Effect of Testosterone Supplementation on Functional Mobility, Cognition, and Other Parameters in Older Men

Emmelot-Vonk, Mariëlle H.; Verhaar, Harald J. J.; Pour, Hamid Reza Nakhai; Alemán, André; Lock, Tycho; Bosch, J. J. van der Werff ten; Grobbee, Diederick E.; Schouw, Yvonne T. van der

doi:10.1001/jama.2007.51

Cited by 433 publications

(358 citation statements)

References 87 publications

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“…Such studies have emphasized the need for interventional studies to clarify cause and effect. In accordance with our findings, four placebo-controlled studies of testosterone therapy in aging men found no effect on insulin sensitivity using surrogate markers of insulin resistance such as the minimal model (Basu et al 2007;Nair et al 2006) and HOMA-IR (Svartberg et al 2008;Emmelot-Vonk et al 2008). Correspondingly, a placebo-controlled, double-blinded study of aging men treated with HCG therapy to increase endogenous testosterone serum levels showed no increase in insulin sensitivity measured by the euglycemic hyperinsulinemic clamp despite an increase in LBM (Liu et al 2003).…”

Section: Discussionsupporting

confidence: 90%

Testosterone therapy increased muscle mass and lipid oxidation in aging men

Frederiksen

Højlund

Hougaard

et al. 2011

AGE

114

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The indication for testosterone therapy in aging hypogonadal men without hypothalamic, pituitary, or testicular disease remains to be elucidated. The aim of this study was to investigate the effect of testosterone therapy on insulin sensitivity, substrate metabolism, body composition, and lipids in aging men with low normal bioavailable testosterone levels using a predefined cutoff level for bioavailable testosterone. A randomized, double-blinded, placebocontrolled study of testosterone treatment (gel) was done on 38 men, aged 60-78 years, with bioavailable testosterone <7.3 nmol/l and a waist circumference >94 cm. Insulin-stimulated glucose disposal (Rd) and substrate oxidation were assessed by euglycemic hyperinsulinemic clamps combined with indirect calorimetry. Lean body mass (LBM) and total fat mass (TFM) were measured by dual x-ray absorptiometry, and serum total testosterone was measured by tandem mass spectrometry. Bioavailable testosterone was calculated. Coefficients (b) represent the placebo-controlled mean effect of intervention. LBM (b=1.9 kg, p=0.003) increased while HDL-cholesterol (b=−0.12 mmol/l, p=0.043) and TFM decreased (b=−1.2 kg, p=0.038) in the testosterone group compared to placebo. Basal lipid oxidation (b=5.65 mg/min/m 2 , p=0.045) increased and basal glucose oxidation (b=−9.71 mg/min/m 2 , p = 0.046) decreased in response to testosterone therapy even when corrected for changes in LBM. No significant changes in insulin-stimulated Rd was observed (b=−0.01mg/min/m 2 , p=0.92). Testosterone therapy increased muscle mass and lipid oxidation in aging men with low normal bioavailable testosterone levels; however, our data did not support an effect of testosterone on whole-body insulin sensitivity using the euglycemic hyperinsulinemic clamp technique.

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Section: Discussionsupporting

confidence: 90%

Testosterone therapy increased muscle mass and lipid oxidation in aging men

Frederiksen

Højlund

Hougaard

et al. 2011

AGE

114

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“…The number of participants in intervention groups ranged from 7 to 113 and in placebo groups from 5 to 110. The drug used was testosterone enanthate (SheffieldMoore et al 2011;Page et al 2005;Ferrando et al 2003;Blackman et al 2002), oxandrolone (Schroeder et al 2005;Schroeder et al 2004;Schroeder et al 2003a), testosterone undecanoate (Emmelot-Vonk et al 2008;Wittert et al 2003), oxymetholone (Schroeder et al 2003b), and Androgel (Kenny et al 2010). The administration method used was oral (6 articles), injection (4 articles), and transdermal gel (1 article).…”

Section: Selected Studiesmentioning

confidence: 99%

Effects of testosterone on lean mass gain in elderly men: systematic review with meta-analysis of controlled and randomized studies

Neto

Gama

Rocha

et al. 2015

AGE

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The objective of this study was to evaluate the effects of steroid anabolic androgenic hormones use on lean mass gain in elderly men through a systematic review with a meta-analysis of randomized controlled studies. We systematically searched PubMed database until 4th October 2013. We included randomized placebo-controlled trials (RCT) that studied testosterone replacement therapy in men over 60 years of age, with total testosterone levels ≤550 ng/dl, observing gains in weight, lean mass tissue and fat mass as outcome. We excluded duplicated studies, studies which mixed men and women, and studies using weak androgens such as dehydroepiandrosterone or androstenedione. The initial search yielded 2681 articles, of which 26 were selected for full text analysis. In the end, 11 studies were included. However, 3 studies were not included in the metaanalysis. Meta-analysis showed that mean weight increased (lean mass), ranging from 1.65 (95 % CI, AGE (2015) ) kg, although it was heterogeneous (I 2 =98 %). Effect estimate was 3.59 [2.38-4.81]. Androgen therapy decreased fat mass; effect estimate was −1.78 [−2.57, −0.99] that analysis had also a high level of heterogeneity (I 2 =81 %). The results suggest that testosterone replacement therapy is able to increase muscle mass in elderly men and that is affected by the time that the treatment is carried out and the method of administration of the drug.

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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%

“…Heart disease, metabolic syndrome and type 2 diabetes (T2D), osteoporosis and fractures, sarcopenia, increase in abdominal fat mass, body hair and skin alterations, mood and cognitive disorders, occasional night sweats and vasomotor disturbances are also reported [4,11,13,14,[18][19][20].…”

Section: Clinical Presentation and Diagnostic Criteriamentioning

confidence: 99%

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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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Effect of Testosterone Supplementation on Functional Mobility, Cognition, and Other Parameters in Older Men

Cited by 433 publications

References 87 publications

Testosterone therapy increased muscle mass and lipid oxidation in aging men

Testosterone therapy increased muscle mass and lipid oxidation in aging men

Effects of testosterone on lean mass gain in elderly men: systematic review with meta-analysis of controlled and randomized studies

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

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