Androgen treatment and muscle strength in elderly men: A meta-analysis.
OBJECTIVE
To review published, randomized trials examining the effect of androgen treatment on muscle strength in older men.


METHODS
Systematic review using meta-analysis procedures.


METHODS
Computerized and manual searches.


METHODS
MEDLINE, EMBASE, CINAHL, and the Cochrane Register were searched for trials. Key words included testosterone, androgen, sarcopenia, muscle loss, aged, aging, elderly, older, geriatric, randomized controlled trials, and controlled clinical trials. Sixty-five nonoverlapping studies were found. Meta-analysis methods were used to evaluate the 11 randomized, double-blind trials.


METHODS
Testosterone or dihydrotestosterone (DHT) replacement therapy in healthy men aged 65 and older.


METHODS
Tests of muscle strength.


RESULTS
The studies included 38 statistical comparisons. The mean g-index (g(i)) adjusted for sample size was 0.53 (95% confidence interval (CI) = 0.21-0.86). Subanalyses revealed larger effects for measures of lower extremity muscle strength (g(i) = 0.63, 95% CI = 0.03-1.28) than for upper extremity muscle strength (g(i) = 0.47, 95% CI = 0.12-0.84). A larger mean g-index was found for injected (g(i) = 0.95, 95% CI = 0.33-1.58) than topical (g(i) = 0.26, 95% CI = 0.08-0.42) or oral (g(i) = -0.21, 95% CI = -1.40-1.02) administration of testosterone/DHT. Effect sizes were related to study characteristics such as subject attrition and design-quality ratings. Sensitivity analyses revealed that the elimination of one study reduced the mean g-index from 0.53 to 0.23.


CONCLUSIONS
The results suggest that testosterone/DHT therapy produced a moderate increase in muscle strength in men participating in 11 randomized trials. One study influenced the mean effect size.
Ottenbacher
Kenneth J
KJ
Division of Rehabilitation Sciences, Sealy Center on Aging, Houston, Texas, USA. kottenba@utmb.edu
Ottenbacher
Margaret E
ME
Ottenbacher
Allison J
AJ
Acha
Ana Alfaro
AA
Ostir
Glenn V
GV
D000368:Aged; D013196:Dihydrotestosterone / Q000627:therapeutic use*; D020249:Hormone Replacement Therapy; D006801:Humans; D008297:Male; D053580:Muscle Strength / Q000187:drug effects*; D016032:Randomized Controlled Trials as Topic; D013739:Testosterone / Q000627:therapeutic use*
D013196:Dihydrotestosterone; D013739:Testosterone