Karl J Philip, Berryman Claire E, Harris Melissa N, Lieberman Harris R, Gadde Kishore M, Rood Jennifer C, Pasiakos Stefan M
Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA, USA.
Oak Ridge Institute for Science and Education, Belcamp, MD, USA.
J Endocr Soc. 2020 Mar 3;4(4):bvaa024. doi: 10.1210/jendso/bvaa024. eCollection 2020 Apr 1.
Severe energy deficits cause interrelated reductions in testosterone and fat free mass. Testosterone supplementation may mitigate those decrements, but could also reduce circulating concentrations of the orexigenic hormone ghrelin, thereby exacerbating energy deficit by suppressing appetite.
To determine whether testosterone supplementation during severe energy deficit influences fasting and postprandial ghrelin concentrations and appetite.
Secondary analysis of a randomized, double-blind trial that determined the effects of testosterone supplementation on body composition changes during and following severe energy deficit in nonobese, eugonadal men. Phase 1 (PRE-ED): 14-day run-in; phase 2: 28 days, 55% energy deficit with 200 mg testosterone enanthate weekly (TEST; n = 24) or placebo (PLA; n = 26); phase 3: free-living until body mass recovered (end-of-study; EOS). Fasting and postprandial acyl ghrelin and des-acyl ghrelin concentrations and appetite were secondary outcomes measured during the final week of each phase.
Fasting acyl ghrelin concentrations, and postprandial acyl and des-acyl ghrelin concentrations increased in PLA during energy deficit then returned to PRE-ED values by EOS, but did not change in TEST (phase-by-group, < 0.05). Correlations between changes in free testosterone and changes in fasting acyl ghrelin concentrations during energy deficit (ρ = -0.42, = 0.003) and body mass recovery (ρ = -0.38; = 0.01) were not mediated by changes in body mass or body composition. Transient increases in appetite during energy deficit were not affected by testosterone treatment.
Testosterone supplementation during short-term, severe energy deficit in healthy men prevents deficit-induced increases in circulating ghrelin without blunting concomitant increases in appetite.
www.clinicaltrials.gov NCT02734238 (registered 12 April 2016).
严重能量缺乏会导致睾酮和去脂体重相互关联地减少。补充睾酮可能会减轻这些减少，但也可能降低促食欲激素胃饥饿素的循环浓度，从而通过抑制食欲加剧能量缺乏。
确定在严重能量缺乏期间补充睾酮是否会影响空腹和餐后胃饥饿素浓度及食欲。
对一项随机双盲试验进行二次分析，该试验确定了补充睾酮对非肥胖、性腺功能正常男性在严重能量缺乏期间及之后身体成分变化的影响。第1阶段（能量缺乏前）：14天的导入期；第2阶段：28天，55%能量缺乏，每周注射200mg庚酸睾酮（睾酮组；n = 24）或安慰剂（安慰剂组；n = 26）；第3阶段：自由生活直至体重恢复（研究结束）。在每个阶段的最后一周测量空腹和餐后酰基胃饥饿素及去酰基胃饥饿素浓度和食欲，作为次要结局。
安慰剂组在能量缺乏期间空腹酰基胃饥饿素浓度以及餐后酰基和去酰基胃饥饿素浓度升高，然后在研究结束时恢复到能量缺乏前的值，但睾酮组未发生变化（阶段×组，P < 0.05）。能量缺乏期间游离睾酮变化与空腹酰基胃饥饿素浓度变化之间的相关性（ρ = -0.42，P = 0.003）以及体重恢复期间的相关性（ρ = -0.38；P = 0.01）不受体重或身体成分变化的介导。能量缺乏期间食欲的短暂增加不受睾酮治疗的影响。
在健康男性短期严重能量缺乏期间补充睾酮可防止能量缺乏引起的循环胃饥饿素增加，同时不会减弱随之而来的食欲增加。
www.clinicaltrials.gov NCT02734238（2016年4月12日注册）
