Physiologic effects of nutritional support and anabolic steroids in patients with chronic obstructive pulmonary disease. A placebo-controlled randomized trial.
Nutritional depletion commonly occurs in patients with COPD, causing muscle wasting and impaired physiologic function. Two hundred seventeen patients with COPD participated in a placebo-controlled, randomized trial investigating the physiologic effects of nutritional intervention alone (N) for 8 wk or combined with the anabolic steroid nandrolone decanoate (N + A). Nandrolone decanoate or placebo (P) was injected intramuscularly (women, 25 mg; men, 50 mg) in a double-blind fashion on Days 1, 15, 29, and 43. Nutritional intervention consisted of a daily high caloric supplement (420 kcal; 200 ml). Also, all patients participated in an exercise program. In the depleted patients, both treatment regimens induced a similar significant body weight gain (2.6 kg) but different body compositional changes. Particularly in the last 4 wk of treatment, weight gain in the N group was predominantly due to an expansion of fat mass (p < 0.03 versus P and N + A), whereas the relative changes in fat-free mass (FFM) and other measures of muscle mass were more favorable in the N + A group (p < 0.03 versus P). Maximal inspiratory mouth pressure improved within both treatment groups in the first 4 wk of treatment, but after 8 wk only N + A was significantly different from P (p < 0.03). Nutritional supplementation in combination with a short course of anabolic steroids may enhance the gain in FFM and respiratory muscle function in depleted patients with COPD without causing adverse side effects.
Schols
A M
AM
Department of Pulmonology, University Hospital Maastricht, Oss, The Netherlands.
Soeters
P B
PB
Mostert
R
R
Pluymers
R J
RJ
Wouters
E F
EF
D045930:Anabolic Agents / Q000627:therapeutic use*; D001823:Body Composition; D004311:Double-Blind Method; D002149:Energy Intake; D004734:Energy Metabolism; D005081:Exercise Therapy; D005260:Female; D005526:Food, Formulated; D006801:Humans; D007273:Injections, Intramuscular; D008173:Lung Diseases, Obstructive / Q000503:physiopathology / Q000534:rehabilitation / Q000628:therapy*; D008297:Male; D009277:Nandrolone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000077603:Nandrolone Decanoate; D012129:Respiratory Function Tests; D012132:Respiratory Muscles / Q000503:physiopathology; D015430:Weight Gain
D045930:Anabolic Agents; D009277:Nandrolone; D000077603:Nandrolone Decanoate