title: Effect of oral anabolic steroid on muscle strength and muscle growth in hemodialysis patients.
abstract: OBJECTIVE
  Sarcopenia is common in hemodialysis patients. This study examined whether the anabolic steroid oxymetholone improves muscle mass and handgrip strength in hemodialysis patients and possible mechanisms that might engender such changes.
  
  
  METHODS
  Forty-three eligible hemodialysis patients were randomly assigned to ingest oxymetholone or placebo for 24 weeks. Body composition, handgrip strength, and quality of life were measured during the study. Muscle biopsies were performed and analyzed for mRNA levels for myostatin, IGF-I, IGF binding proteins, and myosin heavy chains and protein expression. Muscle fiber types and diameter were assessed by reduced nicotinamide-adenine dinucleotide staining.
  
  
  RESULTS
  There was a significantly greater increase in fat-free mass and handgrip strength and decrease in fat mass in the oxymetholone compared with the placebo group. Moreover, compared with baseline values, patients given oxymetholone exhibited an increase in fat-free mass, handgrip strength, physical functioning scores, and type I muscle fiber cross-sectional area and a decrease in fat mass, whereas patients receiving placebo did not undergo changes. There was a significantly greater increase in muscle mRNA levels for myosin heavy chain 2×, IGF-I, and IGF-II receptor with oxymetholone treatment than placebo. Liver enzyme rose significantly in the oxymetholone group, but the number of values greater than three times the upper limit of normal were not different between these groups.
  
  
  CONCLUSIONS
  In hemodialysis patients, ingesting oxymetholone was associated with an increase in fat-free mass, handgrip strength, and muscle mRNA levels for several growth factors and a decrease in fat mass, but it also induced liver injury.
authors.affiliation: Division of Nephrology, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand. ouppatham@hotmail.com
authors.forename: Ouppatham
authors.initials: O
authors.lastname: Supasyndh
authors.forename: Bancha
authors.initials: B
authors.lastname: Satirapoj
authors.forename: Pornanong
authors.initials: P
authors.lastname: Aramwit
authors.forename: Duangkamol
authors.initials: D
authors.lastname: Viroonudomphol
authors.forename: Amnart
authors.initials: A
authors.lastname: Chaiprasert
authors.forename: Vipa
authors.initials: V
authors.lastname: Thanachatwej
authors.forename: Supat
authors.initials: S
authors.lastname: Vanichakarn
authors.forename: Joel D
authors.initials: JD
authors.lastname: Kopple
mesh_terms: D000284:Administration, Oral; D000328:Adult; D045930:Anabolic Agents / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000187:drug effects*; D018482:Muscle, Skeletal / Q000187:drug effects* / Q000254:growth & development*; D010110:Oxymetholone / Q000008:administration & dosage*; D006435:Renal Dialysis
chemical_list: D045930:Anabolic Agents; D010110:Oxymetholone