title: Cardiometabolic risks during anabolic hormone supplementation in older men.
abstract: OBJECTIVE
  To determine the cardiometabolic risks of testosterone and growth hormone (GH) replacement therapy to youthful levels during aging.
  
  
  METHODS
  A double-masked, partially placebo controlled study in 112 men 65-90 years-old was conducted. Transdermal testosterone (5 g vs. 10 g/day) using a Leydig Cell Clamp and subcutaneous recombinant GH (rhGH) (0 vs. 3 vs. 5 μg/kg/day) were administered for 16-weeks. Measurements included testosterone and IGF-1 levels, body composition by DEXA, and cardiometabolic risk factors (upper body fat, blood pressure, insulin sensitivity, fasting triglycerides, HDL-cholesterol, and serum adiponectin) at baseline and after 16 weeks of treatment.
  
  
  RESULTS
  Some cardiometabolic factors improved (total and trunk fat, triglycerides, HDL-cholesterol) and others worsened (systolic blood pressure, insulin sensitivity index [QUICKI], adiponectin). Cardiometabolic risk composite scores (CRCSs) improved (-0.69 ± 1.55, P < 0.001). In multivariate analyses, QUICKI, triglycerides, and HDL-cholesterol contributed 33%, 16%, and 14% of the variance in CRCS, respectively. Pathway analyses indicated that changes in fat and lean mass were related to individual cardiometabolic variables and CRCS in a complex manner. Changes in BMI, reflecting composite effects of changes in fat and lean mass, were more robustly associated with cardiometabolic risks than changes in fat mass or LBM individually.
  
  
  CONCLUSIONS
  Testosterone and rhGH administration was associated with diverse changes in individual cardiometabolic risk factors, but in aggregate appeared not to worsen cardiometabolic risk in healthy older men after 4-months. The long-term effects of these and similar anabolic therapies on cardiovascular events should be investigated in populations with greater functional limitations along with important health disabilities including upper body obesity and other cardiometabolic risks.
authors.affiliation: Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA.
authors.forename: J
authors.initials: J
authors.lastname: He
authors.forename: S
authors.initials: S
authors.lastname: Bhasin
authors.forename: E F
authors.initials: EF
authors.lastname: Binder
authors.forename: K E
authors.initials: KE
authors.lastname: Yarasheski
authors.forename: C
authors.initials: C
authors.lastname: Castaneda-Sceppa
authors.forename: E T
authors.initials: ET
authors.lastname: Schroeder
authors.forename: R
authors.initials: R
authors.lastname: Roubenoff
authors.forename: C-P
authors.initials: CP
authors.lastname: Chou
authors.forename: S P
authors.initials: SP
authors.lastname: Azen
authors.forename: F R
authors.initials: FR
authors.lastname: Sattler
mesh_terms: D052242:Adiponectin / Q000097:blood; D000273:Adipose Tissue / Q000378:metabolism; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D045930:Anabolic Agents / Q000009:adverse effects* / Q000494:pharmacology; D001794:Blood Pressure / Q000187:drug effects; D001823:Body Composition / Q000187:drug effects*; D001825:Body Fluid Compartments / Q000378:metabolism; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology; D008076:Cholesterol, HDL / Q000097:blood; D019587:Dietary Supplements / Q000009:adverse effects*; D004311:Double-Blind Method; D020249:Hormone Replacement Therapy / Q000009:adverse effects*; D019382:Human Growth Hormone / Q000009:adverse effects* / Q000494:pharmacology; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D015999:Multivariate Analysis; D012307:Risk Factors; D013739:Testosterone / Q000009:adverse effects* / Q000494:pharmacology; D014280:Triglycerides / Q000097:blood
chemical_list: D052242:Adiponectin; D045930:Anabolic Agents; D008076:Cholesterol, HDL; D014280:Triglycerides; D019382:Human Growth Hormone; D013739:Testosterone