Effects of testosterone replacement and/or resistance training on interleukin-6, tumor necrosis factor alpha, and leptin in elderly men ingesting megestrol acetate: a randomized controlled trial.
BACKGROUND
Megestrol acetate (MA) has been used to stimulate weight gain in elderly populations with the majority of the gain being adipose tissue. Significant inverse correlations have been reported between weight gain with MA and reductions in circulating the tumor necrosis factor (TNF) alpha receptors. In addition, MA has been shown to reduce circulating interleukin 6 (IL-6) concentrations. We attempted to increase gains in fat-free mass with MA using resistance training and/or testosterone replacement and examined the effects on circulating IL-6, TNF alpha, and leptin in elderly men.


METHODS
All subjects received MA and were randomly assigned to one of these four groups: placebo (P) injections; resistance training and P (RT+P); weekly injections of testosterone (T; 100 mg/wk); or RT and T (RT+T). Cytokines were measured by enzyme-linked immunosorbent assay Preinterventions, Midinterventions, and after 12 weeks of the interventions (Post).


RESULTS
IL-6 decreased ( p =.03) over time for the T and P groups when compared to the RT+T and RT+P groups. A time effect ( p =.013) was observed for TNF alpha with Mid and Post both being lower than Pre. A hormone by time interaction ( p =.03) was observed for plasma leptin with individuals not on T exhibiting higher concentrations Post than those individuals on T. A positive correlation was observed (r =.60; p <.05) between changes in fat mass and the change in leptin.


CONCLUSIONS
IL-6 was reduced by MA except when RT was undertaken; TNF alpha was reduced over time regardless of group; leptin was higher in individuals not on T than those on T; and the change in plasma leptin was correlated with the change in fat mass.
Lambert
Charles P
CP
Nutrition, Metabolism, and Exercise Laboratory, Donald W. Reynolds Center on Aging, Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock 72205, USA. lambercharlesp@uams.edu
Sullivan
Dennis H
DH
Evans
William J
WJ
D000368:Aged; D000704:Analysis of Variance; D001066:Appetite / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004797:Enzyme-Linked Immunosorbent Assay; D015444:Exercise / Q000502:physiology; D006801:Humans; D007273:Injections, Intramuscular; D015850:Interleukin-6 / Q000032:analysis / Q000378:metabolism*; D020738:Leptin / Q000032:analysis / Q000378:metabolism*; D008297:Male; D019290:Megestrol Acetate / Q000008:administration & dosage*; D008875:Middle Aged; D010806:Physical Education and Training; D011336:Probability; D012016:Reference Values; D012680:Sensitivity and Specificity; D013739:Testosterone / Q000008:administration & dosage*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis / Q000378:metabolism*; D015430:Weight Gain / Q000187:drug effects*
D015850:Interleukin-6; D020738:Leptin; D014409:Tumor Necrosis Factor-alpha; D013739:Testosterone; D019290:Megestrol Acetate