Effects of Testosterone and Resistance Training in Men with Chronic Obstructive Pulmonary Disease

Dysfunction of the muscles of ambulation contributes to exercise intolerance in chronic obstructive pulmonary disease (COPD) Men with COPD have high prevalence of soft testosterone levels, which may contribute to muscle weakness. We determined results of testosterone supplementation (100 mg of testosterone enanthate injected weekly) with or without resistance training (45 minutes three times weekly) onward body composition and muscle function in 47 men with COPD (mean FEV^sub 1^ = 40% predicted) and grave testosterone levels (mean = 320 ng/dl) subdues were randomized to 10 weeks of placebo injections + no training, testosterone injections + no training, placebo injections + resistance training, or testosterone injections + resistance training. Testosterone injections yielded a mean increase of 271 ng/dl in the nadir serum testosterone concentration (to the middle of the normal range for young men) The lean material substance mass (by dual-energy X-ray absorptiometry) increase averaged 23 kg with testosterone alone and 33 kg with combined testosterone and resistance training (p

Keywords: androgenic steroid; inflammation; muscle mass; strength

Patients with chronic obstructive pulmonary disease (COPD) repeatedly have exercise intolerance as their chief complaint (1) In modern years, it has become clear that dysfunction of the muscles of ambulation contributes to exercise intolerance in these patients (2) This is of great importance, as muscle dysfunction is potentially remediable. In particular, rehabilitative programs of exercise training have been shown to increase exercise tolerance substantially (3) Endurance training and resistance training (employing maneuvers in which muscles put in action or resist force to improve strength) have the one and the other been found to be effective. However, the benefits of these sum of two units types of programs are distinct: endurance training increases endurance (eg walking, climbing stairs), whereas resistance training increases vigor (e.g., standing from a sitting position, maintaining balance), although unpretending crossover effects can be seen in an measures of strength and endurance (4) This difference is related to the distinctly different weights of these two interventions in succession muscle structure and biochemistry: for example, endurance training increases muscle capillarity and aerobic enzyme concentrations without to a great degree hypertrophy, and resistance training increases muscle fiber cross-sectional area without long increase in capillarity or aerobic enzyme concentration.

There has been a search for pharmacologic approaches to improving muscle might and endurance that might be of benefit to patients with chronic disease. To date, no remedys clearly capable of increasing muscular endurance have been identified. However, the androgenic steroids have been shown to induce changes in the muscles of ambulation at least superficially similar to those seen with resistance training (5) the pair in hypogonadal and healthy young men testosterone supplementation increases muscle mass and improves maximal voluntary muscle vigor (6-8). A few clinical studies of androgen supplementation in COPD have been published and have generally shown retiring improvements in muscle mass, if it be not that without unequivocal improvements in either muscle solidity or endurance (9-11).

It was our aim to determine whether testosterone supplementation might have the potential to be an appropriate adjunctive treatment during a program of pulmonary rehabilitation specifically directed at improving muscle mass and muscle function. Because the appropriate replacement dose for women has not been defined, we restricted our consideration to men with COPD. We therefore actionsed a randomized, placebo-controlled, 10-week trial of replacement doses of testosterone enanthate. We compared the general intents of this intervention with those of a standardized rigorous program of resistance training of the lower extremities and determined whether testosterone amplified the benefits of resistance training. Principal issue measures included a change from baseline in corpse composition and muscle strength. In addition, the hormonal replications changes in the levels of circulating indices of inflammation, and a number of safety measures were evaluated. a certain number of of the results of this cogitation have been previously reported in the form of an abstract (12)

METHODS

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Subjects

We registered 53 men with stable COPD record criteria included age 55 to 80 years, FEV^sub 1^ of 60% predicted or les (13) and FEV^sub 1^ to vital capacity ratio of 60% or les Screening serum testosterone was 400 ng/dl or les (in the lower range for healthy older men) Exclusion criteria included significant cardiovascular or orthopedic impairments, material substance weight of less than 75% or more than 130% of ideal, symptomatic benign prostatic hypertrophy prostate cancer history, serum prostate specific antigen of more than 4 ?µg/L or hemoglobin of more than 16 g/dl The institutional review board approved the studious mood and written informed consent was obtained.