Androgen treatment and muscle strength in elderly men: A meta-analysis.

Abstract

OBJECTIVES:

To review published, randomized trials examining the effect of androgen treatment on muscle strength in older men.

DESIGN:

Systematic review using meta-analysis procedures.

SETTING:

Computerized and manual searches.

PARTICIPANTS:

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.

INTERVENTION:

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

MEASUREMENTS:

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.

CONCLUSION:

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.

• Authors: Kenneth J Ottenbacher, Margaret E Ottenbacher, Allison J Ottenbacher, Ana Alfaro Acha, Glenn V Ostir
• Journal: Journal of the American Geriatrics Society (J Am Geriatr Soc) Vol. 54 Issue 11 Pg. 1666-73 (Nov 2006) ISSN: 0002-8614 [Print] United States
• PMID: 17087692 (Publication Type: Journal Article, Meta-Analysis, Research Support, N.I.H., Extramural, Systematic Review)

Chemical References

• Dihydrotestosterone
• Testosterone

Topics

• Aged
• Dihydrotestosterone (therapeutic use)
• Hormone Replacement Therapy
• Humans
• Male
• Muscle Strength (drug effects)
• Randomized Controlled Trials as Topic
• Testosterone (therapeutic use)