Long-term testosterone supplementation in older men attenuates age-related decline in aerobic capacity

Tinna Traustadottir, S. Mitchell Harman, Panayiotis Tsitouras, Karol M. Pencina, Zhuoying Li, Thomas G. Travison, Richard Eder, Renee Miciek, Jennifer McKinnon, Erin Woodbury, Shehzad Basaria, Shalender Bhasin, Thomas W. Storer

Research output: Contribution to journalArticle

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Abstract

Context: Testosterone increases skeletal muscle mass and strength, but long-term effects of testosterone supplementation on aerobic capacity, or peak oxygen uptake (V.O2peak), in healthy older men with low testosterone have not been evaluated. Objective: To determine the effects of testosterone supplementation on V.O2peak during incremental cycle ergometry. Design: A double-blind, randomized, placebo-controlled, parallel-group trial (Testosterones Effects on Atherosclerosis Progression in Aging Men). Setting: Exercise physiology laboratory. Participants: Healthy men aged ≥ 60 years with total testosterone levels of 100 to 400 ng/dL (3.5 to 13.9 nmol/L) or free testosterone levels <50 pg/mL (174 pmol/L). Interventions: Randomization to 1% transdermal testosterone gel adjusted to achieve serum levels of 500 to 950 ng/dL or placebo applied daily for 3 years. Main Outcome Measures: Change in V.O2peak. Results: Mean (6SD) baseline V.O2peak was 24.2 ± 5.2 and 23.6 ± 5.6 mL/kg/min for testosterone and placebo, respectively. V.O2peak did not change in men treated with testosterone but fell significantly in men receiving placebo (average 3-year decrease, 0.88 mL/kg/min; 95% CI, 21.39 to 0.38 mL/kg/min; P = 0.035); the difference in change in V.O2peak between groups was significant (average 3-year difference, 0.91 mL/kg/min; 95% CI, 0.010 to 0.122 mL/kg/min; P = 0.008). The 1-g/dL mean increase in hemoglobin (P < 0.001) was significantly associated with changes in V.O2peak in testosterone-treated men. Conclusion: The mean 3-year change in V.O2peak was significantly smaller in men treated with testosterone than in men receiving placebo and was associated with increases in hemoglobin. The difference in V.O2peak change between groups may indicate attenuation of its expected agerelated decline; the clinical meaningfulness of the modest treatment effect remains to be determined.

Original languageEnglish (US)
Pages (from-to)2861-2869
Number of pages9
JournalJournal of Clinical Endocrinology and Metabolism
Volume103
Issue number8
DOIs
StatePublished - Jan 1 2018

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Testosterone
Placebos
Ergometry
Muscle Strength
Random Allocation
Physiology
Atherosclerosis
Healthy Volunteers
Hemoglobins
Skeletal Muscle
Muscle
Gels
Outcome Assessment (Health Care)
Exercise
Aging of materials
Oxygen
Serum

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Long-term testosterone supplementation in older men attenuates age-related decline in aerobic capacity. / Traustadottir, Tinna; Harman, S. Mitchell; Tsitouras, Panayiotis; Pencina, Karol M.; Li, Zhuoying; Travison, Thomas G.; Eder, Richard; Miciek, Renee; McKinnon, Jennifer; Woodbury, Erin; Basaria, Shehzad; Bhasin, Shalender; Storer, Thomas W.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 103, No. 8, 01.01.2018, p. 2861-2869.

Research output: Contribution to journalArticle

Traustadottir, T, Harman, SM, Tsitouras, P, Pencina, KM, Li, Z, Travison, TG, Eder, R, Miciek, R, McKinnon, J, Woodbury, E, Basaria, S, Bhasin, S & Storer, TW 2018, 'Long-term testosterone supplementation in older men attenuates age-related decline in aerobic capacity', Journal of Clinical Endocrinology and Metabolism, vol. 103, no. 8, pp. 2861-2869. https://doi.org/10.1210/jc.2017-01902
Traustadottir, Tinna ; Harman, S. Mitchell ; Tsitouras, Panayiotis ; Pencina, Karol M. ; Li, Zhuoying ; Travison, Thomas G. ; Eder, Richard ; Miciek, Renee ; McKinnon, Jennifer ; Woodbury, Erin ; Basaria, Shehzad ; Bhasin, Shalender ; Storer, Thomas W. / Long-term testosterone supplementation in older men attenuates age-related decline in aerobic capacity. In: Journal of Clinical Endocrinology and Metabolism. 2018 ; Vol. 103, No. 8. pp. 2861-2869.
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abstract = "Context: Testosterone increases skeletal muscle mass and strength, but long-term effects of testosterone supplementation on aerobic capacity, or peak oxygen uptake (V.O2peak), in healthy older men with low testosterone have not been evaluated. Objective: To determine the effects of testosterone supplementation on V.O2peak during incremental cycle ergometry. Design: A double-blind, randomized, placebo-controlled, parallel-group trial (Testosterones Effects on Atherosclerosis Progression in Aging Men). Setting: Exercise physiology laboratory. Participants: Healthy men aged ≥ 60 years with total testosterone levels of 100 to 400 ng/dL (3.5 to 13.9 nmol/L) or free testosterone levels <50 pg/mL (174 pmol/L). Interventions: Randomization to 1{\%} transdermal testosterone gel adjusted to achieve serum levels of 500 to 950 ng/dL or placebo applied daily for 3 years. Main Outcome Measures: Change in V.O2peak. Results: Mean (6SD) baseline V.O2peak was 24.2 ± 5.2 and 23.6 ± 5.6 mL/kg/min for testosterone and placebo, respectively. V.O2peak did not change in men treated with testosterone but fell significantly in men receiving placebo (average 3-year decrease, 0.88 mL/kg/min; 95{\%} CI, 21.39 to 0.38 mL/kg/min; P = 0.035); the difference in change in V.O2peak between groups was significant (average 3-year difference, 0.91 mL/kg/min; 95{\%} CI, 0.010 to 0.122 mL/kg/min; P = 0.008). The 1-g/dL mean increase in hemoglobin (P < 0.001) was significantly associated with changes in V.O2peak in testosterone-treated men. Conclusion: The mean 3-year change in V.O2peak was significantly smaller in men treated with testosterone than in men receiving placebo and was associated with increases in hemoglobin. The difference in V.O2peak change between groups may indicate attenuation of its expected agerelated decline; the clinical meaningfulness of the modest treatment effect remains to be determined.",
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T1 - Long-term testosterone supplementation in older men attenuates age-related decline in aerobic capacity

AU - Traustadottir, Tinna

AU - Harman, S. Mitchell

AU - Tsitouras, Panayiotis

AU - Pencina, Karol M.

AU - Li, Zhuoying

AU - Travison, Thomas G.

AU - Eder, Richard

AU - Miciek, Renee

AU - McKinnon, Jennifer

AU - Woodbury, Erin

AU - Basaria, Shehzad

AU - Bhasin, Shalender

AU - Storer, Thomas W.

PY - 2018/1/1

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N2 - Context: Testosterone increases skeletal muscle mass and strength, but long-term effects of testosterone supplementation on aerobic capacity, or peak oxygen uptake (V.O2peak), in healthy older men with low testosterone have not been evaluated. Objective: To determine the effects of testosterone supplementation on V.O2peak during incremental cycle ergometry. Design: A double-blind, randomized, placebo-controlled, parallel-group trial (Testosterones Effects on Atherosclerosis Progression in Aging Men). Setting: Exercise physiology laboratory. Participants: Healthy men aged ≥ 60 years with total testosterone levels of 100 to 400 ng/dL (3.5 to 13.9 nmol/L) or free testosterone levels <50 pg/mL (174 pmol/L). Interventions: Randomization to 1% transdermal testosterone gel adjusted to achieve serum levels of 500 to 950 ng/dL or placebo applied daily for 3 years. Main Outcome Measures: Change in V.O2peak. Results: Mean (6SD) baseline V.O2peak was 24.2 ± 5.2 and 23.6 ± 5.6 mL/kg/min for testosterone and placebo, respectively. V.O2peak did not change in men treated with testosterone but fell significantly in men receiving placebo (average 3-year decrease, 0.88 mL/kg/min; 95% CI, 21.39 to 0.38 mL/kg/min; P = 0.035); the difference in change in V.O2peak between groups was significant (average 3-year difference, 0.91 mL/kg/min; 95% CI, 0.010 to 0.122 mL/kg/min; P = 0.008). The 1-g/dL mean increase in hemoglobin (P < 0.001) was significantly associated with changes in V.O2peak in testosterone-treated men. Conclusion: The mean 3-year change in V.O2peak was significantly smaller in men treated with testosterone than in men receiving placebo and was associated with increases in hemoglobin. The difference in V.O2peak change between groups may indicate attenuation of its expected agerelated decline; the clinical meaningfulness of the modest treatment effect remains to be determined.

AB - Context: Testosterone increases skeletal muscle mass and strength, but long-term effects of testosterone supplementation on aerobic capacity, or peak oxygen uptake (V.O2peak), in healthy older men with low testosterone have not been evaluated. Objective: To determine the effects of testosterone supplementation on V.O2peak during incremental cycle ergometry. Design: A double-blind, randomized, placebo-controlled, parallel-group trial (Testosterones Effects on Atherosclerosis Progression in Aging Men). Setting: Exercise physiology laboratory. Participants: Healthy men aged ≥ 60 years with total testosterone levels of 100 to 400 ng/dL (3.5 to 13.9 nmol/L) or free testosterone levels <50 pg/mL (174 pmol/L). Interventions: Randomization to 1% transdermal testosterone gel adjusted to achieve serum levels of 500 to 950 ng/dL or placebo applied daily for 3 years. Main Outcome Measures: Change in V.O2peak. Results: Mean (6SD) baseline V.O2peak was 24.2 ± 5.2 and 23.6 ± 5.6 mL/kg/min for testosterone and placebo, respectively. V.O2peak did not change in men treated with testosterone but fell significantly in men receiving placebo (average 3-year decrease, 0.88 mL/kg/min; 95% CI, 21.39 to 0.38 mL/kg/min; P = 0.035); the difference in change in V.O2peak between groups was significant (average 3-year difference, 0.91 mL/kg/min; 95% CI, 0.010 to 0.122 mL/kg/min; P = 0.008). The 1-g/dL mean increase in hemoglobin (P < 0.001) was significantly associated with changes in V.O2peak in testosterone-treated men. Conclusion: The mean 3-year change in V.O2peak was significantly smaller in men treated with testosterone than in men receiving placebo and was associated with increases in hemoglobin. The difference in V.O2peak change between groups may indicate attenuation of its expected agerelated decline; the clinical meaningfulness of the modest treatment effect remains to be determined.

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