Shigehara Kazuyoshi, Kato Yuki, Izumi Kouji, Mizokami Atsushi
Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1, Takaramachi, Kanazawa 920-8641, Japan.
J Clin Med. 2022 Oct 20;11(20):6202. doi: 10.3390/jcm11206202.
Age-related decline in testosterone is known to be associated with various clinical symptoms among older men and it is possible that the accompanying decline in muscle mass and strength might lead to a decline in motor and physical functions. Sarcopenia is an important pathophysiological factor associated with frailty in older adults and is diagnosed in older adults as a decrease in muscle strength, muscle mass, and walking speed, which can lead to a significant decline in the quality of life and shortened healthy life expectancy. Testosterone directly interacts with the androgen receptor expressed in myonuclei and satellite cells and is also indirectly associated with muscle metabolism through various cytokines and molecules. Currently, significant correlations between testosterone and frailty in men have been confirmed by numerous cross-sectional studies. Many randomized control studies have also supported the beneficial effect of testosterone replacement therapy (TRT) on muscle volume and strength among men with low to normal testosterone levels. In the world's aging society, TRT can be a tool for preventing the onset of sarcopenia in older-adult men. This narrative review aims to show the relationship between the decline in testosterone with age, sarcopenia, and frailty, as well as the effects of testosterone replacement therapy on muscle mass and strength.
众所周知，老年男性体内睾酮水平随年龄下降与多种临床症状相关，且随之而来的肌肉量和力量下降可能导致运动和身体功能衰退。肌肉减少症是与老年人虚弱相关的一个重要病理生理因素，在老年人中，肌肉减少症被诊断为肌肉力量、肌肉量和步行速度下降，这会导致生活质量显著下降和健康预期寿命缩短。睾酮直接与肌核和卫星细胞中表达的雄激素受体相互作用，还通过各种细胞因子和分子与肌肉代谢间接相关。目前，大量横断面研究已证实男性睾酮水平与虚弱之间存在显著相关性。许多随机对照研究也支持睾酮替代疗法（TRT）对睾酮水平低至正常的男性的肌肉量和力量具有有益作用。在全球老龄化社会中，TRT可以成为预防老年男性肌肉减少症发病的一种手段。这篇叙述性综述旨在阐述睾酮水平随年龄下降、肌肉减少症和虚弱之间的关系，以及睾酮替代疗法对肌肉量和力量的影响。
