Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Centre for Andrology and Sexual Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Andrology. 2018 Jan;6(1):64-73. doi: 10.1111/andr.12454.
Testosterone dose-dependently increases appendicular muscle mass. However, the effects of testosterone administration on the core muscles of the trunk and the pelvis have not been evaluated. The present study evaluated the effects of testosterone administration on truncal and pelvic muscles in a dose-response trial. Participants were young healthy men aged 18-50 years participating in the 5α-Reductase (5aR) Trial. All participants received monthly injections of 7.5 mg leuprolide acetate to suppress endogenous testosterone production and weekly injections of 50, 125, 300, or 600 mg of testosterone enanthate and were randomized to receive either 2.5 mg dutasteride (5aR inhibitor) or placebo daily for 20 weeks. Muscles of the trunk and the pelvis were measured at baseline and the end of treatment using 1.5-Tesla magnetic resonance imaging. The dose effect of testosterone on changes in the psoas major muscle area was the primary outcome; secondary outcomes included changes in paraspinal, abdominal, pelvic floor, ischiocavernosus, and obturator internus muscles. The association between changes in testosterone levels and muscle area was also assessed. Testosterone dose-dependently increased areas of all truncal and pelvic muscles. The estimated change (95% confidence interval) of muscle area increase per 100 mg of testosterone enanthate dosage increase was 0.622 cm (0.394, 0.850) for psoas; 1.789 cm (1.317, 2.261) for paraspinal muscles, 2.530 cm (1.627, 3.434) for total abdominal muscles, 0.455 cm (0.233, 0.678) for obturator internus, and 0.082 cm (0.003, 0.045) for ischiocavernosus; the increase in these volumes was significantly associated with the changes in on-treatment total and free serum testosterone concentrations. In conclusion, core muscles of the trunk and pelvis are responsive to testosterone administration. Future trials should evaluate the potential role of testosterone administration in frail men who are predisposed to falls and men with pelvic floor dysfunction.
睾酮剂量依赖性地增加四肢肌肉量。然而，睾酮给药对躯干核心肌肉和骨盆的影响尚未得到评估。本研究在一项剂量反应试验中评估了睾酮给药对躯干和骨盆肌肉的影响。参与者为年龄在 18-50 岁之间的年轻健康男性，参加 5α-还原酶（5aR）试验。所有参与者每月接受 7.5mg 醋酸亮丙瑞林注射以抑制内源性睾酮生成，每周接受 50、125、300 或 600mg 庚酸睾酮注射，并随机接受每日 2.5mg 度他雄胺（5aR 抑制剂）或安慰剂治疗 20 周。使用 1.5-Tesla 磁共振成像在基线和治疗结束时测量躯干和骨盆的肌肉。睾酮对腰大肌面积变化的剂量效应是主要结局；次要结局包括脊柱旁、腹部、骨盆底、坐骨海绵体和闭孔内肌的变化。还评估了睾酮水平变化与肌肉面积之间的关系。睾酮剂量依赖性地增加了所有躯干和骨盆肌肉的面积。每增加 100mg 庚酸睾酮剂量，肌肉面积增加的估计变化（95%置信区间）为腰大肌 0.622cm（0.394，0.850）；脊柱旁肌肉 1.789cm（1.317，2.261）；总腹部肌肉 2.530cm（1.627，3.434）；闭孔内肌 0.455cm（0.233，0.678）；坐骨海绵体 0.082cm（0.003，0.045）；这些体积的增加与治疗期间总睾酮和游离睾酮浓度的变化显著相关。总之，躯干和骨盆的核心肌肉对睾酮给药有反应。未来的试验应评估睾酮给药在易跌倒和骨盆底功能障碍的虚弱男性中的潜在作用。
