hypogonadism, carefully screened to exclude those at high risk of prostate cancer, the incidences of high-grade or any prostate cancer, acute urinary retention, surgical procedure for benign prostatic hyperplasia, prostate biopsy, or new pharmacologic therapy for lower urinary tract symptoms were low and did not differ between the testosterone and placebo groups. Testosterone did not worsen lower urinary tract symptoms. TRT was associated with a greater increase in prostate-specific antigen than placebo in the first year of treatment. CONCLUSION Testosterone treatment of men with hypogonadism, screened to exclude those at high risk of prostate cancer, is associated with low risk of adverse prostate events. Baseline evaluation of prostate cancer risk and a standardized monitoring plan can minimize the risk of unnecessary prostate biopsy while enabling the detection of high-grade prostate cancers in men receiving TRT.
Collapse
Affiliation(s)
- Shalender Bhasin
- Research Program in Men's Health: Aging and Metabolism, Boston Claude D. Pepper Older Americans Independence Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Ian M Thompson
- Department of Urology, CHRISTUS Santa Rosa Health System and The University of Texas Health Science Center, San Antonio, TX 78229, USA
| |
Collapse
|
2
|
Choi S, Chon J, Yoo MC, Shim GY, Kim M, Soh Y, Won CW. The Association of Free Testosterone with Sarcopenic Obesity in Community-Dwelling Older Men: A Cross-Sectional Study. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:754. [PMID: 38792937 PMCID: PMC11123342 DOI: 10.3390/medicina60050754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 04/27/2024] [Accepted: 04/30/2024] [Indexed: 05/26/2024]
Abstract
Background and Objectives: Sarcopenic obesity, a clinical condition coexisting with obesity and sarcopenia, is associated with a high risk of functional impairment, reduced quality of life, and increased mortality. A decline in age-related free testosterone (FT) levels has been reported to be associated with decreased muscle mass and muscle strength and increased fat mass. However, the association between low FT levels and risk of sarcopenic obesity has not been well studied. This study aimed to investigate the direct association between low FT levels and sarcopenic obesity. Materials and Methods: This cross-sectional study used data of 982 community-dwelling men aged 70-84 years from the Korean Frailty and Aging Cohort Study. Sarcopenia was defined according to the criteria of the Asian Group for Sarcopenia (AWGS) 2019. Obesity was defined as a body fat mass ≥28.3%. Participants who met both sarcopenia and obesity criteria were defined as having sarcopenic obesity. Low FT levels were defined as FT levels <17.35 pmol/L according to the Endocrine Society Clinical Practice Guidelines. Results: The prevalence of sarcopenia, obesity, and sarcopenic obesity was significantly higher in the low-FT group than in the normal-FT group. Low FT levels were significantly associated with a higher risk of obesity (odds ratio [OR], 2.09, 95% confidence interval [CI], 1.11-3.92), sarcopenia (2.57, 95% CI 1.08-6.10), and sarcopenic obesity (3.66, 95% CI 1.58-8.47) compared with the healthy control group. The risk of low appendicular skeletal muscle mass index (ASMI) (1.78, 95% CI 1.04-3.02) and high fat mass (1.92, 95% CI 1.12-3.31) was significantly higher in the low-FT group than in the normal-FT group. Conclusions: This study showed that low FT levels were associated with a higher risk of sarcopenic obesity. Low FT levels were mainly related to body composition parameters such as low ASMI and high fat mass.
Collapse
Affiliation(s)
- Seongmin Choi
- Department of Physical Medicine and Rehabilitation Medicine, Kyung Hee University Medical Center, Seoul 02477, Republic of Korea; (S.C.); (J.C.); (M.C.Y.); (G.Y.S.)
- Department of Physical Medicine and Rehabilitation, Graduate School, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Jinmann Chon
- Department of Physical Medicine and Rehabilitation Medicine, Kyung Hee University Medical Center, Seoul 02477, Republic of Korea; (S.C.); (J.C.); (M.C.Y.); (G.Y.S.)
| | - Myung Chul Yoo
- Department of Physical Medicine and Rehabilitation Medicine, Kyung Hee University Medical Center, Seoul 02477, Republic of Korea; (S.C.); (J.C.); (M.C.Y.); (G.Y.S.)
| | - Ga Yang Shim
- Department of Physical Medicine and Rehabilitation Medicine, Kyung Hee University Medical Center, Seoul 02477, Republic of Korea; (S.C.); (J.C.); (M.C.Y.); (G.Y.S.)
| | - Miji Kim
- Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul 02447, Republic of Korea;
| | - Yunsoo Soh
- Department of Physical Medicine and Rehabilitation Medicine, Kyung Hee University Medical Center, Seoul 02477, Republic of Korea; (S.C.); (J.C.); (M.C.Y.); (G.Y.S.)
| | - Chang Won Won
- Department of Family Medicine, Kyung Hee University Medical Center, Seoul 02447, Republic of Korea
| |
Collapse
|
3
|
Green DJ, Chasland LC, Yeap BB, Naylor LH. Comparing the Impacts of Testosterone and Exercise on Lean Body Mass, Strength and Aerobic Fitness in Aging Men. SPORTS MEDICINE - OPEN 2024; 10:30. [PMID: 38563849 PMCID: PMC10987448 DOI: 10.1186/s40798-024-00703-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 03/20/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Based on the largely untested premise that it is a restorative hormone that may reverse the detrimental impacts of aging, prescription of testosterone (T) has increased in recent decades despite no new clinical indications. It is apparent that middle-aged and older men with low-normal serum T levels are considering T supplementation as an anti-aging strategy. At the same time, there is evidence that physical activity (PA) is at historical lows in the Western world. In this review, we compare the impacts of T treatment aimed at achieving physiological T concentrations in middle-aged and older men, alongside the impacts of ecologically relevant forms of exercise training. The independent, and possible combined, effects of T and exercise therapy on physiological outcomes such as aerobic fitness, body composition and muscular strength are addressed. MAIN BODY Our findings suggest that both T treatment and exercise improve lean body mass in healthy older men. If improvement in lean body mass is the primary aim, then T treatment could be considered, and the combination of T and exercise may be more beneficial than either in isolation. In terms of muscle strength in older age, an exercise program is likely to be more beneficial than T treatment (where the dose is aimed at achieving physiological concentrations), and the addition of such T treatment does not provide further benefit beyond that of exercise alone. For aerobic fitness, T at doses aimed at achieving physiological concentrations has relatively modest impacts, particularly in comparison to exercise training, and there is limited evidence as to additive effects. Whilst higher doses of T, particularly by intramuscular injection, may have larger impacts on lean body mass and strength, this must be balanced against potential risks. CONCLUSION Knowing the impacts of T treatment and exercise on variables such as body composition, strength and aerobic fitness extends our understanding of the relative benefits of physiological and pharmacological interventions in aging men. Our review suggests that T has impacts on strength, body composition and aerobic fitness outcomes that are dependent upon dose, route of administration, and formulation. T treatment aimed at achieving physiological T concentrations in middle-aged and older men can improve lean body mass, whilst exercise training enhances lean body mass, aerobic fitness and strength. Men who are physically able to exercise safely should be encouraged to do so, not only in terms of building lean body mass, strength and aerobic fitness, but for the myriad health benefits that exercise training confers.
Collapse
Affiliation(s)
- Daniel J Green
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, 6009, Australia.
| | - Lauren C Chasland
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, 6009, Australia
- Allied Health Department, Fiona Stanley Hospital, Perth, WA, Australia
| | - Bu B Yeap
- Medical School, University of Western Australia, Perth, WA, Australia
- Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, WA, Australia
| | - Louise H Naylor
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, 6009, Australia
- Allied Health Department, Fiona Stanley Hospital, Perth, WA, Australia
| |
Collapse
|
4
|
Wang J, Bai J, Wang H, Xu G, Yao R, Li J, Zhang W, Wang H, Yao J, Ren X. Relationship between skeletal muscle index at the third lumbar vertebra with infection risk and long-term prognosis in patients with acute-on-chronic liver failure. Front Nutr 2024; 10:1327832. [PMID: 38268672 PMCID: PMC10806060 DOI: 10.3389/fnut.2023.1327832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 12/19/2023] [Indexed: 01/26/2024] Open
Abstract
Objective Infection is a major cause of increased mortality in patients with acute-on-chronic liver failure (ACLF). This study aims to examine the potential correlation of the skeletal muscle index at the third lumbar vertebra (L3-SMI) with infections among ACLF patients and to evaluate its impact on the long-term survival. Methods This retrospective study included 126 patients who underwent abdominal computed tomography (CT) and were diagnosed with ACLF at our center between December 2017 and December 2021. L3-SMI was calculated using CT, and the clinical and biochemical data as well as MELD scores were also collected, so as to analyze the relationship between L3-SMI and infections in ACLF patients and the impact on long-term prognosis. Results Of the 126 ACLF patients enrolled, 50 had infections. In the multivariate logistic regression analysis, both L3-SMI [odds ratio (OR) = 0.89, 95% confidence interval (CI) = 0.81 - 0.97, P = 0.011] and hepatic encephalopathy (OR = 8.20, 95% CI = 1.70 - 39.59, P = 0.009) were independently associated with the risk of infection development. The overall survival (OS) estimates were obtained using Kaplan-Meier curves, and it was found that patients in the lowest tertile of L3-SMI had significantly lower 3-month, 6-month, 1-year, and 2-year survival rates than those in the highest tertile (P = 0.014; log-rank test). Conclusion Low L3-SMI is an independent risk factor for the development of infections and significantly influences the long-term survival in ACLF patients.
Collapse
Affiliation(s)
- Juan Wang
- Department of Gastroenterology, Third Hospital of Shanxi Medical University (Shanxi Bethune Hospital), Shanxi Medical University, Taiyuan, China
| | - Jinjia Bai
- Department of Gastroenterology, Third Hospital of Shanxi Medical University (Shanxi Bethune Hospital), Shanxi Medical University, Taiyuan, China
| | - Huimin Wang
- Endoscopy Center, Second Hospital of Shanxi Medical University, Shanxi Medical University, Taiyuan, China
| | - Guofen Xu
- Department of Gastroenterology, Jincheng General Hospital, Shanxi Medical University, Taiyuan, China
| | - Ruoyu Yao
- Department of Gastroenterology, Third Hospital of Shanxi Medical University (Shanxi Bethune Hospital), Shanxi Medical University, Taiyuan, China
| | - Jing Li
- Department of Gastroenterology, Third Hospital of Shanxi Medical University (Shanxi Bethune Hospital), Shanxi Medical University, Taiyuan, China
| | - Wenrui Zhang
- Department of Gastroenterology, Third Hospital of Shanxi Medical University (Shanxi Bethune Hospital), Shanxi Medical University, Taiyuan, China
| | - Han Wang
- Department of Gastroenterology, Third Hospital of Shanxi Medical University (Shanxi Bethune Hospital), Shanxi Medical University, Taiyuan, China
| | - Jia Yao
- Department of Gastroenterology, Third Hospital of Shanxi Medical University (Shanxi Bethune Hospital), Shanxi Medical University, Taiyuan, China
| | - Xiaojing Ren
- Department of Gastroenterology, Third Hospital of Shanxi Medical University (Shanxi Bethune Hospital), Shanxi Medical University, Taiyuan, China
| |
Collapse
|
5
|
Trumble BC, Pontzer H, Stieglitz J, Cummings DK, Wood B, Emery Thompson M, Raichlen D, Beheim B, Yetish G, Kaplan H, Gurven M. Energetic costs of testosterone in two subsistence populations. Am J Hum Biol 2023; 35:e23949. [PMID: 37365845 PMCID: PMC10749987 DOI: 10.1002/ajhb.23949] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/17/2023] [Accepted: 06/12/2023] [Indexed: 06/28/2023] Open
Abstract
OBJECTIVE Testosterone plays a role in mediating energetic trade-offs between growth, maintenance, and reproduction. Investments in a high testosterone phenotype trade-off against other functions, particularly survival-enhancing immune function and cellular repair; thus only individuals in good condition can maintain both a high testosterone phenotype and somatic maintenance. While these effects are observed in experimental manipulations, they are difficult to demonstrate in free-living animals, particularly in humans. We hypothesize that individuals with higher testosterone will have higher energetic expenditures than those with lower testosterone. METHODS Total energetic expenditure (TEE) was quantified using doubly labeled water in n = 40 Tsimane forager-horticulturalists (50% male, 18-87 years) and n = 11 Hadza hunter-gatherers (100% male, 18-65 years), two populations living subsistence lifestyles, high levels of physical activity, and high infectious burden. Urinary testosterone, TEE, body composition, and physical activity were measured to assess potential physical and behavioral costs associated with a high testosterone phenotype. RESULTS Endogenous male testosterone was significantly associated with energetic expenditure, controlling for fat free mass; a one standard deviation increase in testosterone is associated with the expenditure of an additional 96-240 calories per day. DISCUSSION These results suggest that a high testosterone phenotype, while beneficial for male reproduction, is also energetically expensive and likely only possible to maintain in healthy males in robust condition.
Collapse
Affiliation(s)
- Benjamin C Trumble
- School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona, USA
- Center for Evolution and Medicine, Arizona State University, Tempe, Arizona, USA
| | - Herman Pontzer
- Department of Evolutionary Anthropology, Duke University, Durham, North Carolina, USA
| | | | - Daniel K Cummings
- Department of Health Economics and Anthropology, Economic Science Institute, Argyros School of Business and Economics, Chapman University, Orange, California, USA
| | - Brian Wood
- Department of Anthropology, University of California Los Angeles, Los Angeles, California, USA
| | | | - David Raichlen
- Department of Anthropology, University of Southern California, Los Angeles, California, USA
- Department of Biology, University of Southern California, Los Angeles, California, USA
| | - Bret Beheim
- Department of Human Behavior, Ecology, and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Gandhi Yetish
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, California, USA
| | - Hillard Kaplan
- Department of Health Economics and Anthropology, Economic Science Institute, Argyros School of Business and Economics, Chapman University, Orange, California, USA
| | - Michael Gurven
- Department of Anthropology, University of California Santa Barbara, Santa Barbara, California, USA
| |
Collapse
|
6
|
Buratto J, Kirk B, Phu S, Vogrin S, Duque G. Safety and Efficacy of Testosterone Therapy on Musculoskeletal Health and Clinical Outcomes in Men: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials. Endocr Pract 2023; 29:727-734. [PMID: 37164187 DOI: 10.1016/j.eprac.2023.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/27/2023] [Accepted: 04/29/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVE Age-related declines in muscle and bone, alongside a shift toward greater adiposity, contribute to falls and fracture risk. Testosterone is osteogenic, myogenic, and catabolic to fat. As such, we examined the effects of testosterone therapy on musculoskeletal health and clinical outcomes in men. METHODS Electronic databases (Medline, Embase, Web of Science, Central) were systematically searched for randomized controlled trials (RCTs) reporting on the effects of testosterone therapy versus placebo on any primary outcome (bone density, muscle mass, fat mass, muscle strength/physical performance) or secondary outcome (falls, fractures, disability, adverse events) in men (≥18 years). A random effects meta-regression examined the effects of testosterone on prespecified outcomes. RESULTS One thousand seven hundred twenty-eight men across 16 RCTs were included (mean age: 77.1 ± 7.6 years). Baseline mean serum testosterone ranged from 7.5 ± 0.3 to 18.9 ± 1.2 nmol/L. Compared to placebo, 6 months of testosterone therapy increased hip bone density and total lean mass, but effects for handgrip and total fat mass did not reach statistical significance. No significant effects of testosterone therapy on musculoskeletal outcomes were evident at 12 months. The limited number of RCTs reporting on adverse events/clinical outcomes, and the low incidence of these events across RCTs, prohibited statistical comparisons. CONCLUSION After 6 months, testosterone effectively increases hip bone density and total lean mass in men, but its effects are unclear for lumbar spine bone density and handgrip strength. Further, RCTs are needed to clarify the safety and efficacy of testosterone on musculoskeletal health and clinical outcomes.
Collapse
Affiliation(s)
- Jared Buratto
- Department of Medicine, Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia; Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Melbourne, Victoria, Australia
| | - Ben Kirk
- Department of Medicine, Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia; Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Melbourne, Victoria, Australia
| | - Steven Phu
- Department of Medicine, Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia; Falls, Balance and Injury Research Centre, Neuroscience Research Australia (NeuRA), Randwick, New South Wales, Australia; Faculty of Medicine and Health, School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Sara Vogrin
- Department of Medicine, Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia; Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Melbourne, Victoria, Australia
| | - Gustavo Duque
- Department of Medicine, Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia; Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Melbourne, Victoria, Australia; Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; Dr. Joseph Kaufmann Chair in Geriatric Medicine, McGill University, Montreal, Quebec, Canada.
| |
Collapse
|
7
|
Green DJ, Chasland LC, Naylor LH, Yeap BB. New Horizons: Testosterone or Exercise for Cardiometabolic Health in Older Men. J Clin Endocrinol Metab 2023; 108:2141-2153. [PMID: 36964918 PMCID: PMC10438896 DOI: 10.1210/clinem/dgad175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/14/2023] [Accepted: 03/22/2023] [Indexed: 03/27/2023]
Abstract
Middle-aged and older men have typically accumulated comorbidities, are increasingly sedentary, and have lower testosterone concentrations (T) compared to younger men. Reduced physical activity (PA) and lower T both are associated with, and may predispose to, metabolically adverse changes in body composition, which contribute to higher risks of cardiometabolic disease. Exercise improves cardiometabolic health, but sustained participation is problematic. By contrast, rates of T prescription have increased, particularly in middle-aged and older men without organic diseases of the hypothalamus, pituitary, or testes, reflecting the unproven concept of a restorative hormone that preserves health. Two recent large randomized trials of T, and meta-analyses of randomized trials, did not show a signal for adverse cardiovascular (CV) events, and T treatment on a background of lifestyle intervention reduced type 2 diabetes by 40% in men at high risk. Men with both higher endogenous T and higher PA levels have lower CV risk, but causality remains unproven. Exercise training interventions improve blood pressure and endothelial function in middle-aged and older men, without comparable benefits or additive effects of T treatment. Therefore, exercise training improves cardiometabolic health in middle-aged and older men when effectively applied as a supervised regimen incorporating aerobic and resistance modalities. Treatment with T may have indirect cardiometabolic benefits, mediated via favorable changes in body composition. Further evaluation of T as a pharmacological intervention to improve cardiometabolic health in aging men could consider longer treatment durations and combination with targeted exercise programs.
Collapse
Affiliation(s)
- Daniel J Green
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, 6009, Australia
| | - Lauren C Chasland
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, 6009, Australia
- Allied Health Department, Fiona Stanley Hospital, Perth, WA, 6150, Australia
| | - Louise H Naylor
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, 6009, Australia
- Allied Health Department, Fiona Stanley Hospital, Perth, WA, 6150, Australia
| | - Bu B Yeap
- Medical School, The University of Western Australia, Perth, WA, 6009, Australia
- Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, WA, 6150, Australia
| |
Collapse
|
8
|
Fink J, Horie S. Novel methods for the treatment of low testosterone. Expert Rev Endocrinol Metab 2023; 18:221-229. [PMID: 37010438 DOI: 10.1080/17446651.2023.2197059] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023]
Abstract
INTRODUCTION Testosterone replacement therapy is a promising and growing field in modern healthcare. Several novel testosterone preparations aiming at providing an efficient drug without side effects have been developed in recent years. Several oral, nasal, gel, and self-injection preparations are now available, providing a wide variety of options customized to each individual's needs. AREAS COVERED We searched Google Scholar for keywords related to the different types of testosterone replacement therapy. This review provides information about the benefits and side effects of the newest testosterone preparations, aiming at giving a summary of the options with regard to testosterone replacement therapy to healthcare professionals. EXPERT OPINION As testosterone replacement therapy is increasing in popularity, the development of novel ways of administration minimizing side effects associated with testosterone replacement therapy is growing. Nowadays, hypogonadal patients have several options to treat their conditions and can choose the most beneficial method for their individual condition.
Collapse
Affiliation(s)
- Julius Fink
- Graduate School of Medicine, Department of Urology, Juntendo University, Bunkyo-ku, Japan
| | - Shigeo Horie
- Graduate School of Medicine, Department of Urology, Juntendo University, Bunkyo-ku, Japan
| |
Collapse
|
9
|
Liu Q, You J, Zhong M, Wu Z, Geng Y, Huang C. Hemoglobin level is negatively associated with sarcopenia and its components in Chinese aged 60 and above. Front Public Health 2023; 11:1081843. [PMID: 36992883 PMCID: PMC10040688 DOI: 10.3389/fpubh.2023.1081843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 02/21/2023] [Indexed: 03/18/2023] Open
Abstract
Introduction Sarcopenia and low hemoglobin level are common in older adults. Few studies have evaluated the association between hemoglobin level and sarcopenia and with inconsistent findings. The multifaceted effects of sarcopenia on the human body and the high prevalence of anemia in the Chinese population make it necessary to explore the association between the two. Methods Using the China Health and Retirement Longitudinal Study (CHARLS), we explored the association between hemoglobin with sarcopenia and its components in the Chinese population aged 60 and above. Multivariate logistic and Cox proportional hazards models were constructed to examine the association of hemoglobin level with sarcopenia and sarcopenia components in individuals aged 60 years or above. The subgroup analysis covered residence, body mass index level, drinking status, and smoking status were conducted. The possible difference of associations between sexes was also explored. Results With a total of 3,055 people, the hemoglobin concentration in people without sarcopenia, possible sarcopenia, and sarcopenia are 14.34 ± 2.22, 14.64 ± 2.27, and 13.58 ± 2.02 g/dl, respectively. Cross-sectional analysis showed strong evidence that hemoglobin was negatively associated with sarcopenia [Odds Ratio (OR) = 0.95, 95% Confidence Interval (CI): 0.90-0.99] and low height-adjusted appendicular skeletal muscle mass (OR = 0.91, 95% CI: 0.86-0.97). On average, a per 1 g/dl higher hemoglobin level was associated with 5% lower odds of sarcopenia (OR = 0.95, 95% CI: 0.90-0.98). The cohort study of 1,022 people demonstrated a statistically significant negative association of hemoglobin level with low physical performance [Hazard Ratio (HR) = 0.92, 95% CI: 0.85-0.99], merely with sarcopenia (HR = 0.92, 95% CI: 0.84-1.00) and skeletal muscle mass (HR = 0.95, 95% CI: 0.80-1.00). Sex-specific analysis suggested hemoglobin's association with sarcopenia, muscle mass, and physical performance in all sexes, with weaker magnitudes in females. Hemoglobin in urban residents and people with high body mass index (BMI) has a larger magnitude of the negative association with sarcopenia. Discussion Hemoglobin level associates with sarcopenia, muscle mass, and physical performance in the Chinese population aged 60 and above, with sex-specific, residence-specific, and BMI-specific effects.
Collapse
Affiliation(s)
- Qiaoling Liu
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Jiuhong You
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Min Zhong
- Department of Geriatric Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zhigang Wu
- Department of Chemistry, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Yunjie Geng
- Research Institute of Statistical Sciences, National Bureau of Statistics, Beijing, China
| | - Cheng Huang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| |
Collapse
|
10
|
Miller JA, Nguyen TT, Loeb C, Khera M, Yafi FA. Oral testosterone therapy: past, present, and future. Sex Med Rev 2023; 11:124-138. [PMID: 36779549 DOI: 10.1093/sxmrev/qead003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 12/17/2022] [Accepted: 12/27/2022] [Indexed: 02/14/2023]
Abstract
INTRODUCTION Testosterone replacement therapy (TRT) remains a commonly utilized treatment for men with testosterone deficiency (TD). Despite the recent FDA approval of new oral TRT medications, concerns remain regarding their efficacy and safety, and prescription rates for these medications have decreased compared to those for TD medications with other routes of administration. OBJECTIVE In this study we sought to investigate the efficacy and safety of oral testosterone undecanoate (oTU), a new oral TRT medication. METHODS A comprehensive review of the literature was performed using the Medline, EMBASE, and Cochrane Library databases; 1269 articles were identified, with 44 articles included in the final review and 12 used to perform meta-analyses to investigate the change in serum total testosterone (TT) and risk of adverse effects following oral testosterone undecanoate (oTU) use. Articles were also reviewed to investigate the reported effects of oTU on body composition, liver function, hematologic assays, lipid profiles, hormone assays, prostate growth, hypertension, and symptoms of TD. RESULTS Across placebo-controlled randomized trials, there was no significant increase in TT for those receiving oTU vs placebo (mean difference, -0.26 [95% CI, -1.26 to 0.73]). On subanalysis, when eugonadal participants received oTU, a significant decrease in TT was demonstrated (mean difference -0.86 [95% CI, -1.28 to 0.43]). When participants who were hypogonadal at baseline received oTU, a significant increase in TT compared to placebo was seen (mean difference 1.25 [95% CI, 0.22-2.29]). There was no significant risk of adverse effects (RR, -0.03 [95% CI, -0.08 to 0.03]) or serious adverse effects (RR, 0.15 [95% CI, -0.66 to 0.96]) in the oTU groups compared to placebo. CONCLUSION oTU was found to be well tolerated in hypogonadal patients, resulting in improved testosterone levels, height velocity, and sexual symptoms, without significant hepatotoxicity, prostatic enlargement, or worsening hypertension. There was no consensus regarding the effect of oTU on lean and fat mass percentages, hematologic assays, lipid profiles, mood, and general well-being.
Collapse
Affiliation(s)
- Jake A Miller
- Department of Urology, University of California, Irvine, CA, United States
| | - Tuan T Nguyen
- Department of Urology, University of California, Irvine, CA, United States
| | - Charles Loeb
- Department of Urology, University of California, Irvine, CA, United States
| | - Mohit Khera
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, United States
| | - Faysal A Yafi
- Department of Urology, University of California, Irvine, CA, United States
| |
Collapse
|
11
|
Campbell K, Muthigi A, Ghomeshi A, Schuppe K, Sandler MD, Ramasamy R. Safety Aspects and Rational Use of Testosterone Undecanoate in the Treatment of Testosterone Deficiency: Clinical Insights. Drug Healthc Patient Saf 2023; 15:73-84. [PMID: 37025099 PMCID: PMC10072151 DOI: 10.2147/dhps.s383130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 03/16/2023] [Indexed: 04/08/2023] Open
Abstract
Testosterone deficiency is diagnosed by a serum total testosterone level below 300 ng/dL in combination with symptoms such as decreased energy and libido. These symptoms can be ameliorated by restoring serum testosterone to the physiologic range with testosterone therapy (TT). There are numerous forms of testosterone therapy, such as injectable, transdermal, nasal, and subcutaneous applications. There are also multiple formulations of injection, such as testosterone cypionate, testosterone enanthate, and testosterone undecanoate. Testosterone undecanoate (TU) is a long-acting ester formulation of testosterone that can be provided in an injectable or oral form. Oral testosterone undecanoate is marketed as Andriol, Jatenzo, Tlando, and Kyzatrex. Oral TU provides a convenient option for many patients, which may increase compliance with TT. Injectable testosterone undecanoate is marketed as Aveed and Nebido. Injectable TT remains the most cost-effective therapeutic option and is appropriate for most patients as an initial therapy. This review describes the pharmacokinetics of these testosterone undecanoate products and provides a guide for prescribers using these medications. While many forms of testosterone are appropriate for TT, a patient-centered discussion focused on goals of care should best guide physician prescription of these medications.
Collapse
Affiliation(s)
- Katherine Campbell
- Desai Sethi Urology Institute, University of Miami, Miami, Fl, 33136, USA
| | - Akhil Muthigi
- Desai Sethi Urology Institute, University of Miami, Miami, Fl, 33136, USA
| | - Armin Ghomeshi
- Herbert Wertheim College of Medicine, Florida International University, Miami, FL, 33199, USA
| | - Kyle Schuppe
- Washington State University Elson S. Floyd College of Medicine, Spokane, WA, 99202-2131, USA
| | - Max D Sandler
- University of Miami Miller of Medicine, Miami, Fl, USA
| | - Ranjith Ramasamy
- Desai Sethi Urology Institute, University of Miami, Miami, Fl, 33136, USA
- Correspondence: Ranjith Ramasamy, Desai Sethi Urology Institute, University of Miami, 1120 NW 14th St, Miami, Fl, 33136, USA, Tel +1 305-243-6090, Email
| |
Collapse
|
12
|
Han S, Jeon YJ, Lee TY, Park GM, Park S, Kim SC. Testosterone is associated with abdominal body composition derived from computed tomography: a large cross sectional study. Sci Rep 2022; 12:22528. [PMID: 36581676 PMCID: PMC9800400 DOI: 10.1038/s41598-022-27182-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 12/27/2022] [Indexed: 12/30/2022] Open
Abstract
The aim of this study was to evaluate the association between serum testosterone and abdominal body composition based on abdominopelvic computed tomography (APCT) measurements after adjusting for individual metabolic syndrome components. We performed a cross-sectional study using male subjects (age range: 22-84 years) who underwent a general health examination with abdominopelvic computed tomography and testosterone measurements. Body composition was evaluated with APCT. To confirm an association between testosterone and abdominal body composition, we conducted linear regression analysis. The effect of abdominal body composition was adjusted for important clinical factors such as age, albumin, and metabolic components in the multivariable regression analysis. Overall, 1453 subjects were included in the primary analysis. After adjustment for age, individual metabolic components, albumin, hemoglobin A1c, and C-reactive protein, we found that subcutaneous fat area index (β = - 0.042, p < 0.001), total abdominal muscle area index (β = 0.115, p < 0.001), normal attenuation muscle area index (β = 0.070, p < 0.001), and loge-transformed lower attenuation muscle area index (β = 0.140, p = 0.002) had an association with loge-transformed testosterone level. After adjusting for individual metabolic syndrome components, testosterone was associated negatively with subcutaneous fat, but not visceral fat. In addition, testosterone was positively correlated with abdominal muscle regardless of qualitative features such as fat-rich and fat-free.
Collapse
Affiliation(s)
- Seungbong Han
- grid.222754.40000 0001 0840 2678Department of Biostatistics, Korea University College of Medicine, Seoul, Korea
| | - Young-Jee Jeon
- grid.412830.c0000 0004 0647 7248Department of Family Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Tae Young Lee
- grid.412830.c0000 0004 0647 7248Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Gyung-Min Park
- grid.412830.c0000 0004 0647 7248Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Sungchan Park
- grid.412830.c0000 0004 0647 7248Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Seong Cheol Kim
- grid.412830.c0000 0004 0647 7248Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| |
Collapse
|
13
|
Chung CM, Shin S, Lee Y, Lee DY. Determination of the Predictors with the Greatest Influence on Walking in the Elderly. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:1640. [PMID: 36422178 PMCID: PMC9693411 DOI: 10.3390/medicina58111640] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 08/26/2023]
Abstract
Background and Objectives: Previous studies have revealed that independent variables (lower extremity strength, postural control ability, and body composition) influence gait performance and variability, but the difference in the relative influence between these variables is unclear. Hence, this study determines the variable that is the most influential predictor of gait performance and variability among potential independent variables in the elderly. Materials and Methods: Seventy-eight subjects aged ≥60 years participated. For each subject, the gait variables and lower extremity muscle strength were measured using an accelerometer worn on both feet during a 6-minute walk and a manual force sensor, respectively. The static balance ability was measured through two force plates, and the body composition was measured by applying bioelectrical impedance analysis. Linear regression analyses were performed stepwise to determine whether these variables affect gait performance and variability. Results: After adjusting for sex and gait performance, the ankle strength, body fat mass, mean velocity in the medial-lateral direction, ankle plantar flexion strength, and girth were predictors of gait speed dorsiflexion, gait performance, swing width of the gait performance, walking speed, and gait variability, respectively. Conclusions: Overall, gait performance in the elderly is related to muscle strength, postural control, and body composition in a complex manner, but gait variability appears to be more closely related to ankle muscle strength. This study provides further evidence that muscle strength is important in motor function and stability.
Collapse
Affiliation(s)
- Chul-Min Chung
- Research Institute of Human Ecology, Yeungnam University, Gyeongsan 38541, Republic of Korea
- Neuromuscular Control Laboratory, Yeungnam University, Gyeongsan 38541, Republic of Korea
| | - Sunghoon Shin
- Research Institute of Human Ecology, Yeungnam University, Gyeongsan 38541, Republic of Korea
- Neuromuscular Control Laboratory, Yeungnam University, Gyeongsan 38541, Republic of Korea
| | - Yungon Lee
- Research Institute of Human Ecology, Yeungnam University, Gyeongsan 38541, Republic of Korea
- Neuromuscular Control Laboratory, Yeungnam University, Gyeongsan 38541, Republic of Korea
| | - Do-Youn Lee
- Research Institute of Human Ecology, Yeungnam University, Gyeongsan 38541, Republic of Korea
- Neuromuscular Control Laboratory, Yeungnam University, Gyeongsan 38541, Republic of Korea
| |
Collapse
|
14
|
Laskou F, Patel H, Cooper C, Dennison E. Functional capacity, sarcopenia, and bone health. Best Pract Res Clin Rheumatol 2022; 36:101756. [PMID: 35691825 DOI: 10.1016/j.berh.2022.101756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Bone and muscle are recognised as interacting tissues, the so-called 'muscle-bone unit', in which these two tissues communicate to coordinate their development (chemically and metabolically), as well as their response to loading or injury. Musculoskeletal disorders of ageing, specifically osteoporosis and sarcopenia, are highly prevalent in older individuals. They signify a significant burden for older people affecting their mobility, confidence, and quality of life, as well as being a major cost to healthcare systems worldwide. This review considers the coexistence of osteoporosis and sarcopenia in individuals and describes risk factors, clinical consequences, approaches to management, and the link with functional capacity.
Collapse
Affiliation(s)
- Faidra Laskou
- MRC Lifecourse Epidemiology Centre, Southampton, SO16 6YD, UK, USA.
| | - Harnish Patel
- MRC Lifecourse Epidemiology Centre, Southampton, SO16 6YD, UK, USA.
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, Southampton, SO16 6YD, UK, USA.
| | - Elaine Dennison
- MRC Lifecourse Epidemiology Centre, Southampton, SO16 6YD, UK, USA.
| |
Collapse
|
15
|
Ahmad SW, Molfetto G, Montoya D, Camero A. Is Oral Testosterone the New Frontier of Testosterone Replacement Therapy? Cureus 2022; 14:e27796. [PMID: 36106278 PMCID: PMC9452423 DOI: 10.7759/cureus.27796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2022] [Indexed: 11/05/2022] Open
Abstract
Male hypogonadism is a condition in which the body does not produce enough testosterone, resulting in symptoms such as depressed mood, decreased sex drive, decreased skeletal muscle, and increased fat mass. Male hypogonadism can be readily treated with many available treatments when clinically indicated. The advent of readily available testosterone therapy has increased the importance of finding the most efficacious and cost-efficient treatment modality to approach these patients. Testosterone is typically administered through intramuscular or subcutaneous injections, topical gels, and oral tablets. The efficacy of testosterone therapy on hypogonadal men has been widely studied. However, there has been little research done comparing each modality against each other. This paper seeks to compare the various modalities of testosterone replacement therapy using various parameters such as the beneficial effects on bone mineral density, skeletal muscle mass, fat mass, and libido while simultaneously weighing the distinct undesirable side effects of each form of administration. Our investigation analyzes the methodology and results of the existing research within this field. It aims to draw a nuanced conclusion about the current standard of care for testosterone replacement therapy. According to our research and statistical analyses, we have concluded that oral administration has shown to be as advantageous as other modalities for male hypogonadism. Currently, injectables are the modality of choice, but with the right improvements, oral administration can potentially overtake injectables and transdermal testosterone as the treatment of choice.
Collapse
|
16
|
Vinke JSJ, Wouters HJCM, Stam SP, Douwes RM, Post A, Gomes-Neto AW, van der Klauw MM, Berger SP, Bakker SJL, De Borst MH, Eisenga MF. Decreased haemoglobin levels are associated with lower muscle mass and strength in kidney transplant recipients. J Cachexia Sarcopenia Muscle 2022; 13:2044-2053. [PMID: 35666066 PMCID: PMC9397498 DOI: 10.1002/jcsm.12999] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 02/18/2022] [Accepted: 03/21/2022] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Post-transplant anaemia and reduced muscle mass and strength are highly prevalent in kidney transplant recipients (KTRs). Decreased haemoglobin levels, a marker of anaemia, could adversely affect muscle mass and strength through multiple mechanisms, among others, through diminished tissue oxygenation. We aimed to investigate the association between haemoglobin levels with muscle mass and strength in KTRs. METHODS We included stable KTRs from the TransplantLines Biobank and Cohort study with a functional graft ≥1 year post-transplantation. Muscle mass was assessed using 24 h urinary creatinine excretion rate (CER) and bioelectrical impedance analysis (BIA). Muscle strength was assessed with a handgrip strength test using a dynamometer and, in a subgroup (n = 290), with the five-times sit-to-stand (FTSTS) test. We used multivariable linear and logistic regression analyses to investigate the associations of haemoglobin levels with muscle mass and strength. RESULTS In 871 included KTRs [median age 58 (interquartile range (IQR), 48-66)] years; 60% men; eGFR 51 ± 18 mL/min/1.73 m2 ) who were 3.5 (1.0-10.2) years post-transplantation, the mean serum haemoglobin level was 13.9 ± 1.8 g/dL in men and 12.8 ± 1.5 g/dL in women. Lower haemoglobin levels were independently associated with a lower CER (std. β = 0.07, P = 0.01), BIA-derived skeletal muscle mass (std. β = 0.22, P < 0.001), handgrip strength (std. β = 0.15, P < 0.001), and worse FTSTS test scores (std. β = -0.17, P = 0.02). KTRs in the lowest age-specific and sex-specific quartile of haemoglobin levels had an increased risk of being in the worst age-specific and sex-specific quartile of CER (fully adjusted OR, 2.09; 95% CI 1.15-3.77; P = 0.02), handgrip strength (fully adjusted OR, 3.30; 95% CI 1.95-5.59; P < 0.001), and FTSTS test score (fully adjusted OR, 7.21; 95% CI 2.59-20.05; P < 0.001). CONCLUSIONS Low haemoglobin levels are strongly associated with decreased muscle mass and strength in KTRs. Future investigation will need to investigate whether maintaining higher haemoglobin levels may improve muscle mass and strength in KTRs.
Collapse
Affiliation(s)
- Joanna Sophia J Vinke
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Hanneke J C M Wouters
- Department of Hematology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Suzanne P Stam
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Rianne M Douwes
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Adrian Post
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Antonio W Gomes-Neto
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Melanie M van der Klauw
- Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Stefan P Berger
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Stephan J L Bakker
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | -
- Groningen Transplant Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Martin H De Borst
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Michele F Eisenga
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
17
|
Lin Z, Zhao A, He J. Effect of β-hydroxy-β-methylbutyrate (HMB) on the Muscle Strength in the Elderly Population: A Meta-Analysis. Front Nutr 2022; 9:914866. [PMID: 35911112 PMCID: PMC9326439 DOI: 10.3389/fnut.2022.914866] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 06/01/2022] [Indexed: 11/24/2022] Open
Abstract
Objective This meta-analysis aims to evaluate the effect of the emerging nutritional ingredient β-hydroxy-β-methylbutyrate (HMB) on the muscle strength of elderly people. Methods Computer systems-based search and sorting of relevant documents published before December 2020 in the China Journal Full-text Database (CNKI), Wan Fang Database (Wan Fang), VIP Chinese Science and Technology Journal Database (VIP), PubMed, Web of Science, and EMbase Database was done. Two researchers independently screened the literature based on the inclusion and exclusion criteria and performed data extraction and quality evaluation. Rev Man 5.X software was used for systematic review and meta-analysis. Results A total of 9 randomized controlled trials (RCT) studies were included in the study, which comprised 896 subjects. The overall impact on muscle strength-related indicators (SMD = 0.41; 95% CI: 0.28, 0.54); p < 0.00001) was statistically significant. Conclusion: Supplementation of HMB and preparations containing HMB ingredients aid in increasing muscle strength in the elderly population.
Collapse
|
18
|
Fenton JM, King JA, Hoekstra SP, Valentino SE, Phillips SM, Goosey-Tolfrey VL. Protocols aiming to increase muscle mass in persons with motor complete spinal cord injury: a systematic review. Disabil Rehabil 2022; 45:1433-1443. [PMID: 35465798 DOI: 10.1080/09638288.2022.2063420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE The purpose of this review was to compare all intervention modalities aimed at increasing skeletal muscle mass (SMM) in the paralysed limbs of persons with chronic (>1-year post-injury), motor complete spinal cord injury (SCI). MATERIALS AND METHODS A systematic review of EMBASE, MEDLINE, Scopus, and SPORTDiscus databases was conducted from inception until December 2021. Published intervention studies aimed to increase SMM (measured by magnetic resonance imaging, computed tomography, ultrasound, muscle biopsy, or lean soft tissue mass by dual X-ray absorptiometry) in the paralysed limbs of adults (>18 years) with SCI were included. RESULTS Fifty articles were included that, overall, demonstrated a high risk of bias. Studies were categorised into six groups: neuromuscular electrical stimulation (NMES) with and without external resistance, functional electrical stimulation cycling, walking- and standing-based interventions, pharmacological treatments, and studies that compared or combined intervention modalities. Resistance training (RT) using NMES on the quadriceps produced the largest and most consistent increases in SMM of all intervention modalities. CONCLUSIONS Current evidence suggests that clinical practise aiming to increase SMM in the paralysed limbs of persons with motor complete SCI should perform NMES-RT. However, more high-quality randomised control trials are needed to determine how training variables, such as exercise volume and intensity, can be optimised for increasing SMM. Implications for rehabilitationPersons with spinal cord injury (SCI) experience severe reductions in skeletal muscle mass (SMM) post-injury, which may exacerbate their risk of obesity and metabolic disease.Out of all exercise and non-exercise-based interventions, this systematic review shows that neuromuscular electrical stimulation-based resistance training demonstrates the most robust and consistent evidence for increasing skeletal muscle mass in the paralysed limbs of adults with motor complete spinal cord injury.The findings from this review can be used to inform evidence-based practise for exercise practitioners, as well as direct future research focused on increasing muscle mass in this population.
Collapse
Affiliation(s)
- Jordan M. Fenton
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- Peter Harrison Centre for Disability Sport, Loughborough University, Loughborough, UK
| | - James A. King
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester, UK
| | - Sven P. Hoekstra
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- Peter Harrison Centre for Disability Sport, Loughborough University, Loughborough, UK
| | | | - Stuart M. Phillips
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Victoria L. Goosey-Tolfrey
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- Peter Harrison Centre for Disability Sport, Loughborough University, Loughborough, UK
| |
Collapse
|
19
|
Abstract
Middle-aged and older men with lower testosterone concentrations are more likely to have or to develop metabolic syndrome and type 2 diabetes. Central adiposity is a risk factor for metabolic syndrome and diabetes and predisposes to lower testosterone concentrations. Conversely, testosterone treatment reduces fat mass and insulin resistance. In a randomized controlled trial of 1007 men with either impaired glucose tolerance or newly diagnosed type 2 diabetes, 2 years of testosterone treatment on a background of lifestyle intervention reduced the risk of type 2 diabetes by 40%; this demonstrates the potential utility for testosterone pharmacotherapy to prevent diabetes in men.
Collapse
Affiliation(s)
- Bu B Yeap
- Medical School, University of Western Australia, Perth, Western Australia 6009, Australia; Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Western Australia 6150, Australia.
| | - Gary A Wittert
- Freemasons Centre for Men's Health and Wellbeing, Medical School, University of Adelaide, Adelaide, South Australia 5000, Australia; Department of Endocrinology, Royal Adelaide Hospital, Adelaide, South Australia 5000, Australia; South Australian Health and Medical Research Institute, North Terrace, Adelaide, South Australia 5000, Australia
| |
Collapse
|
20
|
Laskou F, Patel HP, Cooper C, Dennison E. A pas de deux of osteoporosis and sarcopenia: osteosarcopenia. Climacteric 2022; 25:88-95. [PMID: 34308725 DOI: 10.1080/13697137.2021.1951204] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 12/15/2022]
Abstract
The musculoskeletal conditions osteoporosis and sarcopenia are highly prevalent in older adults. Osteoporosis is characterized by low bone mass and microarchitectural deterioration of bone, whereas sarcopenia is identified by the loss of muscle strength, function and mass. Osteoporosis represents a major health problem contributing to millions of fractures worldwide on an annual basis, whereas sarcopenia is associated with a range of adverse physical and metabolic outcomes. They both affect physical and social function, confidence and quality of life as well as contributing to high health-care costs worldwide. Osteosarcopenia is the term given when both conditions occur concomitantly and it has been suggested that interactions between these two conditions may accelerate individual disease progression as co-existence of osteoporosis and sarcopenia is associated with higher morbidity from falls, fracture, disability as well as mortality. In this review, we will outline the epidemiology, pathogenesis and clinical consequences of osteosarcopenia and discuss available management strategies.
Collapse
Affiliation(s)
- F Laskou
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - H P Patel
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospitals Southampton NHS Foundation Trust, Southampton, UK
- NIHR Oxford Biomedical Research Unit, University of Oxford, Oxford, UK
| | - E Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| |
Collapse
|
21
|
Zeng B, Qiu S, Xiong X, Su X, Zhang Z, Wei Q, Yang L. The effect of different administrations of testosterone therapy on adverse prostate events: A Bayesian network meta-analysis. Front Endocrinol (Lausanne) 2022; 13:1009900. [PMID: 36419763 PMCID: PMC9678341 DOI: 10.3389/fendo.2022.1009900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/17/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Hypogonadism has become a major cause endangering men's health and quality of life all over the world. Testosterone Therapy (TT) is a widely accepted treatment for relieving hypogonadal symptoms. However, the effect of different administrations of TT on prostate safety is still unclear. METHODS We did a thorough search of PubMed, Embase and Cochrane Library to identify eligible studies up to January 2022. Randomized controlled trials (RCTs) and Cohort studies evaluating the impacts of using different formulations of TT on prostate parameters were included. Changes of prostate-specific antigen (PSA) level and prostate cancer (Pca) cases were used as the primary outcomes. Quality of individual studies was estimated by RoB2 (Cochrane tool for assessing the risk of bias in randomized trials) and the Newcastle-Ottawa scale (Tool for assessing non-RCTs). Certainty of evidence for each study was evaluated according to the evidence assessment criteria of the Oxford Evidence-based Medicine Center. Random-effect network meta-analysis(NMA)was performed based on the Bayesian model. RESULTS Thirty-five studies (30 RCTs and 5 Cohort studies) with 7,740 participants were included. TT administration led to fewer Pca patients (RR=0.62, 95%CI [0.39,0.99], I2=0%), while little decreasing in PSA level (MD=-0.05, 95%CI [-0.08, -0.02], I2=0%). The NMA revealed that compared with other formulations, the intramuscular injection was the most likely to rank first in decreasing Pca cases. The TT also resulted in more biopsy cases (RR=2.38, 95%CI [1.01,5.60], I2=0%). As for NMA, intramuscular injection also performed relatively better in fewer prostate biopsy cases compared with transdermal group. CONCLUSION TT does not lead to abnormal PSA changes and increased risk of Pca in patients with hypogonadism or low testosterone level. Compared with other preparations of TT, intramuscular injection proved better in minimizing Pca cases and was more likely to result in fewer prostate biopsy cases.
Collapse
Affiliation(s)
- Bin Zeng
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Shi Qiu
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- Center of Biomedical Big Data, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xingyu Xiong
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xingyang Su
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Zilong Zhang
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Qiang Wei
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Qiang Wei, ; Lu Yang,
| | - Lu Yang
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Qiang Wei, ; Lu Yang,
| |
Collapse
|
22
|
Page ST, Blithe D, Wang C. Hormonal Male Contraception: Getting to Market. Front Endocrinol (Lausanne) 2022; 13:891589. [PMID: 35721718 PMCID: PMC9203677 DOI: 10.3389/fendo.2022.891589] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 04/26/2022] [Indexed: 11/30/2022] Open
Abstract
Rates of unplanned pregnancies are high and stagnant globally, burdening women, families and the environment. Local limitations placed upon contraceptive access and abortion services exacerbate global disparities for women. Despite survey data suggesting men and their partners are eager for expanded male contraceptive options, efforts to develop such agents have been stymied by a paucity of monetary investment. Modern male hormonal contraception, like female hormonal methods, relies upon exogenous progestins to suppress the hypothalamic-pituitary-gonadal axis, in turn suppressing testicular testosterone production and sperm maturation. Addition of an androgen augments gonadotropin suppression, more effectively suppressing spermatogenesis in men, and provides androgenic support for male physiology. Previous contraceptive efficacy studies in couples have shown that hormonal male methods are effective and reversible. Recent efforts have been directed at addressing potential user and regulatory concerns by utilizing novel steroids and varied routes of hormone delivery. Provision of effective contraceptive options for men and women is an urgent public health need. Recognizing and addressing the gaps in our contraceptive options and engaging men in family planning will help reduce rates of unplanned pregnancies in the coming decades.
Collapse
Affiliation(s)
- Stephanie T. Page
- Division of Metabolism, Endocrinology and Nutrition, University of Washington, Seattle, WA, United States
- *Correspondence: Stephanie T. Page,
| | - Diana Blithe
- Contraceptive Development Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (NIH), Bethesda, MD, United States
| | - Christina Wang
- Clinical and Translational Science Institute at the Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA, United States
| |
Collapse
|
23
|
Singh P, Covassin N, Marlatt K, Gadde KM, Heymsfield SB. Obesity, Body Composition, and Sex Hormones: Implications for Cardiovascular Risk. Compr Physiol 2021; 12:2949-2993. [PMID: 34964120 PMCID: PMC10068688 DOI: 10.1002/cphy.c210014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Cardiovascular disease (CVD) continues to be the leading cause of death in adults, highlighting the need to develop novel strategies to mitigate cardiovascular risk. The advancing obesity epidemic is now threatening the gains in CVD risk reduction brought about by contemporary pharmaceutical and surgical interventions. There are sex differences in the development and outcomes of CVD; premenopausal women have significantly lower CVD risk than men of the same age, but women lose this advantage as they transition to menopause, an observation suggesting potential role of sex hormones in determining CVD risk. Clear differences in obesity and regional fat distribution among men and women also exist. While men have relatively high fat in the abdominal area, women tend to distribute a larger proportion of their fat in the lower body. Considering that regional body fat distribution is an important CVD risk factor, differences in how men and women store their body fat may partly contribute to sex-based alterations in CVD risk as well. This article presents findings related to the role of obesity and sex hormones in determining CVD risk. Evidence for the role of sex hormones in determining body composition in men and women is also presented. Lastly, the clinical potential for using sex hormones to alter body composition and reduce CVD risk is outlined. © 2022 American Physiological Society. Compr Physiol 12:1-45, 2022.
Collapse
Affiliation(s)
- Prachi Singh
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, USA
| | | | - Kara Marlatt
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, USA
| | - Kishore M Gadde
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, USA
| |
Collapse
|
24
|
Pérez-Ciria L, Miana-Mena FJ, López-Mendoza MC, Álvarez-Rodríguez J, Latorre MA. Influence of Immunocastration and Diet on Meat and Fat Quality of Heavy Female and Male Pigs. Animals (Basel) 2021; 11:3355. [PMID: 34944132 PMCID: PMC8697961 DOI: 10.3390/ani11123355] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 11/19/2022] Open
Abstract
Two experiments were carried out; one with female pigs and the other with male pigs destined for Teruel dry-cured ham production, to evaluate the effect of immunocastration (entire gilts-EG vs. immunocastrated gilts-IG and surgically castrated males vs. immunocastrated males-IM) and diet (control vs. high energy vs. low crude protein and amino acids) on meat quality and fat composition. Fifteen meat samples and eight fat samples of each treatment were analyzed in both experiments. In the case of males, six fat samples per treatment were analyzed to determine boar taint. Immunocastration is a good strategy in gilts intended for dry-cured ham production because improves meat composition; however, in males, immunocastration impairs the results of pork chemical composition compared with surgical castration. The IG presented a lower polyunsaturated/saturated fatty acids ratio than EG, improving fat technological quality. Diets had little effect on pork or fat quality in gilts, but a high-energy level using oilseeds and a low-crude-protein and -amino-acids diet from 80 to 137 kg of body weight could be interesting in IM to maintain or increase fat consistency, respectively. Moreover, in general, immunocastration is effective in avoiding boar taint in males.
Collapse
Affiliation(s)
- Leticia Pérez-Ciria
- Departamento de Producción Animal y Ciencia de los Alimentos, Instituto Agroalimentario de Aragón-IA2, Universidad de Zaragoza-CITA, C/Miguel Servet 177, 50013 Zaragoza, Spain;
| | - Francisco Javier Miana-Mena
- Departamento de Farmacología y Fisiología, Instituto Agroalimentario de Aragón-IA2, Universidad de Zaragoza-CITA, C/Miguel Servet 177, 50013 Zaragoza, Spain;
| | - María Carmen López-Mendoza
- Departamento de Producción Animal y Ciencia y Tecnología de los Alimentos, Universidad Cardenal Herrera-CEU, C/Tirant lo Blanc 7, Alfara del Patriarca, 46115 Valencia, Spain;
| | - Javier Álvarez-Rodríguez
- Departamento de Ciencia Animal, Universidad de Lleida, Av. Alcalde Rovira Roure 191, 25198 Lleida, Spain;
| | - Maria Angeles Latorre
- Departamento de Producción Animal y Ciencia de los Alimentos, Instituto Agroalimentario de Aragón-IA2, Universidad de Zaragoza-CITA, C/Miguel Servet 177, 50013 Zaragoza, Spain;
| |
Collapse
|
25
|
Huang LT, Wang JH. The Therapeutic Intervention of Sex Steroid Hormones for Sarcopenia. Front Med (Lausanne) 2021; 8:739251. [PMID: 34760899 PMCID: PMC8573092 DOI: 10.3389/fmed.2021.739251] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 09/29/2021] [Indexed: 01/09/2023] Open
Abstract
Sarcopenia, characterized by the excessive loss of skeletal muscle mass, strength, and function, is associated with the overall poor muscle performance status of the elderly, and occurs more frequently in those with chronic diseases. The causes of sarcopenia are multifactorial due to the inherent relationship between muscles and molecular mechanisms, such as mitochondrial function, inflammatory pathways, and circulating hormones. Age-related changes in sex steroid hormone concentrations, including testosterone, estrogen, progesterone, and their precursors and derivatives, are an important aspect of the pathogenesis of sarcopenia. In this review, we provide an understanding of the treatment of sarcopenia through the regulation of sex steroid hormones. The potential benefits and future research emphasis of each sex steroid hormone therapeutic intervention (testosterone, SARMs, estrogen, SERMs, DHEA, and progesterone) for sarcopenia are discussed. Enhanced understanding of the role of sex steroid hormones in the treatment for sarcopenia could lead to the development of hormone therapeutic approaches in combination with specific exercise and nutrition regimens.
Collapse
Affiliation(s)
- Le-Tian Huang
- Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jia-He Wang
- Department of Family Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| |
Collapse
|
26
|
Zwetsloot KA, Shanely RA, Godwin JS, Hodgman CF. Phytoecdysteroids Accelerate Recovery of Skeletal Muscle Function Following in vivo Eccentric Contraction-Induced Injury in Adult and Old Mice. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:757789. [PMID: 36188800 PMCID: PMC9397830 DOI: 10.3389/fresc.2021.757789] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/18/2021] [Indexed: 11/25/2022]
Abstract
Background: Eccentric muscle contractions are commonly used in exercise regimens, as well as in rehabilitation as a treatment against muscle atrophy and weakness. If repeated multiple times, eccentric contractions may result in skeletal muscle injury and loss of function. Skeletal muscle possesses the remarkable ability to repair and regenerate after an injury or damage; however, this ability is impaired with aging. Phytoecdysteroids are natural plant steroids that possess medicinal, pharmacological, and biological properties, with no adverse side effects in mammals. Previous research has demonstrated that administration of phytoecdysteroids, such as 20-hydroxyecdysone (20E), leads to an increase in protein synthesis signaling and skeletal muscle strength. Methods: To investigate whether 20E enhances skeletal muscle recovery from eccentric contraction-induced damage, adult (7–8 mo) and old (26–27 mo) mice were subjected to injurious eccentric contractions (EC), followed by 20E or placebo (PLA) supplementation for 7 days. Contractile function via torque-frequency relationships (TF) was measured three times in each mouse: pre- and post-EC, as well as after the 7-day recovery period. Mice were anesthetized with isoflurane and then electrically-stimulated isometric contractions were performed to obtain in vivo muscle function of the anterior crural muscle group before injury (pre), followed by 150 EC, and then again post-injury (post). Following recovery from anesthesia, mice received either 20E (50 mg•kg−1 BW) or PLA by oral gavage. Mice were gavaged daily for 6 days and on day 7, the TF relationship was reassessed (7-day). Results: EC resulted in significant reductions of muscle function post-injury, regardless of age or treatment condition (p < 0.001). 20E supplementation completely recovered muscle function after 7 days in both adult and old mice (pre vs. 7-day; p > 0.05), while PLA muscle function remained reduced (pre vs. 7-day; p < 0.01). In addition, histological markers of muscle damage appear lower in damaged muscle from 20E-treated mice after the 7-day recovery period, compared to PLA. Conclusions: Taken together, these findings demonstrate that 20E fully recovers skeletal muscle function in both adult and old mice just 7 days after eccentric contraction-induced damage. However, the underlying mechanics by which 20E contributes to the accelerated recovery from muscle damage warrant further investigation.
Collapse
Affiliation(s)
- Kevin A. Zwetsloot
- Integrative Muscle Physiology Laboratory, Appalachian State University, Boone, NC, United States
- Department of Health and Exercise Science, Appalachian State University, Boone, NC, United States
- Department of Biology, Appalachian State University, Boone, NC, United States
- *Correspondence: Kevin A. Zwetsloot
| | - R. Andrew Shanely
- Integrative Muscle Physiology Laboratory, Appalachian State University, Boone, NC, United States
- Department of Health and Exercise Science, Appalachian State University, Boone, NC, United States
| | - Joshua S. Godwin
- Integrative Muscle Physiology Laboratory, Appalachian State University, Boone, NC, United States
| | - Charles F. Hodgman
- Integrative Muscle Physiology Laboratory, Appalachian State University, Boone, NC, United States
| |
Collapse
|
27
|
Chasland LC, Yeap BB, Maiorana AJ, Chan YX, Maslen BA, Cooke BR, Dembo L, Naylor LH, Green DJ. Testosterone and exercise: effects on fitness, body composition, and strength in middle-to-older aged men with low-normal serum testosterone levels. Am J Physiol Heart Circ Physiol 2021; 320:H1985-H1998. [PMID: 33739155 DOI: 10.1152/ajpheart.00010.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
As men age, serum testosterone (T) concentrations decrease, as do fitness, strength, and lean mass. Whether testosterone treatment confers additive benefit to reverse these changes when combined with exercise training in middle-to-older aged men remains unclear. We assessed the effects of T treatment and exercise, alone and in combination, on aerobic capacity (V̇o2peak), body composition, and muscular strength in men 50-70 yr, waist circumference ≥95 cm and low-normal serum T (6-14 nmol·L-1). Participants (n = 80) were randomized to AndroForte5 (testosterone 5.0% wt/vol, 100 mg/2 mL) cream (T), or matching placebo (P), applied transdermally daily, and supervised center-based exercise (Ex) or no additional exercise (NEx), for 12-wk. Exercise increased V̇o2peak and strength versus nonexercise (V̇o2peak: T + Ex: +2.5 mL·kg-1·min-1, P + Ex: +3.2 mL·kg-1·min-1, P < 0.001; leg press: T + Ex: +31 kg, P + Ex: +24 kg, P = 0.006). T treatment did not affect V̇o2peak or strength. Exercise decreased total (T + Ex: -1.7, P + Ex: -2.3 kg, P < 0.001) and visceral fat (T + Ex: -0.1 kg, P + Ex: -0.3 kg, P = 0.003), and increased total (T + Ex: +1.4 kg, P + Ex: +0.7 kg, P = 0.008) and arm lean mass (T + Ex: +0.5 kg, P + Ex: +0.3 kg, P = 0.024). T treatment did not affect total or visceral fat, but increased total (T + Ex: +1.4 kg, T + NEx: +0.7 kg, P = 0.015), leg (T + Ex: +0.3 kg, T + NEx: +0.2 kg, P = 0.024), and arm lean mass (T + Ex: +0.5 kg, T + NEx: +0.2 kg, P = 0.046). T + Ex increased arm lean mass (T + Ex: +0.5 kg vs. P + NEx: -0.0 kg, P = 0.001) and leg strength (T + Ex: +31 kg vs. P + NEx: +12 kg, P = 0.032) compared with P + NEx, with no other additive effects. Exercise training was more effective than T treatment in increasing aerobic capacity and decreasing total and visceral fat mass. T treatment at therapeutic doses increased lean mass but conferred limited additional benefit when combined with exercise. Exercise should be evaluated as an antiaging intervention in preference to testosterone treatment in men.NEW & NOTEWORTHY We illustrate that exercise training generates superior outcomes to testosterone treatment for improving aerobic fitness, muscular strength, and total and visceral fat mass in men 50-70 yr with low-normal serum testosterone concentrations. Adding testosterone treatment to exercise did not provide any additive benefit for these variables. Testosterone treatment alone and exercise alone had similar impacts on lean mass. Therefore, men unable to exercise may obtain benefit from testosterone treatment alone to improve lean mass.
Collapse
Affiliation(s)
- Lauren C Chasland
- School of Human Sciences, Exercise and Sport Science, The University of Western Australia, Perth, Western Australia, Australia.,Allied Health Department, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Bu B Yeap
- Medical School, The University of Western Australia, Perth, Western Australia, Australia.,Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Andrew J Maiorana
- Allied Health Department, Fiona Stanley Hospital, Perth, Western Australia, Australia.,School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Yi X Chan
- Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Barbara A Maslen
- School of Human Sciences, Exercise and Sport Science, The University of Western Australia, Perth, Western Australia, Australia
| | - Brian R Cooke
- PathWest Laboratory Medicine, Department of Clinical Biochemistry, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Lawrence Dembo
- Advanced Heart Failure and Cardiac Transplantation Unit, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Louise H Naylor
- School of Human Sciences, Exercise and Sport Science, The University of Western Australia, Perth, Western Australia, Australia.,Allied Health Department, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Daniel J Green
- School of Human Sciences, Exercise and Sport Science, The University of Western Australia, Perth, Western Australia, Australia
| |
Collapse
|
28
|
Tallis J, Shelley S, Degens H, Hill C. Age-Related Skeletal Muscle Dysfunction Is Aggravated by Obesity: An Investigation of Contractile Function, Implications and Treatment. Biomolecules 2021; 11:372. [PMID: 33801275 PMCID: PMC8000988 DOI: 10.3390/biom11030372] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/18/2021] [Accepted: 02/23/2021] [Indexed: 02/07/2023] Open
Abstract
Obesity is a global epidemic and coupled with the unprecedented growth of the world's older adult population, a growing number of individuals are both old and obese. Whilst both ageing and obesity are associated with an increased prevalence of chronic health conditions and a substantial economic burden, evidence suggests that the coincident effects exacerbate negative health outcomes. A significant contributor to such detrimental effects may be the reduction in the contractile performance of skeletal muscle, given that poor muscle function is related to chronic disease, poor quality of life and all-cause mortality. Whilst the effects of ageing and obesity independently on skeletal muscle function have been investigated, the combined effects are yet to be thoroughly explored. Given the importance of skeletal muscle to whole-body health and physical function, the present study sought to provide a review of the literature to: (1) summarise the effect of obesity on the age-induced reduction in skeletal muscle contractile function; (2) understand whether obesity effects on skeletal muscle are similar in young and old muscle; (3) consider the consequences of these changes to whole-body functional performance; (4) outline important future work along with the potential for targeted intervention strategies to mitigate potential detrimental effects.
Collapse
Affiliation(s)
- Jason Tallis
- Centre for Applied Biological and Exercise Sciences, Alison Gingell Building, Coventry University, Priory Street, Coventry CV15FB, UK;
| | - Sharn Shelley
- Centre for Applied Biological and Exercise Sciences, Alison Gingell Building, Coventry University, Priory Street, Coventry CV15FB, UK;
| | - Hans Degens
- Research Centre for Musculoskeletal Science & Sports Medicine, Department of Life Sciences, Manchester Metropolitan University, Manchester M15 6BH, UK;
- Institute of Sport Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania
| | - Cameron Hill
- Randall Centre for Cell and Molecular Biophysics, New Hunt’s House, Guy’s Campus, King’s College London, London SE1 1UL, UK;
| |
Collapse
|
29
|
Amadi C, Green KI, Odum EP. Is serum PSA a predictor of male hypogonadism? Testing the hypothesis. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2021; 65:144-151. [PMID: 33587836 PMCID: PMC10065314 DOI: 10.20945/2359-3997000000326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective Male hypogonadism (MH) is common among infertile men. Besides testosterone, limited MH biomarkers are available, while researchers have suggested the use of prostate-specific antigen (PSA) to help diagnose MH. Hence, we sought to evaluate the potential use of PSA to predict MH among relatively young men with infertility in Nigeria. Methods The study included 707 male partners (35-44 years) in infertile couples seeking infertility evaluation at a third-level care center in Nigeria. MH was diagnosed using standard guidelines. Receiver operating characteristic (ROC) and regression analyses explored the potential of serum free PSA (fPSA) and total PSA (tPSA) in predicting MH and MH-related clinical features. Results In all, 29.7% of the patients had MH (MH+ve). The MH+ve group had lower mean values of fPSA and tPSA than the group without MH (MH-ve). The best fPSA threshold of < 0.25 μg/L compared with the best tPSA threshold of < 0.74 μg/L had higher accuracy (area under the curve [AUC] 0.908 versus 0.866, respectively), sensitivity (87% versus 83%, respectively), and specificity (42% versus 37%, respectively) for MH diagnosis. After adjustment for confounders, fPSA level ≤ 0.25 μg/L was more likely to predict MH-related decreased libido (odds ratio [OR] 2.728, p<0.001) and erectile dysfunction (OR 3.925, p<0.001) compared with tPSA ≤ 0.74 μg/L in the MH+ve group. Conclusion For MH diagnosis, fPSA and tPSA had good sensitivity but very poor specificity, although fPSA had better potential for MH diagnosis and association with MH-related clinical features than tPSA. Hence, fPSA could complement other biomarkers for MH diagnosis in men 35-44 years, although we recommend further studies to confirm these findings.
Collapse
Affiliation(s)
- Collins Amadi
- Department of Chemical Pathology, Rivers State University, Port Harcourt, Rivers State, Nigeria,
| | - Kinikanwo I Green
- Department of Obstetrics and Gynecology, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria
| | - Ehimen P Odum
- Department of Chemical Pathology, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria
| |
Collapse
|
30
|
Ye J, Zhai X, Yang J, Zhu Z. Association between Serum Testosterone Levels and Body Composition among Men 20-59 Years of Age. Int J Endocrinol 2021; 2021:7523996. [PMID: 34589126 PMCID: PMC8476276 DOI: 10.1155/2021/7523996] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 08/26/2021] [Accepted: 09/13/2021] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Sex hormones play an important role in the development and maintenance of bone and muscle mass. However, studies regarding serum testosterone levels, osteoporosis, and sarcopenia in men are relatively sparse and have led to contradictory conclusions. Therefore, this study aimed to investigate the association between serum testosterone levels and body composition, including bone mineral density (BMD), appendicular lean mass index (ALMI), and appendicular fat mass index (AFMI), among men 20-59 years of age through a cross-sectional analysis of the National Health and Nutrition Examination Survey. MATERIALS AND METHODS Our analysis was based on the data for 3,875 men, 20-59 years of age. Weighted multiple regression analyses were used to estimate the independent association between serum testosterone levels and body composition. Weighted generalized additive models and smooth curve fittings were used to characterize the nonlinear associations between them. RESULTS The association between the serum testosterone level and lumbar BMD was positive in each multivariable linear regression model. In the model adjusted for age and race, the serum testosterone level was negatively associated with ALMI. However, in the models adjusted for body mass index, this association became positive. In addition, the association between the serum testosterone level and AFMI was negative in each multivariable linear regression model. CONCLUSION Our study demonstrated a positive association of serum testosterone level with lumbar BMD and ALMI, and a negative association with AFMI, among men 20-59 years of age, suggesting that increasing testosterone levels may be beneficial to skeletal health in young and middle-aged men with low testosterone levels.
Collapse
Affiliation(s)
- Jiajie Ye
- Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning 110847, China
| | - Xiaojun Zhai
- Department of Orthopedics, The Affiliated Jiangnan Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang 311200, China
| | - Jinxiao Yang
- Department of Urology, The Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, Zhejiang 311200, China
| | - Zhongxin Zhu
- Department of Osteoporosis Care and Control, The Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, Zhejiang 311200, China
- Clinical Research Center, The Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, Zhejiang 311200, China
| |
Collapse
|
31
|
Seol A, Kim SI, Song YS. Sarcopenia: Clinical implications in ovarian cancer, diagnosis, etiology, and management. SPORTS MEDICINE AND HEALTH SCIENCE 2020; 2:202-210. [PMID: 35782999 PMCID: PMC9219260 DOI: 10.1016/j.smhs.2020.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/05/2020] [Accepted: 10/06/2020] [Indexed: 12/25/2022] Open
Abstract
Sarcopenia, loss of skeletal muscle and function, is a common condition among the elderly and is known to cause adverse health outcomes and increased risk of morbidity and mortality. This progressive and generalized disorder imposes a considerable socioeconomic burden. Sarcopenia is observed commonly in cancer patients. As Asia is one of the fastest aging regions in the world, it is clear that incidences of both sarcopenia and ovarian cancer will increase together in Asian countries. Ovarian cancer patients are vulnerable to develop sarcopenia during the treatment course and progress of disease, and a considerable number of patients with ovarian cancer seems to have physical inactivity and sarcopenia already at the time of diagnosis. Therefore, management of sarcopenia should be conducted together in parallel with ovarian cancer treatment and surveillance. Thus, in this article, we will review the clinical importance of sarcopenia in the aspect of ovarian cancer. Definition of sarcopenia, diagnosis, etiology, and intervention will be also introduced.
Collapse
Affiliation(s)
- Aeran Seol
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Se Ik Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yong Sang Song
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
- Corresponding author. Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul 03080, Republic of Korea.
| |
Collapse
|
32
|
Parahiba SM, Ribeiro ÉCT, Corrêa C, Bieger P, Perry IS, Souza GC. Effect of testosterone supplementation on sarcopenic components in middle-aged and elderly men: A systematic review and meta-analysis. Exp Gerontol 2020; 142:111106. [PMID: 33045359 DOI: 10.1016/j.exger.2020.111106] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 09/30/2020] [Accepted: 10/01/2020] [Indexed: 10/23/2022]
Abstract
The aim of this study was to conduct a systematic review of the literature of randomized controlled trials on the effect of testosterone (T) supplementation compared to the placebo group or lower dose on sarcopenic components (muscle mass, strength and physical performance) in middle-aged and elderly men. Major electronic databases were searched for articles published on or before December 2019. Studies including individuals with age ≥ 40 years and which described the effect of T supplementation on sarcopenic components were found eligible (11 studies). Outcomes were calculated as the difference in means between the experimental and control/placebo groups, and data were presented as effect size with 95% confidence limits (95%CI). The meta-analysis was performed using a random effects model. Regarding lean body mass (LBM), eight studies evaluated the effect of T supplementation on this outcome, of these, seven reported gains after the intervention period. Our meta-analysis showed a beneficial effect on LBM of 2.54 kg (95% CI, 1.27 to 3.80) (p < 0.001). In muscle strength (MS), seven included studies evaluated the handgrip strength (HGS) and just one reported gain after the intervention period, but the meta-analysis showed an increase for HGS of 1.58 kgf (95%CI, 0.17 to 3.0) (p = 0.03). The second outcome for MS was leg strength (LS), where nine studies were included and five demonstrated gains in this parameter after the intervention period. In the meta-analysis, two out of three tests showed an effect on LS: T supplementation increase the leg press strength in 91.23 N (95%CI, 0.23 to 182.22) (p = 0.05) and leg extension in 144.10 N (95%CI, 44.21 to 244.00) (p < 0.01). In physical performance, four studies evaluated this outcome, with three of them showing positive effects in this parameter. In the meta-analysis, only two studies that reported the same assessment test (Physical Performance Test) were included, but no effect of T supplementation on this parameter was found. It can be concluded that T supplementation influences sarcopenic components in middle-aged and older men, because is associated with increased in muscle mass and strength in addition to physical performance.
Collapse
Affiliation(s)
- Suena Medeiros Parahiba
- Hospital de Clínicas de Porto Alegre, 2350 Ramiro Barcelos Street, Porto Alegre, Rio Grande do Sul, Brazil; Graduate Program in Food, Nutrition and Health, Medical School, Federal University of Rio Grande do Sul, 2400 Ramiro Barcelos Street - 2nd floor, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Édina Caroline Ternus Ribeiro
- Hospital de Clínicas de Porto Alegre, 2350 Ramiro Barcelos Street, Porto Alegre, Rio Grande do Sul, Brazil; Graduate Program in Food, Nutrition and Health, Medical School, Federal University of Rio Grande do Sul, 2400 Ramiro Barcelos Street - 2nd floor, Porto Alegre, Rio Grande do Sul, Brazil
| | - Camila Corrêa
- Hospital de Clínicas de Porto Alegre, 2350 Ramiro Barcelos Street, Porto Alegre, Rio Grande do Sul, Brazil; Graduate Program in Medical Sciences: Endocrinology, Medical School, Federal University of Rio Grande do Sul, 2400 Ramiro Barcelos Street - 2nd floor, Porto Alegre, Rio Grande do Sul, Brazil
| | - Patrícia Bieger
- Graduate Program in Food, Nutrition and Health, Medical School, Federal University of Rio Grande do Sul, 2400 Ramiro Barcelos Street - 2nd floor, Porto Alegre, Rio Grande do Sul, Brazil
| | - Ingrid Schweigert Perry
- Food and Nutrition Research Center, Hospital de Clínicas de Porto Alegre/Federal University of Rio Grande do Sul, 2350 Ramiro Barcelos Street, 3rd floor of the Clinical Research Center, Porto Alegre, Rio Grande do Sul, Brazil
| | - Gabriela Corrêa Souza
- Hospital de Clínicas de Porto Alegre, 2350 Ramiro Barcelos Street, Porto Alegre, Rio Grande do Sul, Brazil; Graduate Program in Food, Nutrition and Health, Medical School, Federal University of Rio Grande do Sul, 2400 Ramiro Barcelos Street - 2nd floor, Porto Alegre, Rio Grande do Sul, Brazil.
| |
Collapse
|
33
|
Varanoske AN, Margolis LM, Pasiakos SM. Effects of Testosterone on Serum Concentrations, Fat-free Mass, and Physical Performance by Population: A Meta-analysis. J Endocr Soc 2020; 4:bvaa090. [PMID: 32864543 DOI: 10.1210/jendso/bvaa090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 06/29/2020] [Indexed: 11/19/2022] Open
Abstract
Testosterone (T) administration (TA) increases serum T and fat-free mass (FFM). Although TA-mediated increases in FFM may enhance physical performance, the data are largely equivocal, which may be due to differences in study populations, the magnitude of change in serum T and FFM, or the performance metrics. This meta-analysis explored effects of TA on serum T, FFM, and performance. Associations between increases in serum T and FFM were assessed, and whether changes in serum T or FFM, study population, or the performance metrics affected performance was determined. A systematic review of double-blind randomized trials comparing TA versus placebo on serum T, FFM, and performance was performed. Data were extracted from 20 manuscripts. Effect sizes (ESs) were assessed using Hedge's g and a random effects model. Data are presented as ES (95% confidence interval). No significant correlation between changes in serum T and FFM was observed (P = .167). Greater increases in serum T, but not FFM, resulted in larger effects on performance. Larger increases in testosterone (7.26 [0.76-13.75]) and FFM (0.80 [0.20-1.41]) were observed in young males, but performance only improved in diseased (0.16 [0.05-0.28]) and older males (0.19 [0.10-0.29]). TA increased lower body (0.12 [0.07-0.18]), upper body (0.26 [0.11-0.40]), and handgrip (0.13 [0.04-0.22]) strength, lower body muscular endurance (0.38 [0.09-0.68]), and functional performance (0.20 [0.00-0.41]), but not lower body power or aerobic endurance. TA elicits increases in serum T and FFM in younger, older, and diseased males; however, the performance-enhancing effects of TA across studies were small, observed mostly in muscular strength and endurance, and only in older and diseased males.
Collapse
Affiliation(s)
- Alyssa N Varanoske
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts.,Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Lee M Margolis
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Stefan M Pasiakos
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts
| |
Collapse
|
34
|
Wouters HJCM, Stam SP, van der Klauw MM, Bakker SJL, Eisenga MF. The association between haemoglobin concentrations and muscle mass determined from urinary creatinine excretion rate: a population-based cohort study. Br J Haematol 2020; 190:e349-e352. [PMID: 32579232 DOI: 10.1111/bjh.16912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Hanneke J C M Wouters
- Department of Hematology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Suzanne P Stam
- Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Melanie M van der Klauw
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Stephan J L Bakker
- Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Michele F Eisenga
- Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| |
Collapse
|
35
|
Zhang Z, Kang D, Li H. The effects of testosterone on bone health in males with testosterone deficiency: a systematic review and meta-analysis. BMC Endocr Disord 2020; 20:33. [PMID: 32145741 PMCID: PMC7060639 DOI: 10.1186/s12902-020-0509-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 02/14/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Testosterone deficiency (TD) may induce a series of clinical symptoms. Studies have shown that testosterone supplementation may prevent these unfavourable symptoms and improve patients' quality of life. Given the conflicting findings across studies, this systematic review aims to evaluate the effects and risks associated with testosterone supplementation in middle-aged or aging males with TD. METHODS Electronic databases (MEDLINE, EMBASE, PubMed, and Cochrane. Library were searched to December 2019. The risk of bias of individual included studies and the quality of the aggregate evidence were assessed using the GRADE approach. Our primary outcome was bone mineral density (BMD). Meta-analyses were performed. This systematic review was reported according to the PRISMA statement. RESULTS A total of 52 randomized controlled trials (RCTs) were included. When compared with placebo, testosterone supplementation did not increase total BMD (short-term: 1081 participants, MD - 0.01 g/cm2, 95% CI - 0.02 g/cm2 to 0.01 g/cm2; long-term: 156 participants, MD 0.04 g/cm2, 95% CI - 0.07 g/cm2 to 0.14 g/cm2), lumbar spine, hip, or femur neck BMD. Furthermore, testosterone supplementation did not decrease the risk of falling or fracture. Lastly, it was found that testosterone supplementation did not increase the risk of cardiovascular events (1374 participants, RR 1.28, 95% CI 0.62 to 2.64), all-cause mortality (729 participants, RR 0.55, 95% CI 0.29 to 1.04), or prostatic events. However, testosterone supplementation may improve sexual function and quality of life (1328 participants, MD -1.32, 95% CI - 2.11 to - 0.52). CONCLUSIONS The effect of testosterone supplementation on BMD and the risk of falls or fracture remains inconclusive. However, supplementation may benefit patients in the areas of sexual function and quality of life without increasing the risk of cardiovascular events, all-cause mortality, or prostatic events. RCTs with a longer follow-up period are still required. TRIAL REGISTRATION We registered our protocol in PROSPERO (CRD42018109738).
Collapse
Affiliation(s)
- Zhichao Zhang
- Andrology Center, Department of Urology, Peking University First Hospital; Institute of Urology, Peking University, No 8 Xishenku Street, Beijing, 100034, China
| | - Deying Kang
- Department of Evidence based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, No. 37 Guoxuexiang, Chengdu, 610041, China
| | - Hongjun Li
- Urological Department of Peking Union Medical College Hospital (PUMCH), Peking Union Medical College, Chinese Academy of Medical Sciences, No. 1 Shuaifu, Eastern District, Beijing, 100730, China.
| |
Collapse
|
36
|
Fatima M, Brennan-Olsen SL, Duque G. Therapeutic approaches to osteosarcopenia: insights for the clinician. Ther Adv Musculoskelet Dis 2019; 11:1759720X19867009. [PMID: 31431811 PMCID: PMC6686316 DOI: 10.1177/1759720x19867009] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 07/06/2019] [Indexed: 12/19/2022] Open
Abstract
Osteopenia/osteoporosis and sarcopenia are both age-related conditions. Given the well-defined bone and muscle interaction, when osteopenia and sarcopenia occur simultaneously, this geriatric syndrome is defined as ‘osteosarcopenia’. Evidence exists about therapeutic interventions common to both bone and muscle, which could thereby be effective in treating osteosarcopenia. In addition, there are roles for common nonpharmacological strategies such as nutritional intervention and physical exercise prescription in the management of this condition. In this review we summarize the evidence on current and upcoming therapeutic approaches to osteosarcopenia.
Collapse
Affiliation(s)
- Mizhgan Fatima
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, VIC, Australia
| | - Sharon L Brennan-Olsen
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, VIC, Australia
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, 176 Furlong Road, St. Albans, VIC 3021, Australia
| |
Collapse
|
37
|
Seara FAC, Barbosa RAQ, Santos MVN, Domingos AE, Monnerat G, Carvalho AB, Olivares EL, Mill JG, Nascimento JHM, Campos de Carvalho AC. Paradoxical effect of testosterone supplementation therapy on cardiac ischemia/reperfusion injury in aged rats. J Steroid Biochem Mol Biol 2019; 191:105335. [PMID: 30930218 DOI: 10.1016/j.jsbmb.2019.03.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 03/18/2019] [Accepted: 03/19/2019] [Indexed: 02/08/2023]
Abstract
Aging is followed by numerous physiological limitations that reduce health span, particularly cardiovascular and metabolic disorders. Testosterone supplementation therapy (TST) has been widely used in the treatment of aging dysfunctions in either adult or aged patients, although recent evidence have suggested that the incidence of myocardial infarction might be increased in elderly patients. So far, though, the effects of TST in the progression of cardiac ischemia/reperfusion (IR) injury in aged hearts remain unclear. Male aged (23-24 months old) and adult (6 months old) Wistar rats were treated with placebo (Old + Placebo n = 5 / Adult + Placebo n = 5) or TST (Old + TST n = 7 / Adult + TST n = 5) for 30 days. After euthanasia, artificially-perfused isolated rat hearts were submitted to IR. Cardiac expression levels of genes encoding α and β myosin heavy chain (MHC), ryanodine receptor (RyR), brain-natriuretic peptide (BNP), sarcoplasmic reticulum Ca2+ ATPase 2a (SERCA2a), glucose-regulated protein 78 kDa (GRP78), eukaryotic initiation factor 2α (eIF2α), C/EBP-homologous protein (CHOP), caspase 3 and B cell lymphoma 2 (Bcl-2) were accessed by qRT-PCR. Protein levels of CHOP, p-Akt, and p-glycogen synthase kinase 3β (p-GSK-3β) were measured by Western Blot. Compared to placebo-treated aged rats, Old + TST group exhibited increased heart weight and up-regulation of αMHC mRNA expression levels, whereas βMHC mRNA expression (p < 0.05). During reperfusion, left ventricular developed pressure, dP/dt+, dP/dt-, and cardiac contractile function index were increased in Old + TST rat hearts (p < 0.05), whereas infarct size was increased (p < 0.05) in comparison with Old + Placebo group. p-Akt levels of Old + TST rat hearts were decreased when compared to Old + Placebo group. Conversely, TST did not promote significant effects in adult rat hearts. Taken together, these findings suggest that myocardial stunning and infarct size of aged hearts were distinctly affected by TST.
Collapse
Affiliation(s)
- Fernando A C Seara
- Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil; Department of Physiological Sciences, Federal Rural University of Rio de Janeiro, Seropedica, RJ, Brazil.
| | - Raiana A Q Barbosa
- Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Marcus V N Santos
- Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Ainá E Domingos
- Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Gustavo Monnerat
- Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Adriana B Carvalho
- Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Emerson L Olivares
- Department of Physiological Sciences, Federal Rural University of Rio de Janeiro, Seropedica, RJ, Brazil
| | - José G Mill
- Department of Physiological Sciences, Federal University of Espirito Santo, Vitoria, ES, Brazil
| | - Jose H M Nascimento
- Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Antonio C Campos de Carvalho
- Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil; National Center for Structural Biology and Bioimaging, Federal University of Rio de Janeiro, RJ, Brazil
| |
Collapse
|
38
|
Rano J, Fridén C, Eek F. Effects of acute psychological stress on athletic performance in elite male swimmers. J Sports Med Phys Fitness 2019; 59:1068-1076. [DOI: 10.23736/s0022-4707.18.08493-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
39
|
Ofori EK, Conde Alonso S, Correas-Gomez L, Carnero EA, Zwygart K, Hugues H, Bardy D, Hans D, Dwyer AA, Amati F. Thigh and abdominal adipose tissue depot associations with testosterone levels in postmenopausal females. Clin Endocrinol (Oxf) 2019; 90:433-439. [PMID: 30575083 DOI: 10.1111/cen.13921] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 12/15/2018] [Accepted: 12/17/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Research findings on the relationship between serum androgens and adipose tissue in older females are inconsistent. We aimed to clarify the relationship using state-of-the-art techniques to evaluate associations between body fat distribution and plasma testosterone (T) levels in older postmenopausal women. DESIGN Observational, cross-sectional study of healthy, community dwelling postmenopausal women. PATIENTS AND MEASUREMENTS Postmenopausal women (60-80 years old) were included in this study. Overall body composition was evaluated by dual-energy X-ray absorptiometry. Abdominal and thigh fat depots were measured by magnetic resonance imaging. Circulating T concentrations were analysed by liquid chromatography-tandem mass spectrometry. RESULTS Thirty-five women (66.6 ± 0.8 years) participated in this study. T levels were positively associated with clinical proxy measures of adiposity including weight (ρ = 0.39), BMI (ρ = 0.43) and waist circumference (ρ = 0.39) (all P < 0.05). Fat mass and % body fat were correlated with T levels (ρ = 0.42 and 0.38 respectively, both P < 0.05). T correlated with overall and superficial abdominal fat (ρ = 0.34 and 0.37 respectively, both P < 0.05) but not with visceral adipose tissue. T increased with greater thigh fat (ρ = 0.49, P < 0.05) in both superficial and deep depots (ρ = 0.50 and 0.35 respectively, both P < 0.05). CONCLUSION Our results suggest that postmenopausal women with higher circulating T levels have both higher regional and overall body adiposity. These findings underscore the sexual dimorphism in the relationship between serum androgen levels and adiposity.
Collapse
Affiliation(s)
- Emmanuel K Ofori
- Aging and Muscle Metabolism Laboratory, Department of Physiology, School of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Sonia Conde Alonso
- Aging and Muscle Metabolism Laboratory, Department of Physiology, School of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Lorena Correas-Gomez
- Aging and Muscle Metabolism Laboratory, Department of Physiology, School of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Elvis A Carnero
- Aging and Muscle Metabolism Laboratory, Department of Physiology, School of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Karin Zwygart
- Magnetic Resonance Spectroscopy and Methodology, Department of Clinical Research, University of Bern, Bern, Switzerland
| | - Henry Hugues
- Clinical Chemistry Laboratory, University Hospital (CHUV), Lausanne, Switzerland
| | - Daniel Bardy
- Clinical Chemistry Laboratory, University Hospital (CHUV), Lausanne, Switzerland
| | - Didier Hans
- Center for Bone Diseases, University Hospital (CHUV), Lausanne, Switzerland
| | - Andrew A Dwyer
- Service of Endocrinology, Diabetology and Metabolism, University Hospital (CHUV), Lausanne, Switzerland
- William F. Connell School of Nursing, Boston College, Boston, Massachusetts
| | - Francesca Amati
- Aging and Muscle Metabolism Laboratory, Department of Physiology, School of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Service of Endocrinology, Diabetology and Metabolism, University Hospital (CHUV), Lausanne, Switzerland
- Institute of Sport Sciences (ISSUL), University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
40
|
Park B, Lee YJ. Upcoming Aging Society and Men's Health: Focus on Clinical Implications of Exercise and Lifestyle Modification. World J Mens Health 2019; 38:24-31. [PMID: 30799560 PMCID: PMC6920071 DOI: 10.5534/wjmh.180103] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 12/14/2018] [Accepted: 12/24/2018] [Indexed: 12/28/2022] Open
Abstract
Recent epidemiological research has indicated that men have increased health risks due to biological and social factors. Research in the area of men's health has been focused on disease events and subsequent disabilities. In future aging societies, more attention should be paid to the importance of men's health because a decreased quality of life and increased social burden are impending unless proper maneuvers are taken to slow the development and progression of morbidity through the use of preventive strategies. The adoption of a healthier lifestyle and the early identification and management of risk factors are very important and can be an initiative for prevention and for slowing the progression of morbidities with related quality of life issues. Males are rather vulnerable in terms of health, and conscious and active efforts are required to promote their health in an aging society. Here, we hope to shed light on the influence of lifestyle modifications and their clinical implications on men's health.
Collapse
Affiliation(s)
- Byoungjin Park
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Korea.,Department of Medicine, Graduate School of Medicine, Yonsei University, Seoul, Korea
| | - Yong Jae Lee
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Korea.,Department of Family Medicine, Gangnam Severance Hospital, Seoul, Korea.
| |
Collapse
|
41
|
Rynders CA, Schmidt SL, Bergouignan A, Horton TJ, Bessesen DH. Effects of short-term sex steroid suppression on dietary fat storage patterns in healthy males. Physiol Rep 2019; 6. [PMID: 29380951 PMCID: PMC5789716 DOI: 10.14814/phy2.13533] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 11/06/2017] [Accepted: 11/10/2017] [Indexed: 11/24/2022] Open
Abstract
Hypogonadism in males is associated with increased body fat and altered postprandial metabolism, but mechanisms remain poorly understood. Using a cross‐over study design, we investigated the effects of short‐term sex hormone suppression with or without testosterone add‐back on postprandial metabolism and the fate of dietary fat. Eleven healthy males (age: 29 ± 4.5 year; BMI: 26.3 ± 2.1 kg/m2) completed two 7‐day study phases during which hormone levels were altered pharmacologically to produce a low sex hormone condition (gonadotropin releasing hormone antagonist, aromatase inhibitor, and placebo gel) or a testosterone add‐back condition (testosterone gel). Following 7 days of therapy, subjects were administered an inpatient test meal containing 50 μCi of [1‐14C] oleic acid. Plasma samples were collected hourly for 5 h to assess postprandial responses. Energy metabolism (indirect calorimetry) and dietary fat oxidation (14CO2 in breath) were assessed at 1, 3, 5, 13.5, and 24 h following the test meal. Abdominal and femoral adipose biopsies were taken 24 h after the test meal to determine uptake of the labeled lipid. Postprandial glucose, insulin, free‐fatty acid, and triglyceride responses were not different between conditions (P > 0.05). Whole‐body energy metabolism was also not different between conditions at any time point (P > 0.05). Dietary fat oxidation trended lower (P = 0.12) and the relative uptake of 14C labeled lipid into femoral adipose tissue was greater (P = 0.03) in the low hormone condition. Short‐term hormone suppression did not affect energy expenditure or postprandial metabolism, but contributed to greater relative storage of dietary fat in the femoral depot. ClinicalTrials.gov Identifier: NCT03289559.
Collapse
Affiliation(s)
- Corey A Rynders
- Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | | | - Audrey Bergouignan
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado.,IPHC-DEPE, Université de Strasbourg, Strasbourg, France.,UMR 7178 Centre National de la Recherche Scientifique (CNRS), Strasbourg, France
| | - Tracy J Horton
- Department of Art and Art History, Colorado State University, Fort Collins, Colorado
| | - Daniel H Bessesen
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado.,Department of Medicine, Denver Health Medical Center, Denver, Colorado
| |
Collapse
|
42
|
Tchernof A, Brochu D, Maltais‐Payette I, Mansour MF, Marchand GB, Carreau A, Kapeluto J. Androgens and the Regulation of Adiposity and Body Fat Distribution in Humans. Compr Physiol 2018; 8:1253-1290. [DOI: 10.1002/cphy.c170009] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
|
43
|
Carson RG. Get a grip: individual variations in grip strength are a marker of brain health. Neurobiol Aging 2018; 71:189-222. [PMID: 30172220 DOI: 10.1016/j.neurobiolaging.2018.07.023] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 07/06/2018] [Accepted: 07/29/2018] [Indexed: 02/06/2023]
Abstract
Demonstrations that grip strength has predictive power in relation to a range of health conditions-even when these are assessed decades later-has motivated claims that hand-grip dynamometry has the potential to serve as a "vital sign" for middle-aged and older adults. Central to this belief has been the assumption that grip strength is a simple measure of physical performance that provides a marker of muscle status in general, and sarcopenia in particular. It is now evident that while differences in grip strength between individuals are influenced by musculoskeletal factors, "lifespan" changes in grip strength within individuals are exquisitely sensitive to integrity of neural systems that mediate the control of coordinated movement. The close and pervasive relationships between age-related declines in maximum grip strength and expressions of cognitive dysfunction can therefore be understood in terms of the convergent functional and structural mediation of cognitive and motor processes by the human brain. In the context of aging, maximum grip strength is a discriminating measure of neurological function and brain health.
Collapse
Affiliation(s)
- Richard G Carson
- Trinity College Institute of Neuroscience, School of Psychology, Trinity College Dublin, Dublin, Ireland; School of Psychology, Queen's University Belfast, Belfast, Northern Ireland, UK; School of Human Movement and Nutrition Sciences, The University of Queensland, Australia.
| |
Collapse
|
44
|
Park HM. Current Status of Sarcopenia in Korea: A Focus on Korean Geripausal Women. Ann Geriatr Med Res 2018; 22:52-61. [PMID: 32743248 PMCID: PMC7387617 DOI: 10.4235/agmr.2018.22.2.52] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 03/29/2018] [Accepted: 04/26/2018] [Indexed: 12/14/2022] Open
Abstract
Sarcopenia is defined as an age-associated decline in muscle mass and function caused by several etiologies and mechanisms. Muscle mass and function do not decrease concurrently, and a loss of muscle function may be more highly associated with adverse health outcomes. Despite the clinical significance of sarcopenia, no universally operational definition of sarcopenia or standardized intervention programs are currently available. Sarcopenia, osteoporosis, and obesity share several pathophysiological mechanisms, and a combination of these entities may lead to an increased risk of musculoskeletal, cardio-metabolic, and psychological morbidities especially in geripause populations. Treatment for sarcopenia is mainly nonpharmacological, however, various drugs are currently being developed. It is conceivable that sarcopenia is the next immediate clinical target in musculoskeletal science.
Collapse
|
45
|
Effects of clomiphene citrate on male obesity-associated hypogonadism: a randomized, double-blind, placebo-controlled study. Int J Obes (Lond) 2018; 42:953-963. [PMID: 29777228 DOI: 10.1038/s41366-018-0105-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 03/13/2018] [Accepted: 03/25/2018] [Indexed: 11/09/2022]
Abstract
BACKGROUND Obesity causes secondary hypogonadism (HG) in men. Standard testosterone (T) replacement therapy improves metabolic parameters but leads to infertility. OBJECTIVE To evaluate clomiphene citrate (CC) treatment of adult men with male obesity-associated secondary hypogonadism (MOSH). DESIGN Single-center, randomized, double-blind, placebo-controlled trial. PARTICIPANTS Seventy-eight men aged 36.5 ± 7.8 years with a body mass index (BMI) > 30 kg/m2, total testosterone (TT) ≤ 300 ng/dL, and symptoms in the ADAM questionnaire. INTERVENTION Random allocation to receive 50 mg CC or placebo (PLB) for 12 weeks. OUTCOMES (1) Clinical features: ADAM and sexual behavior questionnaires; (2) hormonal profile: serum TT, free T, estradiol (E2), luteinizing hormone (LH), follicle-stimulating hormone (FSH), and sex hormone-binding globulin (SHBG); (3) body composition: BMI, waist circumference, and bioelectric impedance analysis; (4) metabolic profile: blood pressure, fasting blood glucose, HbA1c, insulin, HOMA-IR, and lipid profile; (5) endothelial function: flow-mediated dilation of the brachial artery, quantitative assessment of endothelial progenitor cells and serum sICAM-1, sVCAM-1, and selectin-sE levels; (6) safety aspects: hematocrit, serum prostate-specific antigen, International Prostate Symptom Score, and self-reported adverse effects. RESULTS There was an improvement in one sexual complaint (weaker erections; P < 0.001); increases (P < 0.001) in TT, free T, E2, LH, FSH, and SHBG; and improvements in lean mass (P < 0.001), fat-free mass (P = 0.004), and muscle mass (P < 0.001) in the CC group. CC reduced HDL (P < 0.001). No statistically significant differences were seen in endothelial function. CONCLUSIONS CC appeared to effectively improve the hormonal profile and body composition. CC may be an alternative treatment for MOSH in adult men.
Collapse
|
46
|
Shin MJ, Jeon YK, Kim IJ. Testosterone and Sarcopenia. World J Mens Health 2018; 36:192-198. [PMID: 29756416 PMCID: PMC6119844 DOI: 10.5534/wjmh.180001] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 03/19/2018] [Accepted: 03/27/2018] [Indexed: 01/06/2023] Open
Abstract
Aging affects metabolism, leading to physiological and functional impairments, and is also related to changes in body composition, including reduced skeletal muscle mass and increased body fat. These changes are correlated with the pathophysiology of sarcopenia, which is defined as age-related loss of skeletal muscle mass and strength. Low testosterone levels are associated with unfavorable body composition changes, and sex hormones decrease with aging. Androgen deficiency, along with lack of exercise and poor nutrition, may be among the modifiable contributors to sarcopenia. Testosterone treatment has been reported to have beneficial effects on muscle mass and function, but the results have been inconsistent. Here, we discuss the correlation between testosterone and muscle mass and function, the impact of testosterone on sarcopenia, and the probable mechanisms underlying these effects.
Collapse
Affiliation(s)
- Myung Jun Shin
- Department of Rehabilitation Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.,Medical Research Institute, Pusan National University, Busan, Korea
| | - Yun Kyung Jeon
- Division of Endocrinology, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.,Medical Research Institute, Pusan National University, Busan, Korea.
| | - In Joo Kim
- Division of Endocrinology, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.,Medical Research Institute, Pusan National University, Busan, Korea
| |
Collapse
|
47
|
Nam YS, Lee G, Yun JM, Cho B. Testosterone Replacement, Muscle Strength, and Physical Function. World J Mens Health 2018; 36:110-122. [PMID: 29623702 PMCID: PMC5924952 DOI: 10.5534/wjmh.182001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 12/19/2017] [Accepted: 12/26/2017] [Indexed: 12/15/2022] Open
Abstract
Muscle strength and physical function decrease in older men, as do testosterone levels. Nonetheless, the effects of testosterone replacement therapy on muscle strength and physical function remain inconclusive and equivocal. We conducted a rapid systematic review, the results of which showed that testosterone replacement does not affect muscle strength (measured by hand grip strength and leg muscle strength), although it may increase physical function (measured by the 6-minute walk test, Physical Activity Scale for the Elderly score, and other physical performance tests). However, most of the studies were conducted in the United States or Europe and did not include participants from Asian or other ethnic backgrounds; therefore, further studies are needed to evaluate the effects of testosterone replacement in a broader population.
Collapse
Affiliation(s)
- You Seon Nam
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Gyeongsil Lee
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jae Moon Yun
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Belong Cho
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea.,Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.,Advanced Institutes of Convergence Technology, Seoul National University, Suwon, Korea.,Institute on Aging, Seoul National University College of Medicine, Seoul, Korea.
| |
Collapse
|
48
|
Gao J, Zhang M, Zhu C, Zhang Y, Liu Q, Wang X, Li L, Zhou D, Qu S. The Change in the Percent of Android and Gynoid Fat Mass Correlated with Increased Testosterone After Laparoscopic Sleeve Gastrectomy in Chinese Obese Men: a 6-Month Follow-Up. Obes Surg 2018; 28:1960-1965. [DOI: 10.1007/s11695-018-3116-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
|
49
|
Ferlin A, De Toni L, Agoulnik AI, Lunardon G, Armani A, Bortolanza S, Blaauw B, Sandri M, Foresta C. Protective Role of Testicular Hormone INSL3 From Atrophy and Weakness in Skeletal Muscle. Front Endocrinol (Lausanne) 2018; 9:562. [PMID: 30323788 PMCID: PMC6172310 DOI: 10.3389/fendo.2018.00562] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 09/04/2018] [Indexed: 01/06/2023] Open
Abstract
Androgens are primarily involved in muscle growth, whilst disease-driven muscle wasting is frequently associated with hypogonadism. The Leydig cells of the testes also produce the peptide-hormone Insulin-like peptide 3 (INSL3). INSL3 displays anabolic activity on bone, a target tissue of androgens, and its plasma concentrations are diminished in male hypogonadism. Here we tested the role of INSL3 on muscle mass regulation, in physiological and pathological conditions. Studies on C2C12 cell line showed that INSL3, acting on his specific receptor RXFP2, promotes skeletal muscle protein synthesis through the Akt/mTOR/S6 pathway. Next, studies on Rxfp2 -/- mice showed that INSL3 is required to prevent excessive muscle loss after denervation. Mechanistically, denervated Rxfp2 -/- mice lacked the compensatory activation of the Akt/mTOR/S6 pathway and showed an abnormal ubiquitin-proteasome system activation. Lack of INSL3 activity resulted also in reduced contractile force. These findings underlie a role of INSL3/RXFP2 in protein turnover, contributing to muscle wasting in male hypogonadism.
Collapse
Affiliation(s)
- Alberto Ferlin
- Unit of Endocrinology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Luca De Toni
- Department of Medicine, University of Padova, Padova, Italy
| | - Alexander I. Agoulnik
- Department of Human and Molecular Genetics, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, United States
| | | | - Andrea Armani
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Sergia Bortolanza
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Bert Blaauw
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Marco Sandri
- Department of Biomedical Sciences, University of Padova, Padova, Italy
- Venetian Institute of Molecular Medicine, Padova, Italy
- *Correspondence: Marco Sandri
| | - Carlo Foresta
- Department of Medicine, University of Padova, Padova, Italy
- Carlo Foresta
| |
Collapse
|
50
|
Padilla Colón CJ, Molina-Vicenty IL, Frontera-Rodríguez M, García-Ferré A, Rivera BP, Cintrón-Vélez G, Frontera-Rodríguez S. Muscle and Bone Mass Loss in the Elderly Population: Advances in diagnosis and treatment. JOURNAL OF BIOMEDICINE (SYDNEY, NSW) 2018; 3:40-49. [PMID: 30505650 PMCID: PMC6261527 DOI: 10.7150/jbm.23390] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Aging is the result of different functional changes leading to a substantial reduction of all human capabilities. A variety of anatomical and physiological changes occur with advancing age. These changes are more evident in the elderly population. There are various methods to measure muscle and bone mass loss, but the dual X-ray absorptiometry (DXA) is considered one of the most efficient. The elderly population (65 years and older) has been increasing throughout the years. Loss of muscle mass (sarcopenia) and loss bone mass (osteopenia or osteoporosis) with advancing age, when untreated, represent a major public health problem for the elderly population and may result in loss of independence in later life. Untreated age-related sarcopenia and osteopenia/osteoporosis increase the risk for falls and fractures, making older individuals more susceptible to the development of mobility limitations or severe disabilities that ultimately affect their capacity for independence. In this review, we will discuss the muscle and bone mass loss in the elderly population and advances in diagnosis and treatment.
Collapse
Affiliation(s)
- Carlos J. Padilla Colón
- Department of Education, Physical Education and Health Programs, San Juan, PR, USA
- Research and Development Service (151), VA Caribbean Healthcare System, San Juan PR, USA
| | - Irma L. Molina-Vicenty
- Research and Development Service (151), VA Caribbean Healthcare System, San Juan PR, USA
- Department of Biology, University of Puerto Rico, Rio Piedras Campus, San Juan, PR, USA
- Department of Radiological Sciences, University of Puerto Rico, Medical Sciences Campus, San Juan, PR, USA
| | - María Frontera-Rodríguez
- Research and Development Service (151), VA Caribbean Healthcare System, San Juan PR, USA
- Department of Biology, University of Puerto Rico, Rio Piedras Campus, San Juan, PR, USA
| | - Alejandra García-Ferré
- Research and Development Service (151), VA Caribbean Healthcare System, San Juan PR, USA
- Department of Biology, University of Puerto Rico, Rio Piedras Campus, San Juan, PR, USA
| | | | - Gerardo Cintrón-Vélez
- Research and Development Service (151), VA Caribbean Healthcare System, San Juan PR, USA
- Department of Biology, University of Puerto Rico, Rio Piedras Campus, San Juan, PR, USA
| | - Sebastián Frontera-Rodríguez
- Research and Development Service (151), VA Caribbean Healthcare System, San Juan PR, USA
- Department of Biology, University of Puerto Rico, Rio Piedras Campus, San Juan, PR, USA
| |
Collapse
|