Effect of testosterone and a nutritional supplement, alone and in combination, on hospital admissions in undernourished older men and women
Effect of testosterone and a nutritional supplement, alone and in combination, on hospital admissions in undernourished older men and women
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DOI：
10.3945/ajcn.2008.26538
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发表时间：
2009-03-01
影响因子：
7.1
通讯作者：
Horowitz, Michael
中科院分区：
文献类型：
--
作者：
Chapman, Ian M.;Visvanathan, Renuka;Horowitz, Michael
背景：在老年人中，营养不良与住院率和死亡率增加有关。由于老年人的体重减轻往往反映了骨骼肌的不成比例的减少，合成代谢治疗可能是有益的。目的：我们的目的是评估睾酮治疗和营养补充剂具有附加效益的假设。设计：口服十一酸睾酮（女性每日40毫克，男性每日两次，80毫克）和口服营养补充剂（475 kcal/d）单独或联合给49名社区居住的营养不良者服用1年[迷你营养评估评分65岁（平均年龄：77岁; 26名女性和23名男性）。结果：在接受睾酮和营养补充剂联合治疗的受试者（n=11）中，没有住院，而有9例住院（2例选择性）未治疗组13例受试者、睾酮治疗组4例（n=12）和睾酮治疗组5例（n=13）;与联合治疗相比，未治疗P=0.06。与未治疗组相比，联合治疗组的住院人数明显减少（0与5相比，P=0.03），住院天数更少（0比74，P=0.041），以及更长的入院时间（P=0.017）。在营养不良的老年人中，睾酮和营养补充剂的联合治疗减少了住院人数和住院时间，这是该组的重要终点。现在需要更大规模的验证性研究。本试验在临床试验开始前注册。编号为NCT 00117000。美国临床营养杂志2009; 89：880-9.
Background: In older people, undernutrition is associated with increased hospitalization rates and mortality. Because weight loss in older people often reflects a disproportionate reduction of skeletal muscle, anabolic treatments may be beneficial.Objective: Our aim was to evaluate the hypothesis that testosterone treatment and a nutritional supplement have additive benefits.Design: Oral testosterone undecanoate (40 mg daily for women, 80 mg twice daily for men) and an oral nutritional supplement (475 kcal/d) were administered, alone or combined, for 1 y to 49 community-dwelling, undernourished people [Mini Nutritional Assessment score 65 y (mean age: 77 y; 26 women and 23 men). Hospital admissions and other variables were assessed.Results: In subjects receiving combined testosterone and nutritional supplements (n=11), there were no hospital admissions, whereas there were 9 admissions (2 elective) in 13 subjects in the no-treatment group, 4 in the testosterone-treated group (n=12), and 5 in the supplement-treated group (n=13); P=0.06 with no-treatment compared with combined treatment. When compared with the no-treatment group, the combined-treatment group had significantly fewer subjects admitted to hospital (0 compared with 5, P=0.03), fewer days in hospital (0 compared with 74, P=0.041), and a longer time to hospital admission (P=0.017).Conclusions: In undernourished older people, combined treatment with testosterone and nutritional supplementation reduced the number of people hospitalized and the duration of hospital admissions, which are important endpoints in this group. Larger, confirmatory studies are now needed. This trial was registered before commencement at clinical trials. gov as NCT00117000. Am J Clin Nutr 2009; 89:880-9.