This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (134)  • Contact me when this article is cited  Related Content  • Related letter  • Related article  • Similar articles in JAMA  Social Bookmarking   What's this?

Shalender Bhasin, MD; Thomas W. Storer, PhD; Marjan Javanbakht, MPH; Nancy Berman, PhD; Kevin E. Yarasheski, PhD; Jeffrey Phillips, MD; Marjorie Dike, PhD; Indrani Sinha-Hikim, PhD; Ruoquing Shen, MD; Ron D. Hays, PhD; Gildon Beall, MD

JAMA. 2000;283:763-770.

Context  Previous studies of testosterone supplementation in HIV-infected men failed to demonstrate improvement in muscle strength. The effects of resistance exercise combined with testosterone supplementation in HIV-infected men are unknown.

Objective  To determine the effects of testosterone replacement with and without resistance exercise on muscle strength and body composition in HIV-infected men with low testosterone levels and weight loss.

Design and Setting  Placebo-controlled, double-blind, randomized clinical trial conducted from September 1995 to July 1998 at a general clinical research center.

Participants  Sixty-one HIV-infected men aged 18 to 50 years with serum testosterone levels of less than 12.1 nmol/L (349 ng/dL) and weight loss of 5% or more in the previous 6 months, 49 of whom completed the study.

Interventions  Participants were randomly assigned to 1 of 4 groups: placebo, no exercise (n = 14); testosterone enanthate (100 mg/wk intramuscularly), no exercise (n = 17); placebo and exercise (n = 15); or testosterone and exercise (n = 15). Treatment duration was 16 weeks.

Main Outcome Measures  Changes in muscle strength, body weight, thigh muscle volume, and lean body mass compared among the 4 treatment groups.

Results  Body weight increased significantly by 2.6 kg (P<.001) in men receiving testosterone alone and by 2.2 kg (P = .02) in men who exercised alone but did not change in men receiving placebo alone (-0.5 kg; P = .55) or testosterone and exercise (0.7 kg; P = .08). Men treated with testosterone alone, exercise alone, or both experienced significant increases in maximum voluntary muscle strength in leg press (range, 22%-30%), leg curls (range, 18%-36%), bench press (range, 19%-33%), and latissimus pulls (range, 17%-33%). Gains in strength in all exercise categories were greater in men assigned to the testosterone-exercise group or to the exercise-alone group than in those assigned to the placebo-alone group. There was a greater increase in thigh muscle volume in men receiving testosterone alone (mean change, 40 cm³; P<.001 vs zero change) or exercise alone (62 cm; P = .003) than in men receiving placebo alone (5 cm³; P = .70). Average lean body mass increased by 2.3 kg (P = .004) and 2.6 kg (P<.001), respectively, in men who received testosterone alone or testosterone and exercise but did not change in men receiving placebo alone (0.9 kg; P = .21).Hemoglobin levels increased in men receiving testosterone but not in those receiving placebo.

Conclusion  Our data suggest that testosterone and resistance exercise promote gains in body weight, muscle mass, muscle strength, and lean body mass in HIV-infected men with weight loss and low testosterone levels. Testosterone and exercise together did not produce greater gains than either intervention alone.

Author Affiliations: Division of Endocrinology, Metabolism, and Molecular Medicine, Charles R. Drew University of Medicine and Science (Drs Bhasin, Dike, Sinha-Hikim, and Shen and Ms Javanbakht), and Department of General Internal Medicine and Health Service Research (Dr Hays), University of California, Los Angeles; Laboratory for Exercise Sciences, El Camino College (Dr Storer), and Departments of Pediatrics (Dr Berman), Radiology (Dr Phillips), and Medicine (Dr Beall), Harbor-University of California, Los Angeles Medical Center, Torrance; and Division of Metabolism, Endocrinology, and Diabetes, Washington University Medical School, St Louis, Mo (Dr Yarasheski).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED LETTER

Exercise Regimens for Men With HIV
Richard A. Winett, Ralph N. Carpinelli, Shalender Bhasin, and Thomas W. Storer
JAMA. 2000;284(2):175-176.
EXTRACT | FULL TEXT  

RELATED ARTICLE

February 9, 2000
JAMA. 2000;283(6):817-818.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Effect of nandrolone decanoate administration on recovery from bupivacaine-induced muscle injury
White et al.
J. Appl. Physiol. 2009;107:1420-1430.
ABSTRACT | FULL TEXT  

Is there a neuroendocrinological rationale for testosterone as a therapeutic option in depression?
Ebinger et al.
J Psychopharmacol 2009;23:841-853.
ABSTRACT  

Unraveling Androgen Action in Muscle: Genetic Tools Probing Cellular Mechanisms
MacLean and Handelsman
Endocrinology 2009;150:3437-3439.
FULL TEXT  

Physical activity uptake in patients with HIV: who does how much?
Fillipas et al.
Int J STD AIDS 2008;19:514-518.
ABSTRACT | FULL TEXT  

Effects of a supraphysiological dose of testosterone on physical function, muscle performance, mood, and fatigue in men with HIV-associated weight loss
Knapp et al.
Am. J. Physiol. Endocrinol. Metab. 2008;294:E1135-E1143.
ABSTRACT | FULL TEXT  

Transcriptional Profiling of Testosterone-Regulated Genes in the Skeletal Muscle of Human Immunodeficiency Virus-Infected Men Experiencing Weight Loss
Montano et al.
J. Clin. Endocrinol. Metab. 2007;92:2793-2802.
ABSTRACT | FULL TEXT  

Effects of Testosterone Supplementation on Whole Body and Regional Fat Mass and Distribution in Human Immunodeficiency Virus-Infected Men with Abdominal Obesity
Bhasin et al.
J. Clin. Endocrinol. Metab. 2007;92:1049-1057.
ABSTRACT | FULL TEXT  

Modifying muscle mass - the endocrine perspective.
Solomon and Bouloux
J Endocrinol 2006;191:349-360.
ABSTRACT | FULL TEXT  

Effects of Testosterone Supplementation on Skeletal Muscle Fiber Hypertrophy and Satellite Cells in Community-Dwelling Older Men
Sinha-Hikim et al.
J. Clin. Endocrinol. Metab. 2006;91:3024-3033.
ABSTRACT | FULL TEXT  

Testosterone Therapy in Adult Men with Androgen Deficiency Syndromes: An Endocrine Society Clinical Practice Guideline
Bhasin et al.
J. Clin. Endocrinol. Metab. 2006;91:1995-2010.
ABSTRACT | FULL TEXT  

Cachexia: pathophysiology and clinical relevance.
Morley et al.
Am. J. Clin. Nutr. 2006;83:735-743.
ABSTRACT | FULL TEXT  

Sex Differences of Endogenous Sex Hormones and Risk of Type 2 Diabetes: A Systematic Review and Meta-analysis
Ding et al.
JAMA 2006;295:1288-1299.
ABSTRACT | FULL TEXT  

Testosterone Inhibits Adipogenic Differentiation in 3T3-L1 Cells: Nuclear Translocation of Androgen Receptor Complex with {beta}-Catenin and T-Cell Factor 4 May Bypass Canonical Wnt Signaling to Down-Regulate Adipogenic Transcription Factors
Singh et al.
Endocrinology 2006;147:141-154.
ABSTRACT | FULL TEXT  

A Randomized, Placebo-Controlled Trial of Nandrolone Decanoate in Human Immunodeficiency Virus-Infected Men with Mild to Moderate Weight Loss with Recombinant Human Growth Hormone as Active Reference Treatment
Storer et al.
J. Clin. Endocrinol. Metab. 2005;90:4474-4482.
ABSTRACT | FULL TEXT  

Androgen regulation of satellite cell function
Chen et al.
J Endocrinol 2005;186:21-31.
ABSTRACT | FULL TEXT  

Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease
Troosters et al.
Am. J. Respir. Crit. Care Med. 2005;172:19-38.
FULL TEXT  

Gonadal dysfunction in systemic diseases
Karagiannis and Harsoulis
Eur J Endocrinol 2005;152:501-513.
ABSTRACT | FULL TEXT  

Effect of Nandrolone Decanoate Therapy on Weight and Lean Body Mass in HIV-Infected Women With Weight Loss: A Randomized, Double-blind, Placebo-Controlled, Multicenter Trial
Mulligan et al.
Arch Intern Med 2005;165:578-585.
ABSTRACT | FULL TEXT  

Effects of Testosterone Replacement in Human Immunodeficiency Virus-Infected Women with Weight Loss
Choi et al.
J. Clin. Endocrinol. Metab. 2005;90:1531-1541.
ABSTRACT | FULL TEXT  

Older Men Are as Responsive as Young Men to the Anabolic Effects of Graded Doses of Testosterone on the Skeletal Muscle
Bhasin et al.
J. Clin. Endocrinol. Metab. 2005;90:678-688.
ABSTRACT | FULL TEXT  

Effects of Testosterone and Resistance Training in Men with Chronic Obstructive Pulmonary Disease
Casaburi et al.
Am. J. Respir. Crit. Care Med. 2004;170:870-878.
ABSTRACT | FULL TEXT  

Androgen Receptor in Human Skeletal Muscle and Cultured Muscle Satellite Cells: Up-Regulation by Androgen Treatment
Sinha-Hikim et al.
J. Clin. Endocrinol. Metab. 2004;89:5245-5255.
ABSTRACT | FULL TEXT  

Hormonal and lifestyle determinants of appendicular skeletal muscle mass in men: the MINOS study
Szulc et al.
Am. J. Clin. Nutr. 2004;80:496-503.
ABSTRACT | FULL TEXT  

Current Concepts in Anabolic-Androgenic Steroids
Evans
Am J Sports Med 2004;32:534-542.
ABSTRACT | FULL TEXT  

Dose-Dependent Effects of Testosterone on Regional Adipose Tissue Distribution in Healthy Young Men
Woodhouse et al.
J. Clin. Endocrinol. Metab. 2004;89:718-726.
ABSTRACT | FULL TEXT  

The Mechanisms of Androgen Effects on Body Composition: Mesenchymal Pluripotent Cell as the Target of Androgen Action
Bhasin et al.
Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2003;58:M1103-1110.
ABSTRACT | FULL TEXT  

Testosterone Supplementation for Aging-Associated Sarcopenia
Bhasin
Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2003;58:M1002-1008.
ABSTRACT | FULL TEXT  

Androgens Stimulate Myogenic Differentiation and Inhibit Adipogenesis in C3H 10T1/2 Pluripotent Cells through an Androgen Receptor-Mediated Pathway
Singh et al.
Endocrinology 2003;144:5081-5088.
ABSTRACT | FULL TEXT  

Androgen therapy improves muscle mass and strength but not muscle quality: results from two studies
Schroeder et al.
Am. J. Physiol. Endocrinol. Metab. 2003;285:E16-E24.
ABSTRACT | FULL TEXT  

Testosterone-induced muscle hypertrophy is associated with an increase in satellite cell number in healthy, young men
Sinha-Hikim et al.
Am. J. Physiol. Endocrinol. Metab. 2003;285:E197-E205.
ABSTRACT | FULL TEXT  

Development of models to predict anabolic response to testosterone administration in healthy young men
Woodhouse et al.
Am. J. Physiol. Endocrinol. Metab. 2003;284:E1009-E1017.
ABSTRACT | FULL TEXT  

Testosterone Dose-Dependently Increases Maximal Voluntary Strength and Leg Power, but Does Not Affect Fatigability or Specific Tension
Storer et al.
J. Clin. Endocrinol. Metab. 2003;88:1478-1485.
ABSTRACT | FULL TEXT  

Metabolic effects of nandrolone decanoate and resistance training in men with HIV
Sattler et al.
Am. J. Physiol. Endocrinol. Metab. 2002;283:E1214-E1222.
ABSTRACT | FULL TEXT  

Testosterone-induced increase in muscle size in healthy young men is associated with muscle fiber hypertrophy
Sinha-Hikim et al.
Am. J. Physiol. Endocrinol. Metab. 2002;283:E154-E164.
ABSTRACT | FULL TEXT  

Differential Effects of Oral Estrogen versus Oral Estrogen-Androgen Replacement Therapy on Body Composition in Postmenopausal Women
Dobs et al.
J. Clin. Endocrinol. Metab. 2002;87:1509-1516.
ABSTRACT | FULL TEXT  

Changes in Body Composition during Androgen Deprivation Therapy for Prostate Cancer
Smith et al.
J. Clin. Endocrinol. Metab. 2002;87:599-603.
ABSTRACT | FULL TEXT  

The Effects of Varying Doses of T on Insulin Sensitivity, Plasma Lipids, Apolipoproteins, and C-Reactive Protein in Healthy Young Men
Singh et al.
J. Clin. Endocrinol. Metab. 2002;87:136-143.
ABSTRACT | FULL TEXT  

Anabolic Steroids
Kuhn
Recent Prog Horm Res 2002;57:411-434.
ABSTRACT | FULL TEXT  

Guidelines for the Use of Parenteral and Enteral Nutrition in Adult and Pediatric Patients
American Society for Parenteral and Enteral Nutrit
JPEN J Parenter Enteral Nutr 2002;26:1SA-138SA.
 

Testosterone dose-response relationships in healthy young men
Bhasin et al.
Am. J. Physiol. Endocrinol. Metab. 2001;281:E1172-E1181.
ABSTRACT | FULL TEXT  

Anabolic-Androgenic Steroid Therapy in the Treatment of Chronic Diseases
Basaria et al.
J. Clin. Endocrinol. Metab. 2001;86:5108-5117.
ABSTRACT | FULL TEXT  

Reproductive Function in Human Immunodeficiency Virus Infection
Lo and Schambelan
J. Clin. Endocrinol. Metab. 2001;86:2338-2343.
FULL TEXT  

Effects of Age on Testicular Function and Consequences of Testosterone Treatment
Snyder
J. Clin. Endocrinol. Metab. 2001;86:2369-2372.
FULL TEXT  

Osteopenia in Eugonadal Men with Acquired Immune Deficiency Syndrome Wasting Syndrome
Fairfield et al.
J. Clin. Endocrinol. Metab. 2001;86:2020-2026.
ABSTRACT | FULL TEXT  

Resistance exercise training reduces hypertriglyceridemia in HIV-infected men treated with antiviral therapy
Yarasheski et al.
J. Appl. Physiol. 2001;90:133-138.
ABSTRACT | FULL TEXT  

Effects of Testosterone and Progressive Resistance Training in Eugonadal Men with AIDS Wasting: A Randomized, Controlled Trial
Grinspoon et al.
ANN INTERN MED 2000;133:348-355.
ABSTRACT | FULL TEXT  

Exercise Regimens for Men With HIV
Winett et al.
JAMA 2000;284:175-176.
FULL TEXT  

Pharmacokinetics of a Novel Testosterone Matrix Transdermal System in Healthy, Premenopausal Women and Women Infected with the Human Immunodeficiency Virus
Javanbakht et al.
J. Clin. Endocrinol. Metab. 2000;85:2395-2401.
ABSTRACT | FULL TEXT  

Testosterone Replacement and Exercise
AIDS Clin Care 2000;2000:4-4.
FULL TEXT  

To Treat HIV-Induced Weight Loss, Try the Gym
JWatch General 2000;2000:2-2.
FULL TEXT