Clinical Meaningfulness of the Changes in Muscle Performance and Physical Function Associated With Testosterone Administration in Older Men With Mobility Limitation

Travison, Thomas G.; Basaria, Shehzad; Storer, Thomas W.; Jette, Alan M.; Miciek, Renee; Farwell, Wildon; Choong, Karen; Lakshman, Kishore M.; Mazer, Norman A.; Coviello, Andrea D.; Knapp, Philip E.; Ulloor, Jagadish; Zhang, Anqi; Brooks, Brad; Nguyen, Ahn; Eder, Richard; LeBrasseur, Nathan K.; Elmi, Ayan; Appleman, Erica R.; Hede-Brierley, Leife; Bhasin, Geeta; Bhatia, Amiya; Lazzari, A; Davis, Stanley N.; Ni, Pengsheng; Collins, Lauren F; Bhasin, Shalender

doi:10.1093/gerona/glr100

Cited by 141 publications

(100 citation statements)

References 39 publications

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“…For example, performing 50-m walk test or climbing a flight of 12 steps while carrying a load was better able to discriminate performances among older, HC and older men with mobility limitations. 93,94 BODY COMPOSITION Body composition is defined as the proportion of different tissue masses in the body. Its analysis can be very detailed and include water compartments, and elemental components of the body; however, the most common approach used to study the effect of ADT on body composition in studies of effects are measurements of fat mass (often expressed as percent body fat), lean mass (% LBM) and bone density.…”

Section: Adt: Body Composition and Physical Functionmentioning

confidence: 99%

Muscle function, physical performance and body composition changes in men with prostate cancer undergoing androgen deprivation therapy

Storer¹,

Miciek²,

Travison³

2012

Asian J Androl

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Prostate cancer (PCa) is the most common visceral malignancy in men with androgen deprivation therapy (ADT) the preferred therapy to suppress testosterone production and hence tumor growth. Despite its effectiveness in lowering testosterone, ADT is associated with side effects including loss of muscle mass, diminished muscle strength, decrements in physical performance, earlier fatigue and declining quality of life. This review reports a survey of the literature with a focus on changes in muscle strength, physical function and body composition, due to short-term and long-term ADT. Studies in these areas are sparse, especially well-controlled, prospective randomized trials. Cross-sectional and longitudinal data (up to 2 years) for men with PCa treated with ADT as well as patients with PCa not receiving ADT and age-matched healthy men are presented when available. Based on limited longitudinal data, the adverse effects of ADT on muscle function, physical performance and body composition occur shortly after the onset of ADT and tend to persist and worsen over time. Exercise training is a safe and effective intervention for mitigating these changes and initial guidelines for exercise program design for men with PCa have been published by the American College of Sports Medicine. Disparities in study duration, types of studies and other patient-specific variables such as time since diagnosis, cancer stage and comorbidities may all affect an understanding of the influence of ADT on health, physical performance and mortality. Keywords: androgen deprivation therapy; androgen suppression; exercise prescription; exercise training; functional assessment; lean body mass; older men; prostate cancer INTRODUCTION Prostate cancer (PCa) is the most common visceral malignancy in men.1 Since the tumor is initially testosterone dependent, androgen deprivation therapy (ADT) is the preferred modality to suppress testosterone production in men with this disease. ADT has been extensively studied with surgical and chemical castration achieved via bilateral orchiectomy, use of a gonadotropin hormone-releasing hormone (GnRH) agonist or anti-androgens. Annually, about 500 000 men in the United States are treated with GnRH agonists.2 Though their effectiveness in lowering serum testosterone to castrate levels is well established, side effects are common.Testosterone and its metabolites are essential for the maintenance of muscle mass and bone mineral content. Body composition changes in men undergoing ADT place them at increased risk not only for diminished physical capacity, but also for coronary artery disease, type II diabetes and the metabolic syndrome, 3 though a recent meta-analysis suggests no increase in cardiovascular mortality. 4 In addition, ADTassociated decreases in muscle and bone mass are thought to be associated with increased fracture risk, diminished muscle strength, decrements in physical performance, earlier fatigue and declining quality of life (Figure 1).This narrative review focuses on changes in muscle strength, physi...

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Section: Adt: Body Composition and Physical Functionmentioning

confidence: 99%

Muscle function, physical performance and body composition changes in men with prostate cancer undergoing androgen deprivation therapy

Storer¹,

Miciek²,

Travison³

2012

Asian J Androl

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“…En plus des effets de l'hypogonadisme, la réduction de la synthèse protéique et de l'anabolisme musculaire observés dans la BPCO et d'autres maladies chroniques pourraient être la conséquence de la diminution des concentrations plasmatiques en IGF-1, elles-mêmes secondaires à la réduc-tion de la sécrétion de GH [11,41,58,59]. Chez les patients avec testostéronémie basse, l'androgénothérapie était associée à une diminution de la masse grasse sous-cutanée et à une augmentation de la masse musculaire [52,56,57,60,61], ainsi qu'à une amélioration de la force musculaire et des capacités fonctionnelles [52,54,56,57,[60][61][62][63][64][65]. Le bien-fondé de l'androgénothérapie chez les patients BPCO est basé sur sa capacité à améliorer l'IMC et la masse musculaire [66,67] et, associée à la réhabilitation respiratoire, à diminuer la morbi-mortalité.…”

Section: Physiopathologie De La Perte Musculaire Dans La Bpcounclassified

Réhabilitation respiratoire dans la broncho-pneumopathie chronique obstructive (BPCO) : l’androgénothérapie, pourquoi ? Pour qui ? Comment ?

Thibault

Samaras

et al. 2016

Nutrition Clinique et Métabolisme

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Résumé L'insuffisance respiratoire chronique obstructive secondaire à la broncho-pneumopathie chronique obstructive (BPCO) combine les effets délétères de l'hypoxie chronique, l'inflammation chronique, l'insulinorésistance, l'augmentation de la dépense énergétique, la fonte musculaire, et le déconditionnement à l'exercice. Comme pour d'autres maladies chroniques, la perte de masse non grasse diminue la survie. Préserver la masse et la fonction musculaires en maintenant le métabolisme mitochondrial oxydatif est un point clé de la prise en charge du patient BPCO. Du fait du vieillissement de la population, de l'augmentation de prévalence de la BPCO et du progrès médical, les années futures vont connaître l'augmentation de la prévalence de la dénutrition chez les patients BPCO. L'androgénopénie, ou l'hypogonadisme, définie par une testostéronémie libre inférieure à 50 pg/mL, est observée chez 40 % des patients BPCO. Comme les androgènes stimulent l'anabolisme musculaire, l'androgénopénie s'associe à une fonte musculaire. Des études, dont une récente méta-analyse, indiquent que l'androgénothérapie pouvait augmenter l'indice de masse corporelle et la masse non grasse, ainsi que la qualité de vie des patients BPCO, mais, seule, était insuffisante pour améliorer la fonction respiratoire. Deux essais randomisés multicentriques ont démontré que l'association androgénothérapie-exercice physique-compléments nutritionnels oraux contenant des acides gras poly-insaturés oméga-3, pendant au moins trois mois, diminuait la morbi-mortalité. Ce traitement multimodal est optimisé dans le cadre de la réhabilitation respiratoire, qui est le traitement de référence de la dénutrition du patient BPCO. © 2016 Elsevier Masson SAS. Tous droits réservés.Mots clés : Dénutrition ; Insuffisance respiratoire ; Activité physique ; Compléments nutritionnels oraux ; Nutrition AbstractChronic obstructive pulmonary disease (COPD) combines the deleterious effects of chronic hypoxia, chronic inflammation, insulin-resistance, increased energy expenditure, muscle wasting, and exercise deconditioning. As for other chronic disorders, loss of fat-free mass decreased survival. The preservation of muscle mass and function, through the protection of the mitochondrial oxidative metabolism, is an important challenge in the management of COPD patients. As the prevalence of the disease is increasing and the medical advances make COPD patients live longer, the prevalence of COPD-associated nutritional disorders is expected to augmentation in future decades. Androgenopenia, or hypogonadism, defined by free testosterone plasma concentrations below 50 pg/mL, is observed in 40% of COPD patients. Due to the stimulating effects of androgens on muscle anabolism, androgenopenia favors loss of muscle mass. Studies, including one recent meta-analysis, indicate that androgen substitution * Auteur correspondant. R. Thibault et al. / Nutrition clinique et métabolisme 30 (2016) 74-82 75 could improve body mass index and fat-free mass as well as quality of life in COPD pa...

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“…Studies of TRT on muscle strength are less clear, most showing a positive effect [8,[35][36][37][39][40][41] but others none [20]. The results of TRT on physical performance were also inconsistent [20,35,36,39,40,[42][43][44].…”

Section: Musculoskeletal Disordersmentioning

confidence: 99%

A view of geriatrics through hormones. What is the relation between andropause and well-known geriatric syndromes?

Samaras

Lang

et al. 2013

Maturitas

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a b s t r a c tAge related male hypogonadism, or "andropause", is increasingly recognized as of frequent occurrence in older patients. Diagnosis requires both the presence of clinical symptoms and low testosterone levels. However, diagnosing andropause in this age group may be challenging since symptoms are frequently non specific and testosterone levels are influenced by a multitude of parameters such as lifestyle factors and chronic diseases. In this article we discuss the pathophysiology, definition and diagnostic difficulties of andropause in geriatric patients. Moreover, we review the relation between testosterone levels and frequent geriatric syndromes such as falls, osteoporosis, cognitive and mood disorders, anemia and cardiovascular disease. Finally, we examine the potential benefits and risks of testosterone replacement therapy in this age group.

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Clinical Meaningfulness of the Changes in Muscle Performance and Physical Function Associated With Testosterone Administration in Older Men With Mobility Limitation

Cited by 141 publications

References 39 publications

Muscle function, physical performance and body composition changes in men with prostate cancer undergoing androgen deprivation therapy

Muscle function, physical performance and body composition changes in men with prostate cancer undergoing androgen deprivation therapy

Réhabilitation respiratoire dans la broncho-pneumopathie chronique obstructive (BPCO) : l’androgénothérapie, pourquoi ? Pour qui ? Comment ?

A view of geriatrics through hormones. What is the relation between andropause and well-known geriatric syndromes?

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