Do the Effects of Testosterone on Muscle Strength, Physical Function, Body Composition, And Quality of Life Persist Six Months after Treatment in Intermediate-Frail and Frail Elderly Men?

O’Connell, Matthew; Roberts, Stephen A.; Srinivas-Shankar, Upendram; Tajar, Abdelouahid; Connolly, Martin J.; Adams, Judith E.; Oldham, Jacqueline; Wu, Frederick C. W.

doi:10.1210/jc.2010-1167

Cited by 85 publications

(59 citation statements)

References 18 publications

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“…Comparatively, lower levels of baseline free testosterone were correlated with an increased risk of incident or worsening mobility limitation in older men of the Framingham Offspring Study (38). In a randomized trial in 274 elderly hypogonadal prefrail or frail males a 6-month testosterone treatment improved muscle mass and strength, but the effects were not maintained at 6 months after treatment (39,40). Presently, testosterone treatment has not yet been shown to reverse frailty in a large randomized trial (41).…”

Section: Discussionmentioning

confidence: 99%

Serum sex steroid hormones and frailty in older American men of the Third National Health and Nutrition Examination Survey (NHANES III)

et al. 2012

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Objective To determine whether frailty is associated with circulating total and free testosterone, total and free estradiol, and sex-hormone binding globulin (SHBG) in older men. Methods With NHANES III data of 461 men aged 60 years and older, we used logistic regression to analyze the associations between serum concentrations of sex steroid hormones, SHBG and frailty. Participants meeting any 3 or more of the 5 frailty criteria were classified as “frail”, all others were considered as non-frail. Results 2.5% of men were frail. Men with SHBG ≥66 nmol/L had three times the odds of frailty (OR=2.97; 95% CI 1.28–6.86) compared to men with SHBG <66 nmol/L. Men with free testosterone levels below 243 pmol/L had an increased odds of frailty (OR=3.92; 95% CI 1.29–11.89). None of these associations was statistically significant after additionally adjusting for body mass index, smoking and history of cardiovascular diseases (CVD). Total testosterone, and total and free estradiol serum levels were not statistically significantly associated with frailty. Conclusions In this US nationally representative study of older men, low free testosterone and high SHBG serum levels were associated with a significantly increased odds of frailty after adjustment for age and race/ethnicity. These associations may, however, be explained by confounding due to obesity, smoking, and the higher prevalence of cardiovascular disease in frail men or by low hormones or high SHBG mediating the association between obesity, smoking, CVD and frailty.

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Section: Discussionmentioning

confidence: 99%

Serum sex steroid hormones and frailty in older American men of the Third National Health and Nutrition Examination Survey (NHANES III)

et al. 2012

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“…For instance, in a recent 12-month trial with 274 intermediate-frail and frail older men, lean body mass and leg muscle strength increased after 6-month treatment with 25-75 mg day 21 testosterone gel, but returned to baseline 6 months after withdrawal from treatment. 13 The differing changes in lean mass and strength between groups appeared to be the direct influence of changing testosterone levels and not secondary treatment-related factors. A similar pattern of on-treatment gains and subsequent losses in muscle mass and strength were reported in a 24-week study of the durability of effects of 12 weeks' administration of oxandrolone on lean body mass, fat mass and several measures of muscle strength.…”

Section: Muscle Function Changes With Adtmentioning

confidence: 91%

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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“…However, there were no attendant improvements in grip strength or physical function [44]. The follow-up study reported loss of treatment gains during in the 6 months after treatment ceased, concluding that the benefits on the above parameters were entirely hormone-dependent, and that ongoing treatment was likely necessary to reduce frailty [45]. Another trial investigating the effects of resistance training along with testosterone supplementation in frail elderly men found that, although testosterone therapy increased muscle size relative to placebo, muscle strength was not significantly improved, nor was there a significant effect on physical function [46].…”

Section: Testosteronementioning

confidence: 92%

Emerging drug therapies for frailty

Shum

Hubbard

2013

Maturitas

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Do the Effects of Testosterone on Muscle Strength, Physical Function, Body Composition, And Quality of Life Persist Six Months after Treatment in Intermediate-Frail and Frail Elderly Men?

Abstract: The effects of 6-month T treatment on muscle strength, lean mass, and QoL in frail men are not maintained at 6 months post treatment.

Cited by 85 publications

References 18 publications

Serum sex steroid hormones and frailty in older American men of the Third National Health and Nutrition Examination Survey (NHANES III)

Serum sex steroid hormones and frailty in older American men of the Third National Health and Nutrition Examination Survey (NHANES III)

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

Emerging drug therapies for frailty

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