Mavros Yorgi, O'Neill Evelyn, Connerty Maureen, Bean Jonathan F, Broe Kerry, Kiel Douglas P, Maclean David, Taylor Ann, Fielding Roger A, Singh Maria A Fiatarone
1Exercise Health and Performance Faculty Research Group, University of Sydney, Sydney, AUSTRALIA; 2Institute for Aging Research, Hebrew SeniorLife, Boston, MA; 3Spaulding Rehabilitation Hospital, Boston, MA; 4Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA; 5New England GRECC, Boston VA Healthcare System, Boston, MA; 6Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; 7Oncology Clinical Research, Takeda, Boston, MA; 8Novartis Institutes for BioMedical Research, Cambridge, MA; 9Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA; and 10Sydney Medical School, University of Sydney, Sydney, AUSTRALIA.
Med Sci Sports Exerc. 2015 Nov;47(11):2257-67. doi: 10.1249/MSS.0000000000000690.
Sarcopenia is disproportionately present in older women with disability, and optimum treatment is not clear. We conducted a double-blind, randomized, placebo-controlled trial to determine whether oxandrolone administration in elderly women improves body composition or physical function beyond that which occurs in response to progressive resistance training (PRT).
Twenty-nine sedentary women (age 74.9 ± 6.8 yr; 5.9 ± 2.8 medications per day) were randomized to receive high-intensity PRT (three times a week for 12 wk) combined with either oxandrolone (10 mg·d(-1)) or an identical placebo. Peak strength was assessed for leg press, chest press, triceps, knee extension, and knee flexion. Power was assessed for leg press and chest press. Physical function measures included static and dynamic balance, chair rise, stair climb, gait speed, and 6-min walk test. Body composition was assessed using dual energy x-ray absorptiometry.
Oxandrolone treatment augmented increases in lean tissue for the whole body (2.6 kg; 95% confidence interval (CI), 1.0-4.2 kg; P = 0.003), arms (0.3 kg; 95% CI, 0.1-0.5 kg; P = 0.001), legs (0.8 kg; 95% CI, 0.1-1.4 kg; P = 0.018), and trunk (1.4 kg; 95% CI, 0.4-2.3 kg; P = 0.004). Oxandrolone also augmented loss of fat tissue of the whole body (-1 kg; 95% CI, -1.6 to -0.4; P = 0.002), arms (-0.2 kg; 95% CI, -0.5 to -0.02 kg; P = 0.032), legs (-0.4 kg; 95% CI, -0.6 to -0.1; P = 0.009), and tended to reduce trunk fat (-0.4 kg; 95% CI, -0.9 to 0.04; P = 0.07). Improvements in muscle strength and power, chair stand, and dynamic balance were all significant over time (P < 0.05) but not different between groups (P > 0.05).
Oxandrolone improves body composition adaptations to PRT in older women over 12 wk without augmenting muscle function or functional performance beyond that of PRT alone.
肌肉减少症在残疾老年女性中更为普遍,最佳治疗方法尚不清楚。我们进行了一项双盲、随机、安慰剂对照试验,以确定老年女性服用氧雄龙是否能改善身体成分或身体功能,且效果优于渐进性抗阻训练(PRT)。
29名久坐不动的女性(年龄74.9±6.8岁;每天服用5.9±2.8种药物)被随机分为接受高强度PRT(每周三次,共12周)联合氧雄龙(10mg·d⁻¹)或相同安慰剂。评估腿举、卧推、三头肌、膝关节伸展和膝关节屈曲的峰值力量。评估腿举和卧推的功率。身体功能测量包括静态和动态平衡、从椅子上起身、爬楼梯、步速和6分钟步行试验。使用双能X线吸收法评估身体成分。
氧雄龙治疗可增加全身瘦组织(2.6kg;95%置信区间(CI),1.0 - 4.2kg;P = 0.003)、手臂(0.3kg;95%CI,0.1 - 0.5kg;P = 0.001)、腿部(0.8kg;95%CI,0.1 - 1.4kg;P = 0.018)和躯干(1.4kg;95%CI,0.4 - 2.3kg;P = 0.004)。氧雄龙还可增加全身脂肪组织的减少量(-1kg;95%CI,-1.6至-0.4;P = 0.002)、手臂(-0.2kg;95%CI,-0.5至-0.02kg;P = 0.032)、腿部(-0.4kg;95%CI,-0.6至-0.1;P = 0.009),并倾向于减少躯干脂肪(-0.4kg;95%CI,-0.9至0.04;P = 0.07)。随着时间的推移,肌肉力量和功率、从椅子上站起和动态平衡的改善均具有显著性(P < 0.05),但两组之间无差异(P > 0.05)。
在12周内,氧雄龙可改善老年女性对PRT的身体成分适应性,但不会增强肌肉功能或功能表现,其效果不超过单独进行PRT。