Greater physical activity and higher androgen concentrations are independently associated with lower cardiometabolic risk in men

Knuiman

Divitini

et al. 2018

Clinical Endocrinology

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Objective Low endogenous sex hormones and low physical activity (PA) levels have been associated with CVD risk. Whether these interact to influence CVD outcomes remains unclear. We assessed whether sex hormone concentrations and PA were additively associated with lower central adiposity and CVD risk. Patients 3351 community‐dwelling men, mean age 77 years. Measurements Baseline testosterone (T), dihydrotestosterone (DHT) and oestradiol (E2) were assayed. Levels of PA were ascertained by questionnaire. Men were stratified using median splits into high hormone + high PA (H/H), high hormone + low PA (H/L); low hormone + high PA (L/H) and low hormone + low PA (L/L) groups. Results A total of 865 CVD events and 499 CVD deaths occurred during 10‐year mean follow‐up. Men with higher T, DHT or SHBG and higher PA had the lowest BMI, waist circumference and risk of metabolic syndrome. Men with higher T had the lowest risk of incident CVD events, irrespective of PA level. Men with higher T or DHT and higher PA had the lowest risk of dying from CVD (eg, hazard ratios for T/PA H/H 0.76 P = 0.031; H/L 0.85 P = 0.222; L/H 0.80 P = 0.075; L/L 1.00). Conclusion Higher circulating androgens and higher PA were associated with less central adiposity at baseline and fewer CVD deaths during follow‐up. These findings are consistent with a potential additive effect of androgens and PA on cardiometabolic outcomes in older men.

Section: Discussioncontrasting

confidence: 75%

Higher circulating androgens and higher physical activity levels are associated with less central adiposity and lower risk of cardiovascular death in older men

Knuiman

Divitini

et al. 2018

Clinical Endocrinology

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“…Men with baseline serum T <6 nmol/L were not recruited for the study but were asked to see their own doctor for further investigation. Conversely, based on our previous epidemiological study (19), men with baseline serum T >14 nmol/L would be less likely to benefit from supplementation with exogenous T so were excluded. Our entry criteria are also in line with recent studies of T treatment in middle-aged and older men for cardiovascular and health benefit (28)(29)(30).…”

Section: Methods Participantsmentioning

confidence: 99%

“…Exercise is therefore strongly recommended to help maintain independence and quality of life into older age (18). Previous research also suggests that the combination of higher endogenous serum T concentrations and higher physical activity levels may decrease cardiometabolic risk and cardiovascular death in middle-to-older aged men (19,20). Intervention studies have demonstrated that the combination of moderate-to-high dose T treatment and exercise training can increase muscle mass (21)(22)(23), however the effect of T treatment on aerobic fitness, measured by peak oxygen uptake (V _ O 2peak ) in older overweight men, is unclear (8,9,24).…”

Section: Introductionmentioning

confidence: 99%

Testosterone and exercise: effects on fitness, body composition, and strength in middle-to-older aged men with low-normal serum testosterone levels

American Journal of Physiology-Heart and Circulatory Physiology

Yeap

Maiorana

et al. 2021

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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 (VO2peak), body composition and muscular strength in men 50-70yrs, waist circumference ≥95cm and low-normal serum T (6-14nmol·L−1). Participants (n=80) were randomised to AndroForte5® (Testosterone 5.0%w/v, 100mg/2mL) cream (T), or matching placebo (P), applied transdermally daily, and supervised centre-based exercise (Ex) or no additional exercise (NEx), for 12-weeks. Exercise increased VO2peak and strength vs non-exercise (VO2peak: T+Ex:+2.5, P+Ex:+3.2mL·kg−1·min−1, P<0.001; leg press: T+Ex:+31, P+Ex:+24kg, P=0.006). T treatment did not affect VO2peak or strength. Exercise decreased total (T+Ex:-1.7, P+Ex-2.3kg, P<0.001) and visceral fat (T+Ex:-0.1, P+Ex:-0.3kg, P=0.003), and increased total (T+Ex:+1.4, P+Ex:+0.7kg, P=0.008) and arm lean mass (T+Ex:+0.5, P+Ex:+0.3kg, P=0.024). T treatment did not affect total or visceral fat, but increased total (T+Ex:+1.4, T+NEx:+0.7kg, P=0.015), leg (T+Ex:+0.3, T+NEx:+0.2kg, P=0.024) and arm lean mass (T+Ex:+0.5, T+NEx:+0.2kg, P=0.046). T+Ex increased arm lean mass (T+Ex:+0.5kg vs P+NEx:-0.0kg, P=0.001) and leg strength (T+Ex:+31 vs P+NEx:+12kg, P=0.032) compared to 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 anti-ageing intervention in preference to testosterone treatment in men.

“…Men with baseline T < 6 nmol/L were not recruited for the study but were encouraged to see their own doctor for further investigation. Conversely, based on our previous epidemiological study, 20 men with baseline T > 14 nmol/L were excluded as they were deemed to be less likely to benefit from exogenous T supplementation. Our entry criteria are also in line with previous studies of T supplementation for cardiovascular and health benefit 21,22 …”

Section: Participants and Methodsmentioning

confidence: 99%

Effects of testosterone treatment, with and without exercise training, on ambulatory blood pressure in middle‐aged and older men

Green

Schlaich

et al. 2021

Clinical Endocrinology

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Context With age, testosterone (T) and physical activity levels often decline in parallel. The effect of combining T treatment and exercise training on ambulatory blood pressure (ABP) is unclear. Objective To assess T and exercise effects, alone and in combination, on ABP in men aged 50–70 years, waist circumference ≥ 95 cm and low‐normal serum T (6–14 nmol/L), without organic hypogonadism. Design A 2 × 2 factorial randomised, placebo‐controlled study. Intervention Randomization to daily transdermal AndroForte5® (Testosterone 5.0%w/v, 100 mg in 2 ml) cream (T), or matching placebo (P) (double‐blind), and to supervised exercise (Ex) or no additional exercise (NEx), for 12 weeks. Results Average 24‐h systolic blood pressure (SBP) increased with T treatment (testosterone*time, p = .035). Average 24‐h SBP increased in T+Ex (T+Ex:+3.0 vs. P+NEx: −3.0 mmHg, p = .026) driven by day‐time changes (T+Ex:+3.5 vs. P+NEx: −3.0 mmHg, p = .026). There was an effect of T for 24‐h average diastolic blood pressure (DBP, testosterone*time, p = .044) driven by the decrease in P+Ex (P+Ex: −3.9 vs. T+NEx: −0.5 mmHg, p = .015). Night‐time DBP was lower with exercise (P+Ex: −4.0 vs. P+NEx: +0.7 mmHg, p = .032). The effect of exercise to lower night‐time DBP was not apparent in the presence of T (T+Ex: −0.4 vs. P+NEx: +0.7 mmHg, p > .05). Ex increased average 24‐h pulse pressure (PP, exercise*time, p = .022), largely during daytime hours (exercise*time, p = .013). Conclusions There was a main effect of T to increase 24‐h SBP, primarily seen when T was combined with Ex. Exercise alone decreased 24‐h and night‐time DBP; an effect attenuated by T. BP should be carefully assessed and monitored, when prescribing T treatment to middle‐aged and older men, especially when combined with exercise training.