Woodhouse Linda J, Gupta Nidhi, Bhasin Meenakshi, Singh Atam B, Ross Robert, Phillips Jeffrey, Bhasin Shalender
Division of Endocrinology, Metabolism, and Molecular Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, California 90059, USA.
J Clin Endocrinol Metab. 2004 Feb;89(2):718-26. doi: 10.1210/jc.2003-031492.
Testosterone supplementation reduces total body adipose tissue (AT), but we do not know whether the effects are uniformly distributed throughout the body or are region specific, or whether they are dose related. We determined the effects of graded doses of testosterone on regional AT distribution in 54 healthy men (18-35 yr) in a 20-wk, randomized, double-blind study of combined treatment with GnRH agonist plus one of five doses (25, 50, 125, 300, or 600 mg/wk) of testosterone enanthate (TE). Total body, appendicular, and trunk AT and lean body mass were measured by dual-energy x-ray absorptiometry, and sc, intermuscular, and intraabdominal AT of the thigh and abdomen were measured by magnetic resonance imaging. Treatment regimens resulted in serum nadir testosterone concentrations ranging from subphysiological to supraphysiological levels. Dose-dependent changes in AT mass were negatively correlated with TE dose at all sites and were equally distributed between the trunk and appendices. The lowest dose was associated with gains in sc, intermuscular, and intraabdominal AT, with the greatest percent increase occurring in the sc stores. At the three highest TE doses, thigh intermuscular AT volume was significantly reduced, with a greater percent loss in intermuscular than sc depots, whereas intraabdominal AT stores remained unchanged. In conclusion, changes in testosterone concentrations in young men are associated with dose-dependent and region-specific changes in AT and lean body mass in the appendices and trunk. Lowering testosterone concentrations below baseline increases sc and deep AT stores in the appendices and abdomen, with a greater percent increase in sc depots. Conversely, elevating testosterone concentrations above baseline induces a greater loss of AT from the smaller, deeper intermuscular stores of the thigh.
补充睾酮可减少全身脂肪组织（AT），但我们尚不清楚其作用是否在全身均匀分布、是否具有区域特异性，或者是否与剂量相关。在一项为期20周的随机双盲研究中，我们确定了不同剂量睾酮对54名健康男性（18 - 35岁）区域AT分布的影响，该研究为GnRH激动剂联合五种剂量（25、50、125、300或600 mg/周）庚酸睾酮（TE）的联合治疗。通过双能X线吸收法测量全身、四肢和躯干的AT以及瘦体重，通过磁共振成像测量大腿和腹部的皮下、肌间和腹腔内AT。治疗方案导致血清睾酮最低浓度范围从低于生理水平到高于生理水平。AT质量的剂量依赖性变化在所有部位均与TE剂量呈负相关，且在躯干和四肢之间均匀分布。最低剂量与皮下、肌间和腹腔内AT增加有关，皮下储存的增加百分比最大。在三个最高TE剂量时，大腿肌间AT体积显著减少，肌间的损失百分比大于皮下储存，而腹腔内AT储存保持不变。总之，年轻男性睾酮浓度的变化与四肢和躯干中AT和瘦体重的剂量依赖性及区域特异性变化相关。将睾酮浓度降至基线以下会增加四肢和腹部的皮下和深部AT储存，皮下储存的增加百分比更大。相反，将睾酮浓度升高至基线以上会导致大腿较小、较深的肌间储存中AT的更大损失。
