Effects of Testosterone on Muscle Strength, Physical Function, Body Composition, and Quality of Life in Intermediate-Frail and Frail Elderly Men: A Randomized, Double-Blind, Placebo-Controlled Study
Effects of Testosterone on Muscle Strength, Physical Function, Body Composition, and Quality of Life in Intermediate-Frail and Frail Elderly Men: A Randomized, Double-Blind, Placebo-Controlled Study
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DOI：
10.1210/jc.2009-1251
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发表时间：
2010-02-01
影响因子：
5.8
通讯作者：
Wu, Frederick C. W.
中科院分区：
文献类型：
--
作者：
Srinivas-Shankar, Upendram;Roberts, Stephen A.;Wu, Frederick C. W.
背景：身体虚弱与肌肉力量下降、身体功能受损和生活质量有关。睾酮（T）增加性腺功能减退患者的肌肉质量和力量。目前还不清楚T是否对中度虚弱和虚弱的老年男性有类似的作用，这些男性的T水平低到临界低。目的：我们的目的是确定6个月T治疗对中度虚弱和虚弱的老年男性的肌肉质量和力量、身体功能和生活质量的影响。设计和设置：我们进行了一项随机、双盲、安慰剂对照、平行组、单中心研究。参与者：参与者是社区居住的中间体弱和体弱的老年男性至少65岁的总T在或低于12纳摩尔/升或免费T在或低于250 pmol/liter.Methods：二百七十四名参与者被随机分配到透皮T（50毫克/天）或安慰剂凝胶6个月。结果测量包括肌肉力量，瘦和脂肪质量，身体功能，自我报告的生活quality of life.Results：等距膝关节伸展峰值扭矩改善T组（与安慰剂在6个月），调整后的差异为8.6（95%置信区间，1.3-16.0; P = 0.02）牛顿米。T组的瘦体重增加，脂肪量显著减少，分别为1.08 +/- 1.8和0.9 +/- 1.6 kg。老年人和体弱者的身体功能得到改善。躯体和性症状评分随着T治疗而降低;校正差异为-1.2（-2.4至-0.04）和-1.3（-2.5 ~-0.2）。对中度虚弱和虚弱的老年男性进行6个月的T治疗，可预防与年龄相关的下肢肌肉力量丧失，改善身体组成，生活质量，和身体功能。进一步的调查是必要的，以扩大这些结果。（临床内分泌代谢杂志95：639- 50，2010）
Context: Physical frailty is associated with reduced muscle strength, impaired physical function, and quality of life. Testosterone (T) increases muscle mass and strength in hypogonadal patients. It is unclear whether T has similar effects in intermediate-frail and frail elderly men with low to borderline-low T.Objective: Our objective was to determine the effects of 6 months T treatment in intermediate-frail and frail elderly men, on muscle mass and strength, physical function, and quality of life.Design and Setting: We conducted a randomized, double-blind, placebo-controlled, parallel-group, single-center study.Participants: Participants were community-dwelling intermediate-frail and frail elderly men at least 65 yr of age with a total T at or below 12 nmol/liter or free T at or below 250 pmol/liter.Methods: Two hundred seventy-four participants were randomized to transdermal T (50 mg/d) or placebo gel for 6 months. Outcome measures included muscle strength, lean and fat mass, physical function, and self-reported quality of life.Results: Isometric knee extension peak torque improved in the T group ( vs. placebo at 6 months), adjusted difference was 8.6 (95% confidence interval, 1.3-16.0; P = 0.02) Newton-meters. Lean body mass increased and fat mass decreased significantly in the T group by 1.08 +/- 1.8 and 0.9 +/- 1.6 kg, respectively. Physical function improved among older and frailer men. Somatic and sexual symptom scores decreased with T treatment; adjusted difference was -1.2 (-2.4 to -0.04) and -1.3 (-2.5 to -0.2), respectively.Conclusions: T treatment in intermediate-frail and frail elderly men with low to borderline-low T for 6 months may prevent age-associated loss of lower limb muscle strength and improve body composition, quality of life, and physical function. Further investigations are warranted to extend these results. ( J Clin Endocrinol Metab 95: 639- 50, 2010)