The use of a transscrotal testosterone delivery system in the treatment of patients with weight loss related to human immunodeficiency virus infection

Dobs, Adrian S.; Cofrancesco, Joseph; Nolten, William E; Danoff, Ann; Anderson, R. N.; Hamilton, Carol; Feinberg, Judith; Seekins, Daniel; Yangco, Bienvenido G.; Rhame, Frank S.

doi:10.1016/s0002-9343(99)00193-x

Cited by 60 publications

(26 citation statements)

References 35 publications

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“…Indeed, we observed greater gains in FFM in HIV-infected men treated with TE injections, 100 mg weekly (6), than those receiving testosterone replacement by a 5-mg testosterone patch (12). Because the 100-mg weekly dose of TE delivers a larger amount of testosterone than that delivered by the 5-mg patch, our model would predict greater accretion of lean tissue with this higher dose.…”

Section: Discussionmentioning

confidence: 79%

“…However, there are striking qualitative and quantitative differences in this anabolic response to testosterone administration among the various studies. Of the six, placebo-controlled, clinical trials evaluating testosterone administration in HIV-infected men, two (11,12) reported no significant difference in the change in FFM between the placebo-and testosterone-treated men. Among the studies that did demonstrate significant gains in lean body mass (LBM) after androgen administration, the magnitude of increase varied considerably (3,6,15,16).…”

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confidence: 99%

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Development of models to predict anabolic response to testosterone administration in healthy young men

Woodhouse

Reisz‐Porszasz

Javanbakht

et al. 2003

American Journal of Physiology-Endocrinology and Metabolism

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. Development of models to predict anabolic response to testosterone administration in healthy young men. Am J Physiol Endocrinol Metab 284: E1009-E1017, 2003. First published January 7, 2003 10.1152/ajpendo.00536.2002.-Considerable heterogeneity exists in the anabolic response to androgen administration; however, the factors that contribute to variation in an individual's anabolic response to androgens remain unknown. We investigated whether testosterone dose and/or any combination of baseline variables, including concentrations of hormones, age, body composition, muscle function, and morphometry or polymorphisms in androgen receptor could explain the variability in anabolic response to testosterone. Fifty-four young men were treated with a long-acting gonadotropin-releasing hormone (GnRH) agonist and one of five doses (25, 50, 125, 300, or 600 mg/wk) of testosterone enanthate (TE) for 20 wk. Anabolic response was defined as a change in whole body fat-free mass (FFM) by dual-energy X-ray absorptiometry (DEXA), appendicular FFM (by DEXA), and thigh muscle volume (by magnetic resonance imaging) during TE treatment. We used univariate and multivariate analysis to identify the subset of baseline measures that best explained the variability in anabolic response to testosterone supplementation. The three-variable model of TE dose, age, and baseline prostate-specific antigen (PSA) level explained 67% of the variance in change in whole body FFM. Change in appendicular FFM was best explained (64% of the variance) by the linear combination of TE dose, baseline PSA, and leg press strength, whereas TE dose, log of the ratio of luteinizing hormone to testosterone concentration, and age explained 66% of the variation in change in thigh muscle volume. The models were further validated by using Ridge analysis and cross-validation in data subsets. Only the model using testosterone dose, age, and PSA was a consistent predictor of change in FFM in subset analyses. The length of CAG tract was only a weak predictor of change in thigh muscle volume and lean body mass. Hence, the anabolic response of healthy, young men to exogenous testosterone administration can largely be predicted by the testosterone dose. testosterone dose response; testosterone effects on muscle; predicting lean body mass response to testosterone; androgen receptor genetic polymorphism; polyglutamine repeats; polyglycine repeats TESTOSTERONE SUPPLEMENTATION increases fat-free mass (FFM) and muscle size in healthy, hypogonadal men (5,8,18,29,35,36), human immunodeficiency virus (HIV)-infected men with low testosterone levels (3, 6, 15, 16), and older men with low testosterone levels (19,30,31,33). However, there are striking qualitative and quantitative differences in this anabolic response to testosterone administration among the various studies. Of the six, placebo-controlled, clinical trials evaluating testosterone administration in HIV-infected men, two (11, 12) reported no significant difference in the change in FFM between the placebo-and testosterone-trea...

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Section: Discussionmentioning

confidence: 79%

mentioning

confidence: 99%

Development of models to predict anabolic response to testosterone administration in healthy young men

Woodhouse

Reisz‐Porszasz

Javanbakht

et al. 2003

American Journal of Physiology-Endocrinology and Metabolism

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“…These studies also emphasize the need to use muscle function tests that are androgen-responsive, and to control for the confounding influence of the learning effect. (Schambelan et al 1996, Waters et al 1996, insulin-like growth factor (IGF)-I (Waters et al 1996) and androgens (Coodley & Coodley 1997, Grinspoon et al 1998, 2000, Bhasin & Javanbakht 1999, Dobs et al 1999, Sattler et al 1999, Strawford et al 1999a, and modulators of the immune response such as thalidomide. Dronabinol increases appetite, but has not been shown to increase lean body mass (Beal et al 1995).…”

Section: Effects Of Testosterone Replacement In Older Men With Low Tementioning

confidence: 99%

“…Several studies on the effects of androgen supplementation in HIV-infected men have been reported (Coodley & Coodley 1997, 2000, Bhasin & Javanbakht 1999, Grinspoon et al 1998, Dobs et al 1999, Sattler et al 1999, Strawford et al 1999a. However, many of these studies were not controlled clinical trials.…”

Section: Effects Of Testosterone Replacement In Older Men With Low Tementioning

confidence: 99%

Proof of the effect of testosterone on skeletal muscle

Bhasin¹,

Woodhouse²,

Tw³

2001

Journal of Endocrinology

236

147

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In spite of the widespread abuse of androgenic steroids by athletes and recreational body-builders, the effects of these agents on athletic performance and physical function remain poorly understood. Experimentally induced androgen deficiency is associated with a loss of fat-free mass; conversely, physiologic testosterone replacement of healthy, androgen-deficient men increases fat-free mass and muscle protein synthesis. Testosterone supplementation of HIV-infected men with low testosterone levels and of older men with normally low testosterone concentrations also increases muscle mass. However, we do not know whether physiologic testosterone replacement can improve physical function and health-related quality of life, and reduce the risk of falls and disability in older men or those with chronic illness. Testosterone increases maximal voluntary strength in a dose-dependent manner and thus might improve performance in power-lifting events. However, testosterone has not been shown to improve performance in endurance events. The mechanisms by which testosterone increases muscle mass are not known, but probably involve alterations in the expression of multiple muscle growth regulators. Journal of Endocrinology (2001) 170, 27-38The abuse of androgenic steroids by athletes and the proposed anabolic applications of these agents in sarcopenia (loss of muscle mass and strength) associated with aging or chronic illness is based on the premise that these agents increase muscle mass and improve measures of skeletal muscle performance, and that androgen-induced changes in skeletal muscle performance translate into improvements in athletic performance and health-related outcomes (Fig. 1). The premise remains unsubstantiated. There is agreement that testosterone supplementation increases muscle mass and maximal voluntary strength in a variety of clinical and experimental paradigms (Tenover

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“…20 It is possible that this system of testosterone replacement does not achieve high enough testosterone levels to produce such changes. A recent meta-analysis of placebo-controlled trials that compared the effects of testosterone therapy with placebo in HIV patients with wasting supports the greater efficacy of i.m.…”

Section: S22mentioning

confidence: 99%

Role of testosterone in maintaining lean body mass and bone density in HIV-infected patients

Dobs

2003

Int J Impot Res

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The use of a transscrotal testosterone delivery system in the treatment of patients with weight loss related to human immunodeficiency virus infection

Cited by 60 publications

References 35 publications

Development of models to predict anabolic response to testosterone administration in healthy young men

Development of models to predict anabolic response to testosterone administration in healthy young men

Proof of the effect of testosterone on skeletal muscle

Role of testosterone in maintaining lean body mass and bone density in HIV-infected patients

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