Hypogonadism, quadriceps weakness, and exercise intolerance in chronic obstructive pulmonary disease.
BACKGROUND
Circulating levels of testosterone and gonadotrophins of patients with chronic obstructive pulmonary disease (COPD) have never been compared with those of elderly men with normal pulmonary function. Moreover, the relationship of hypogonadism with quadriceps muscle weakness and exercise intolerance has been studied scarcely in men with COPD.


OBJECTIVE
To compare circulating levels of hormones of the pituitary-gonadotrophic axis of men with COPD with those of age-matched control subjects. Moreover, to study the relationship of hypogonadism with quadriceps muscle force, 6-min walking distance, and systemic markers of inflammation in the patients.


METHODS
Circulating levels of follicle-stimulating hormone, luteinizing hormone, testosterone, and sex hormone-binding globulin were determined, and free testosterone was calculated in 78 patients (FEV1: 44 +/- 17% of the predicted values) and 21 control subjects. Moreover, quadriceps muscle force, 6-min walking distance, number of pack-yr, and systemic inflammation were determined.


RESULTS
Follicle-stimulating hormone and luteinizing hormone were higher in the patients, whereas testosterone was lower (p < or = 0.05). The latter finding was also present in 48 non-steroid-using patients with normal blood gases. Low androgen status was significantly related to quadriceps muscle weakness (r = 0.48) and C-reactive protein (r = -0.39) in the patients, but not to exercise intolerance, the number of pack-yr, or increased circulating levels of interleukin 8 or soluble receptors of tumor necrosis factor alpha.


CONCLUSIONS
In contrast to exercise intolerance, quadriceps muscle weakness is related to low circulating levels of testosterone in men with COPD.
Van Vliet
Monique
M
Respiratory Rehabilitation, University Hospital Gasthuisberg, Herestraat 49, B-3000, Leuven, Belgium.
Spruit
Martijn A
MA
Verleden
Geert
G
Kasran
Ahmad
A
Van Herck
Erik
E
Pitta
Fabio
F
Bouillon
Roger
R
Decramer
Marc
M
D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D000068800:Etanercept; D017079:Exercise Tolerance / Q000502:physiology*; D043373:Follicle Stimulating Hormone, Human / Q000097:blood; D006801:Humans; D007006:Hypogonadism / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D007074:Immunoglobulin G / Q000097:blood; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D018482:Muscle, Skeletal / Q000503:physiopathology; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D020800:Receptor, Nerve Growth Factor / Q000097:blood; D018124:Receptors, Tumor Necrosis Factor / Q000097:blood; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D013739:Testosterone / Q000097:blood*
D043373:Follicle Stimulating Hormone, Human; D007074:Immunoglobulin G; D020800:Receptor, Nerve Growth Factor; D018124:Receptors, Tumor Necrosis Factor; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D007986:Luteinizing Hormone; D002097:C-Reactive Protein; D000068800:Etanercept