Effects of testosterone on skeletal muscle architecture in intermediate-frail and frail elderly men.
BACKGROUND
Testosterone increases lean mass and may help to counter the changes in muscle architecture associated with sarcopenia. This study was designed to investigate the effects of testosterone replacement therapy on skeletal muscle architecture in intermediate-frail and frail elderly men.


METHODS
A subgroup of 30 intermediate-frail and frail elderly men (65-89 years) with low to borderline-low testosterone levels were enrolled from a single-center randomized, double-blind placebo-controlled trial. Participants received either a transdermal testosterone (50 mg) or placebo gel daily for 6 months. Architecture (muscle thickness, fascicle length, and pennation angle) of the gastrocnemius medialis muscle was assessed by ultrasound imaging at baseline and after 6 months of treatment.


RESULTS
Serum testosterone increased from 11.6 ± 3.5 to 18.0 ± 8.1 nmol/L by 10 days after randomization in the active group (but not the placebo group) and was maintained throughout the treatment period. Testosterone treatment resulted in a preservation of muscle thickness at 6 months while it decreased in the placebo group (effect size 1.4 [95% confidence interval = 0.3-2.5; p = .015]). There was no significant effect of treatment on fascicle length (effect size 1.9 mm [95% confidence interval = -1.2 to 5.0 mm; p = .22]) or pennation angle (effect size 1.2° [95% confidence interval = -1.3 to 3.7°; p = .32]).


CONCLUSIONS
Testosterone replacement in intermediate-frail and frail elderly men is associated with preservation of muscle thickness. The results suggest that testosterone mitigates sarcopenia by improving muscle tissue to maintain a state of normality in aging men.
Atkinson
Ross A
RA
Institute for Biomedical Research into Human Movement and Health, Manchester Metropolitan University, UK. r.a.atkinson@mmu.ac.uk
Srinivas-Shankar
U
U
Roberts
Stephen A
SA
Connolly
Martin J
MJ
Adams
Judith E
JE
Oldham
Jackie A
JA
Wu
Frederick C W
FC
Seynnes
Olivier R
OR
Stewart
Claire E H
CE
Maganaris
Constantinos N
CN
Narici
Marco V
MV
D000279:Administration, Cutaneous; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D004311:Double-Blind Method; D016330:Frail Elderly; D020249:Hormone Replacement Therapy; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging / Q000187:drug effects*; D010919:Placebos; D055948:Sarcopenia / Q000517:prevention & control; D013739:Testosterone / Q000008:administration & dosage / Q000097:blood / Q000494:pharmacology*; D016896:Treatment Outcome; D014463:Ultrasonography
D010919:Placebos; D013739:Testosterone