GONADAL PHYSIOLOGY AND SOMATOTROPH FUNCTION IN AIDS

本研究方案的目的是确定1)性腺功能减退是否有助于艾滋病消瘦综合征（AWS）特征的体重和瘦体重减轻，以及2)睾酮给药是否会增强性腺功能减退人群的内源性GH分泌。晚期艾滋病毒疾病是一种高度分解代谢状态，其特征是与严重体重减轻相关的瘦体重严重和不成比例的损失。由于性腺功能减退在男性AWS患者中有显著比例的记录，研究人员假设，缺乏有效的合成代谢激素，睾酮，促进了晚期HIV疾病的分解代谢状态。此外，性腺功能减退导致内源性生长激素（GH）分泌减少，这可能进一步导致AWS瘦体重的损失。已知生理性雄激素替代可以改善其他性腺功能低下人群的氮平衡、瘦体重和内源性生长激素分泌，但尚未对艾滋病患者进行研究。本建议的目的是确定雄激素替代对性腺功能低下男性的合成代谢影响。

The purpose of this research protocol is two determine whether 1) hypogonadism contributes to the loss of weight and lean body mass characteristic of the AIDS Wasting Syndrome (AWS), and 2) testosterone administration will enhance endogenous GH secretion in this hypogonadal population. Advanced HIV disease is a highly catabolic state characterized by the profound and disproportionate loss of lean body mass in association with severe weight loss. Because hypogonadism has been documented in a significant percentage of men with the AWS, the investigators hypothesize that a deficiency of the potent anabolic hormone, testosterone, facilitates the catabolic state in advanced HIV disease. In addition, hypogonadism results in diminished secretion of endogenous Growth Hormone (GH) which may further contribute to the loss of lean body mass in the AWS. Physiologic androgen replacement is known to improve nitrogen balance, lean body mass and endogenous GH secretion in other hypogonadal populations, but has not been studied in men with AIDS. The goal of this proposal is to determine the anabolic effects of androgen replacement in hypogonadal men with the AWS.