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| |  ERS: Testosterone Leads to Improvements in Lean Mass for Men with Pulmonary Disease By Cameron Johnston Special to DG News BERLIN, GERMANY -- September 25, 2001 -- Testosterone injections, coupled with a well-planned exercise program, can help men with chronic obstructive pulmonary disease add significantly to their lean muscle mass, and overall body mass. The injections also increase men's weight and contribute to a general improvement in their quality of life, according to Dr. R. Casaburi, of the department of respiratory medicine, Harbor-University of California - Los Angeles Research and Education Institute, in Torrance, California, who presented a study on testosterone injections yesterday (September 24) at the annual meeting of the European Respiratory Society, in Berlin, Germany. Men with chronic obstructive pulmonary disease (COPD) tend to have low testosterone levels, which can seriously affect their overall quality of life. Dr. Casaburi's study enrolled 40 men with COPD and who were diagnosed with either very low or clinically deficient testosterone levels (mean levels of 319 ng/dL). They were, in general, in poor health as a result of the COPD, with mean forced expiratory volume in one second (FEV1) of only 40 per cent predicted. They were a mean of 67 years of age, and none was obese according to body mass index. Patients were randomized into one of four groups: 1) placebo; 2) placebo plus a planned exercise program of 45 minutes three times per week; 3) weekly injections of 100 mg testosterone ethanate; 4) weekly injections of 100 mg testosterone ethanate plus the same exercise program over a 10-week period. At the end of the 10-week period, the men who received testosterone but did not do the exercise program showed weight gain of approximately 2 kg, while those who received testosterone and exercise gained a mean of 3 kg. By comparison, those who did not receive the steroid continued to lose weight. Dr. Casaburi said that the men actually gained lean muscle mass and lost body fat. Dual energy X-ray absorptiometry (DEXA) showed a mean increase in lean muscle leg mass of 8.7 percent for those in the testosterone and exercise arm, and of 5.9 percent for those receiving testosterone alone. By comparison, those who received the placebo and did not exercise lost 1.7 percent of lean leg mass, and those who exercised but did not receive testosterone increased lean leg mass by 3.4 percent. The men who received testosterone alone had an improvement in the amount of weight they were able to leg-press of 70 lbs; those who underwent the exercise program but did not receive testosterone improved their leg-press weight by 100 lbs, and those who received testosterone and underwent the exercise program improved their leg-press weight by 130 lbs. Dr. Casaburi said there were no increases in levels of prostate-specific antigen, in liver enzymes, or in blood lipids, all of which might have been expected with exogenous testosterone use. It is known that testosterone is often low in men with COPD - as it is with any chronic disease - but the reasons are unclear, Dr. Casaburi said. One reason may be that the brain has stopped secreting luteinizing hormone and follicle stimulating hormone, or it might be that the testes have become refractory. "It's both a gonadal and a pituitary problem, but I think the reasons why are best left up to endocrinologists," he commented.
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