Effects of testosterone and progressive resistance training in eugonadal men with AIDS wasting. A randomized, controlled trial.
BACKGROUND
Substantial loss of muscle mass occurs among men with AIDS wasting.


OBJECTIVE
To investigate the independent effects of testosterone therapy and progressive resistance training in eugonadal men with AIDS wasting.


METHODS
Randomized, controlled trial.


METHODS
University hospital.


METHODS
54 eugonadal men with AIDS wasting (weight < 90% ideal body weight or weight loss > 10%).


METHODS
In a 2 x 2 factorial design, patients were assigned to receive testosterone enanthate (200 mg/wk) or placebo injections and progressive resistance training (three times weekly) or no training for 12 weeks.


METHODS
Cross-sectional muscle area and other indices of muscle mass.


RESULTS
Cross-sectional muscle area increased in response to training compared with nontraining (change in arm muscle mass, 499 +/- 349 mm2 vs. 206 +/- 264 mm2 [P = 0.004]; change in leg muscle mass, 1106 +/- 854 mm2 vs. 523 +/- 872 mm2 [P = 0.045]) and in response to testosterone therapy compared with placebo (change in arm muscle mass, 512 +/- 371 mm2 vs. 194 +/- 215 mm2 [P< 0.001]; change in leg muscle mass, 1,236 +/- 881 mm2 vs. 399 +/- 729 mm2 [P = 0.002]). Levels of high-density lipoprotein cholesterol decreased in response to testosterone therapy compared with placebo (-0.03 +/- 0.13 mmol/L vs. 0.05 +/- 0.13 mmol/L [-1 +/- 5 mg/dL vs. 2 +/- 5 mg/dL]; P= 0.011) and increased in response to training compared with nontraining (0.05 +/- 0.13 mmol/L vs. 0.00 +/- 0.16 mmol/L [2 +/- 5 mg/dL vs. 0 +/- 6 mg/dL]; P = 0.052).


CONCLUSIONS
In contrast to anabolic therapies that may have adverse effects on metabolic variables, supervised exercise effectively increases muscle mass and is associated with significant positive health benefits in eugonadal men with AIDS wasting.
Grinspoon
S
S
Massachusetts General Hospital, Harvard Medical School, Boston University School of Medicine, and Boston Veterans Administration Medical Center, 02114, USA.
Corcoran
C
C
Parlman
K
K
Costello
M
M
Rosenthal
D
D
Anderson
E
E
Stanley
T
T
Schoenfeld
D
D
Burrows
B
B
Hayden
D
D
Basgoz
N
N
Klibanski
A
A
D001132:Arm; D018791:CD4 Lymphocyte Count; D008076:Cholesterol, HDL / Q000097:blood; D015444:Exercise; D005081:Exercise Therapy; D019247:HIV Wasting Syndrome / Q000097:blood / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007273:Injections, Intramuscular; D007866:Leg; D008297:Male; D018482:Muscle, Skeletal / Q000473:pathology; D013739:Testosterone / Q000031:analogs & derivatives* / Q000097:blood / Q000627:therapeutic use*; D019562:Viral Load; D014891:Weight Lifting; D015431:Weight Loss
D008076:Cholesterol, HDL; D013739:Testosterone; C004648:testosterone enanthate