睾酮对中年和体弱老年男性肌肉力量、身体功能、身体成分和生活质量的影响：一项随机、双盲、安慰剂对照研究。

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.

机构信息

Andrology Research Unit, Department of Medicine and Endocrinology, University of Manchester, Manchester Royal Infirmary, Grafton Street, Manchester, United Kingdom M13 9WL.

出版信息

J Clin Endocrinol Metab. 2010 Feb;95(2):639-50. doi: 10.1210/jc.2009-1251. Epub 2010 Jan 8.

DOI:10.1210/jc.2009-1251

PMID:20061435

Abstract

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.

摘要

背景

身体虚弱与肌肉力量减弱、身体机能受损和生活质量下降有关。睾丸激素（T）可增加性腺功能减退患者的肌肉质量和力量。目前尚不清楚 T 对低至边缘低 T 的中老年体弱男性是否具有类似的作用。

目的

我们的目的是确定 6 个月 T 治疗对中、重度体弱老年人的肌肉质量和力量、身体机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

参与者为居住在社区的中、重度体弱老年人，年龄至少 65 岁，总 T 水平为 12 nmol/L 或游离 T 水平为 250 pmol/L 或以下。

方法

274 名参与者被随机分配接受透皮 T（50 mg/d）或安慰剂凝胶治疗 6 个月。主要观察指标包括肌肉力量、瘦体重和脂肪量、身体机能和自我报告的生活质量。

结果

与安慰剂组相比，T 组的等速膝关节伸展峰值扭矩在 6 个月时有所改善，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 组的瘦体重增加了 1.08 ± 1.8 公斤，脂肪量减少了 0.9 ± 1.6 公斤。身体机能在年龄较大和体弱的男性中得到改善。T 治疗后躯体和性症状评分下降，调整后的差异分别为-1.2（-2.4 至-0.04）和-1.3（-2.5 至-0.2）。