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Bahat G, Ozkok S. The Current Landscape of Pharmacotherapies for Sarcopenia. Drugs Aging 2024; 41:83-112. [PMID: 38315328 DOI: 10.1007/s40266-023-01093-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2023] [Indexed: 02/07/2024]
Abstract
Sarcopenia is a skeletal muscle disorder characterized by progressive and generalized decline in muscle mass and function. Although it is mostly known as an age-related disorder, it can also occur secondary to systemic diseases such as malignancy or organ failure. It has demonstrated a significant relationship with adverse outcomes, e.g., falls, disabilities, and even mortality. Several breakthroughs have been made to find a pharmaceutical therapy for sarcopenia over the years, and some have come up with promising findings. Yet still no drug has been approved for its treatment. The key factor that makes finding an effective pharmacotherapy so challenging is the general paradigm of standalone/single diseases, traditionally adopted in medicine. Today, it is well known that sarcopenia is a complex disorder caused by multiple factors, e.g., imbalance in protein turnover, satellite cell and mitochondrial dysfunction, hormonal changes, low-grade inflammation, senescence, anorexia of aging, and behavioral factors such as low physical activity. Therefore, pharmaceuticals, either alone or combined, that exhibit multiple actions on these factors simultaneously will likely be the drug of choice to manage sarcopenia. Among various drug options explored throughout the years, testosterone still has the most cumulated evidence regarding its effects on muscle health and its safety. A mas receptor agonist, BIO101, stands out as a recent promising pharmaceutical. In addition to the conventional strategies (i.e., nutritional support and physical exercise), therapeutics with multiple targets of action or combination of multiple therapeutics with different targets/modes of action appear to promise greater benefit for the prevention and treatment of sarcopenia.
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Affiliation(s)
- Gulistan Bahat
- Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey.
| | - Serdar Ozkok
- Division of Geriatrics, Department of Internal Medicine, Hatay Training and Research Hospital, Hatay, 31040, Turkey
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Rolland Y, Dray C, Vellas B, Barreto PDS. Current and investigational medications for the treatment of sarcopenia. Metabolism 2023; 149:155597. [PMID: 37348598 DOI: 10.1016/j.metabol.2023.155597] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/20/2023] [Accepted: 05/25/2023] [Indexed: 06/24/2023]
Abstract
Sarcopenia, defined as the loss of muscle mass and function, is a widely prevalent and severe condition in older adults. Since 2016, it is recognized as a disease. Strength exercise training and nutritional support are the frontline treatment of sarcopenia, with no drug currently approved for this indication. However, new therapeutic options are emerging. In this review, we evidenced that only very few trials have focused on sarcopenia/sarcopenic patients. Most drug trials were performed in different clinical older populations (e.g., men with hypogonadism, post-menopausal women at risk for osteoporosis), and their efficacy were tested separately on the components of sarcopenia (muscle mass, muscle strength and physical performances). Results from trials testing the effects of Testosterone, Selective Androgen Receptor Modulators (SARMs), Estrogen, Dehydroepiandrosterone (DHEA), Insulin-like Growth Factor-1 (IGF-1), Growth Hormone (GH), GH Secretagogue (GHS), drug targeting Myostatin and Activin receptor pathway, Vitamin D, Angiotensin Converting Enzyme inhibitors (ACEi) and Angiotensin Receptor Blockers (ARBs), or β-blockers, were compiled. Although some drugs have been effective in improving muscle mass and/or strength, this was not translated into clinically relevant improvements on physical performance. Finally, some promising molecules investigated in on-going clinical trials and in pre-clinical phase were summarized, including apelin and irisin.
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Affiliation(s)
- Yves Rolland
- Gérontopôle de Toulouse, IHU HealthAge, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, France; CERPOP UMR 1295, University of Toulouse III, Inserm, UPS, Toulouse, France.
| | - Cedric Dray
- Université de Toulouse III Université Paul Sabatier, Toulouse, France; Restore, a geroscience and rejuvenation research center, UMR 1301-Inserm, 5070-CNRS EFS, France
| | - Bruno Vellas
- Gérontopôle de Toulouse, IHU HealthAge, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, France; CERPOP UMR 1295, University of Toulouse III, Inserm, UPS, Toulouse, France
| | - Philipe De Souto Barreto
- Gérontopôle de Toulouse, IHU HealthAge, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, France; CERPOP UMR 1295, University of Toulouse III, Inserm, UPS, Toulouse, France
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Guo Y, Piasecki J, Swiecicka A, Ireland A, Phillips BE, Atherton PJ, Stashuk D, Rutter MK, McPhee JS, Piasecki M. Circulating testosterone and dehydroepiandrosterone are associated with individual motor unit features in untrained and highly active older men. GeroScience 2022; 44:1215-1228. [PMID: 34862585 PMCID: PMC9213614 DOI: 10.1007/s11357-021-00482-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 10/28/2021] [Indexed: 10/31/2022] Open
Abstract
Long-term exercise training has been considered as an effective strategy to counteract age-related hormonal declines and minimise muscle atrophy. However, human data relating circulating hormone levels with motor nerve function are scant. The aims of the study were to explore associations between circulating sex hormone levels and motor unit (MU) characteristics in older men, including masters athletes competing in endurance and power events. Forty-three older men (mean ± SD age: 69.9 ± 4.6 years) were studied based on competitive status. The serum concentrations of dehydroepiandrosterone (DHEA), total testosterone (T) and estradiol were quantified using liquid chromatography mass spectrometry. Intramuscular electromyographic signals were recorded from vastus lateralis (VL) during 25% of maximum voluntary isometric contractions and processed to extract MU firing rate (FR), and motor unit potential (MUP) features. After adjusting for athletic status, MU FR was positively associated with DHEA levels (p = 0.019). Higher testosterone and estradiol were associated with lower MUP complexity; these relationships remained significant after adjusting for athletic status (p = 0.006 and p = 0.019, respectively). Circulating DHEA was positively associated with MU firing rate in these older men. Higher testosterone levels were associated with reduced MUP complexity, indicating reduced electrophysiological temporal dispersion, which is related to decreased differences in conduction times along axonal branches and/or MU fibres. Although evident in males only, this work highlights the potential of hormone administration as a therapeutic interventional strategy specifically targeting human motor units in older age.
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Affiliation(s)
- Yuxiao Guo
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and NIHR Nottingham BRC, School of Medicine, University of Nottingham, Nottingham, UK
| | - Jessica Piasecki
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, Nottingham Trent University, Nottingham, UK
| | - Agnieszka Swiecicka
- Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, Cyprus
| | - Alex Ireland
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, UK
| | - Bethan E. Phillips
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and NIHR Nottingham BRC, School of Medicine, University of Nottingham, Nottingham, UK
| | - Philip J. Atherton
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and NIHR Nottingham BRC, School of Medicine, University of Nottingham, Nottingham, UK
| | - Daniel Stashuk
- Department of Systems Design Engineering, University of Waterloo, Waterloo, ON Canada
| | - Martin K. Rutter
- Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Diabetes, Endocrinology and Metabolism Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Jamie S. McPhee
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, UK
| | - Mathew Piasecki
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research and NIHR Nottingham BRC, School of Medicine, University of Nottingham, Nottingham, UK
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Chen YT, Yu CC, Lin YC, Chan SH, Lin YY, Chen NC, Lin WC. Brain CT can predict low lean mass in the elderly with cognitive impairment: a community-dwelling study. BMC Geriatr 2022; 22:3. [PMID: 34979925 PMCID: PMC8722183 DOI: 10.1186/s12877-021-02626-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 11/11/2021] [Indexed: 12/28/2022] Open
Abstract
Background The coexistence of sarcopenia and dementia in aging populations is not uncommon, and they may share common risk factors and pathophysiological pathways. This study aimed to evaluate the relationship between brain atrophy and low lean mass in the elderly with impaired cognitive function. Methods This cross-sectional study included 168 elderly patients who visited the multi-disciplinary dementia outpatient clinic at Kaohsiung Chang Gung Memorial Hospital for memory issues, between 2017 and 2019. The body composition was assessed by dual energy X-ray absorptiometry (DEXA) and CT based skeletal muscle index including L3 skeletal muscle index (L3SMI) and masseter muscle mass index (MSMI). The brain atrophy assessment was measured by CT based visual rating scale. Possible predictors of low lean mass in the elderly with cognitive impairement were identified by binary logistic regression. ROC curves were generated from binary logistic regression. Results Among the 81 participants, 43 (53%) remained at a normal appendicular skeletal muscle index (ASMI), whereas 38 (47%) showed low ASMI. Compared with the normal ASMI group, subjects with low ASMI exhibited significantly lower BMI, L3SMI, and MSMI (all p < 0.05), and showed significant brain atrophy as assessed by visual rating scale (p < 0.001). The accuracy of predictive models for low ASMI in the elderly with cognitive impairment were 0.875, (Area under curve (AUC) = 0.926, 95% confidence interval [CI] 0.844–0.972) in model 1 (combination of BMI, GCA and L3SMI) and 0.885, (Area under curve (AUC) = 0.931, [CI] 0.857–0.979) in model 2 (combination of BMI, GCA and MSMI). Conclusions Global cortical atrophy and body mass index combined with either L3 skeletal muscle index or masseter skeletal muscle index can predict low lean mass in the elderly with cognitive impairment. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02626-8.
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Affiliation(s)
- Yun-Ting Chen
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123 Ta-Pei Road, Niao-Sung Dist, Kaohsiung City, 83305, Taiwan
| | - Chiun-Chieh Yu
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123 Ta-Pei Road, Niao-Sung Dist, Kaohsiung City, 83305, Taiwan
| | - Yu-Ching Lin
- Department of Medical Imaging and Intervention, Keelung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 222, Maijin Road, Anle Dist, Keelung City, 204201, Taiwan
| | - Shan-Ho Chan
- Department of Medical Imaging and Radiology, Shu-Zen Junior College of Medicine and Management, No. 452, Hwan-chio Road, Luju Dist, Kaohsiung City, 821004, Taiwan
| | - Yi-Yun Lin
- School of Nursing, Shu Zen College of Medicine and Management, No.452, Hwan-chio Road, Luju Dist, Kaohsiung, 821004, Taiwan
| | - Nai-Ching Chen
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Ta-Pei Road, Niao-Sung Dist, Kaohsiung City, 83305, Taiwan.
| | - Wei-Che Lin
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123 Ta-Pei Road, Niao-Sung Dist, Kaohsiung City, 83305, Taiwan.
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Singh P, Covassin N, Marlatt K, Gadde KM, Heymsfield SB. Obesity, Body Composition, and Sex Hormones: Implications for Cardiovascular Risk. Compr Physiol 2021; 12:2949-2993. [PMID: 34964120 PMCID: PMC10068688 DOI: 10.1002/cphy.c210014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Cardiovascular disease (CVD) continues to be the leading cause of death in adults, highlighting the need to develop novel strategies to mitigate cardiovascular risk. The advancing obesity epidemic is now threatening the gains in CVD risk reduction brought about by contemporary pharmaceutical and surgical interventions. There are sex differences in the development and outcomes of CVD; premenopausal women have significantly lower CVD risk than men of the same age, but women lose this advantage as they transition to menopause, an observation suggesting potential role of sex hormones in determining CVD risk. Clear differences in obesity and regional fat distribution among men and women also exist. While men have relatively high fat in the abdominal area, women tend to distribute a larger proportion of their fat in the lower body. Considering that regional body fat distribution is an important CVD risk factor, differences in how men and women store their body fat may partly contribute to sex-based alterations in CVD risk as well. This article presents findings related to the role of obesity and sex hormones in determining CVD risk. Evidence for the role of sex hormones in determining body composition in men and women is also presented. Lastly, the clinical potential for using sex hormones to alter body composition and reduce CVD risk is outlined. © 2022 American Physiological Society. Compr Physiol 12:1-45, 2022.
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Affiliation(s)
- Prachi Singh
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, USA
| | | | - Kara Marlatt
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, USA
| | - Kishore M Gadde
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, USA
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Tang J, Chen LR, Chen KH. The Utilization of Dehydroepiandrosterone as a Sexual Hormone Precursor in Premenopausal and Postmenopausal Women: An Overview. Pharmaceuticals (Basel) 2021; 15:46. [PMID: 35056103 PMCID: PMC8781653 DOI: 10.3390/ph15010046] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/16/2021] [Accepted: 12/27/2021] [Indexed: 12/03/2022] Open
Abstract
Dehydroepiandrosterone (DHEA), and its metabolite, dehydroepiandrosterone sulfate ester (DHEAS), are the most abundant circulating steroid hormones, and are synthesized in the zona reticularis of the adrenal cortex, in the gonads, and in the brain. The precise physiological role of DHEA and DHEAS is not yet fully understood, but these steroid hormones can act as androgens, estrogens, and neurosteroids, and perform many roles in the human body. Since both levels decline with age, use of DHEA supplements have gained more attention due to being advertised as an antidote to aging in postmenopausal women, who may have concerns on age-related diseases and overall well-being. However, current research has not reached an overall consensus on the effects of DHEA on postmenopausal women. This overview is a summary of the current literature, addressing the metabolic pathway for DHEA synthesis and utilization, as well as the effects of DHEA on premenopausal and postmenopausal women with disease states and other factors. As for the therapeutic effects on menopausal syndrome and other age-related diseases, several studies have found that DHEA supplementations can alleviate vasomotor symptoms, preserve the integrity of the immune system, reduce bone loss, and increase muscle mass. Intravaginal DHEA has shown significant beneficial effects in menopausal women with severe vulvovaginal symptoms. On the other hand, DHEA supplements have not shown definitive effects in cardiovascular disease, adrenal insufficiency, insulin sensitivity, and cognition. Due to inadequate sample sizes and treatment durations of current studies, it is difficult to assess the safety and efficacy of DHEA and draw reliable conclusions for the physiological role, the optimal dosage, and the effects on premenopausal and postmenopausal women; therefore, the study of DHEA warrants future investigation. Further research into the roles of these steroid hormones may bring us closer to a therapeutic option in the future.
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Affiliation(s)
- Justine Tang
- School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan;
| | - Li-Ru Chen
- Department of Physical Medicine and Rehabilitation, Mackay Memorial Hospital, Taipei 104, Taiwan;
- Department of Mechanical Engineering, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan
| | - Kuo-Hu Chen
- Department of Obstetrics and Gynecology, Taipei Tzu-Chi Hospital, The Buddhist Tzu-Chi Medical Foundation, Taipei 231, Taiwan
- School of Medicine, Tzu-Chi University, Hualien 970, Taiwan
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Huang LT, Wang JH. The Therapeutic Intervention of Sex Steroid Hormones for Sarcopenia. Front Med (Lausanne) 2021; 8:739251. [PMID: 34760899 PMCID: PMC8573092 DOI: 10.3389/fmed.2021.739251] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 09/29/2021] [Indexed: 01/09/2023] Open
Abstract
Sarcopenia, characterized by the excessive loss of skeletal muscle mass, strength, and function, is associated with the overall poor muscle performance status of the elderly, and occurs more frequently in those with chronic diseases. The causes of sarcopenia are multifactorial due to the inherent relationship between muscles and molecular mechanisms, such as mitochondrial function, inflammatory pathways, and circulating hormones. Age-related changes in sex steroid hormone concentrations, including testosterone, estrogen, progesterone, and their precursors and derivatives, are an important aspect of the pathogenesis of sarcopenia. In this review, we provide an understanding of the treatment of sarcopenia through the regulation of sex steroid hormones. The potential benefits and future research emphasis of each sex steroid hormone therapeutic intervention (testosterone, SARMs, estrogen, SERMs, DHEA, and progesterone) for sarcopenia are discussed. Enhanced understanding of the role of sex steroid hormones in the treatment for sarcopenia could lead to the development of hormone therapeutic approaches in combination with specific exercise and nutrition regimens.
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Affiliation(s)
- Le-Tian Huang
- Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jia-He Wang
- Department of Family Medicine, Shengjing Hospital of China Medical University, Shenyang, China
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Chen H, Jin Z, Sun C, Santos HO, Kord Varkaneh H. Effects of dehydroepiandrosterone (DHEA) supplementation on cortisol, leptin, adiponectin, and liver enzyme levels: A systematic review and meta-analysis of randomised clinical trials. Int J Clin Pract 2021; 75:e14698. [PMID: 34342920 DOI: 10.1111/ijcp.14698] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/17/2021] [Accepted: 08/01/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND AND AIMS Dehydroepiandrosterone (DHEA) supplementation has been investigated in patients with altered cortisol levels and is proposed to ameliorate the metabolic profile related to adipose tissue. However, further research is warranted and evidence is no compelling for liver safety. Hence, we aimed to meta-analyse the effects of DHEA supplementation on circulating levels of cortisol, liver enzymes, and adipokines. METHODS We searched literature published in PubMed, Web of Science, Embase and Scopus, until December 2020. We obtained overall results using the generic inverse of variance method with a random-effects model. RESULTS Through 10 arms, serum cortisol levels decreased significantly after DHEA supplementation [weighted mean difference (WMD): -53.581 nmol/L, 95% confidence interval (CI): -88.2, -18.9, P = .002], without significant heterogeneity (I2 = 36%, P = .117). In contrast, any significance was noted for adiponectin (WMD: -0.045 µg/mL, 95% CI: -0.56, 0.47; P = .865), leptin (WMD: -2.55 µg/mL, 95% CI: -6.2, 1.06; P = .166), aspartate transaminase (AST) (WMD: -3.7 U/L, 95% CI: -10.35, 2.95; P = .276), and alanine aminotransferase (ALT) (WMD: -1.7 U/L, 95% CI: -3.45, 0.06; P = .058). CONCLUSION DHEA supplementation decreased circulating cortisol but did not alter adiponectin, leptin, AST, and ALT levels. Hence, DHEA supplementation could be considered as an adjunct in the management of hypercortisolaemia and is safe for the liver.
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Affiliation(s)
- Hu Chen
- Department of Pharmacy, Yichun People's Hospital, Yichun, Jiangxi Province, China
| | - Zhao Jin
- Department of Pharmacy, Yichun People's Hospital, Yichun, Jiangxi Province, China
| | - Changliang Sun
- Department of Pharmacy, Yichun People's Hospital, Yichun, Jiangxi Province, China
| | - Heitor O Santos
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Hamed Kord Varkaneh
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Zhu Y, Qiu L, Jiang F, Găman MA, Abudoraehem OS, Okunade KS, Zhang M. The effect of dehydroepiandrosterone (DHEA) supplementation on estradiol levels in women: A dose-response and meta-analysis of randomized clinical trials. Steroids 2021; 173:108889. [PMID: 34246664 DOI: 10.1016/j.steroids.2021.108889] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 06/27/2021] [Accepted: 07/05/2021] [Indexed: 12/17/2022]
Abstract
Estradiol, an estrogen steroid hormone, serves as the dominant female hormone and its levels fluctuate during lifetime. In women, after the menopause, all estrogens and almost all androgens are locally developed in the peripheral tissues from dehydroepiandrosterone (DHEA). However, the effect of DHEA supplementation on estradiol levels in women is unclear as previously published data has resulted in conflicting findings. Thus, we conducted the present dose-response meta-analysis of randomized controlled trials (RCTs) evaluating the influence of DHEA on estradiol concentrations in women. The PubMed/Medline, Embase, Web of Science and Scopus databases were systematically searched for articles published on this topic until May 10, 2021. No time or language restrictions were applied. The data were expressed as weighted mean differences (WMDs) and 95% confidence intervals (CI), and a P-value of less than 0.05 was considered to be statistically significant. The pooled results were obtained using the generic inverse of variance method with a random effects model. A total of 21 arms, including 1223 participants (case = 610, and control = 613), reported estradiol concentrations as an outcome measure. The overall results demonstrated that estradiol significantly increased following the administration of DHEA (WMD: 7.02 pg/mL, 95% CI: 5.43, 8.62, P = 0.000). The stratified analyses revealed that the elevation of estradiol concentrations was more pronounced in subjects aged ≥60 years old (WMD: 8.56 pg/mL, 95% CI: 6.97, 10.16, I2 = 94%) and in those receiving DHEA supplements for ≥26 weeks (WMD: 7.30 pg/mL, 95% CI: 6.28, 8.32, I2 = 61%). Moreover, estradiol levels increased significantly with DHEA dosages of 50 mg/day (WMD: 7.75 pg/mL, 95% CI: 9.12, 9.39, I2 = 94%) and when DHEA was prescribed to postmenopausal women (WMD: 7.61 pg/mL, 95% CI: 5.97, 9.24, I2 = 93%). This meta-analysis has provided a comprehensive overview of the effects of DHEA administration on circulating estradiol levels, far beyond the available evidence from different RCTs. Subsequent subgroup analyses revealed that postmenopausal women, females aged 60 years and above, those on DHEA dosages of 50 mg/day and those receiving DHEA for ≥26 weeks registered a more pronounced elevation of the circulating estradiol levels.
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Affiliation(s)
- Yan Zhu
- Department of Endocrinology, The First Hospital of Nanchang, Nanchang, Jiangxi 330008, China
| | - Lei Qiu
- Department of Oncology, Zhucheng Hospital of Traditional Chinese Medicine, Zhucheng, Shandong 262200, China
| | - Fangfang Jiang
- Department of Endocrinology, The First Hospital of Nanchang, Nanchang, Jiangxi 330008, China
| | - Mihnea-Alexandru Găman
- Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; Department of Hematology, Center of Hematology and Bone Marrow Transplantation, Fundeni Clinical Institute, Bucharest, Romania
| | | | - Kehinde S Okunade
- Department of Obstetrics & Gynaecology, College of Medicine, University of Lagos/Lagos University Teaching Hospital, PMB 12003, Lagos, Nigeria
| | - Ming Zhang
- Clinical Laboratory, Zhucheng Maternal and Child Health Hospital, Zhucheng, Shandong 262200, China.
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Falqueto H, Júnior JLR, Silvério MNO, Farias JCH, Schoenfeld BJ, Manfredi LH. Can conditions of skeletal muscle loss be improved by combining exercise with anabolic-androgenic steroids? A systematic review and meta-analysis of testosterone-based interventions. Rev Endocr Metab Disord 2021; 22:161-178. [PMID: 33783694 DOI: 10.1007/s11154-021-09634-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/02/2021] [Indexed: 12/11/2022]
Abstract
Sarcopenia, cachexia, and atrophy due to inactivity and disease states are characterized by a loss of skeletal muscle mass, often accompanied by reduced levels of anabolic hormones (e.g. testosterone). These conditions are associated with an increase in mortality, hospitalization and worsening in quality of life. Both physical exercise (EX) and anabolic-androgenic steroid (AAS) administration can improve the prognosis of patients as they increase physical functionality. However, there is a gap in the literature as to the impact of these therapies on the gains in strength and muscle mass and their implications for patient safety. Accordingly, we performed a random-effects meta-analysis to elucidate the effects of AAS and/or EX interventions on lean body mass (LBM) and muscle strength in conditions involving muscle loss. A systematic search for relevant clinical trials was conducted in MEDLINE, EMBASE, SCOPUS, Web of Science, and SPORTDiscus. Comparisons included AAS vs. Control, EX vs. Control, AAS vs. EX, AAS + EX vs. AAS and AAS + EX vs. EX. A total of 1114 individuals were analyzed. AAS increased LBM (effect size [ES]: 0.46; 95% CI: 0.25, 0.68, P = 0.00) and muscle strength (ES: 0.31; 95% CI: 0.08, 0.53, P = 0.01) when compared to a control group. EX promoted an increase in muscular strength (ES: 0.89; 95% CI: 0.53, 1.25, P = 0.00), with no effect on LBM when compared to the control group (ES: 0.15; 95% CI: -0.07, 0.38, P = 0.17). AAS did not demonstrate statistically significant differences when compared to EX for LBM and muscle strength. The combination of EX + AAS promoted a greater increase in LBM and muscular strength when compared to AAS or EX in isolation. Qualitatively, AAS administration had relatively few side effects. Significant heterogeneity was found in some analyses, which may be explained by the use of different AAS types and EX protocols. Our findings suggest that AAS administration in cachectic and sarcopenic conditions may be a viable interventional strategy to enhance muscle function when exercise is not a possible approach. Moreover, combining AAS with exercise may enhance positive outcomes in this population.
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Affiliation(s)
- Hugo Falqueto
- Medical School, Federal University of Fronteira Sul, SC 484 - Km 02, Chapecó, Santa Catarina, Brazil
- Graduate Program in Biomedical Sciences, UFFS, Chapecó, Santa Catarina, Brazil
| | - Jorge L R Júnior
- Laboratory of Sport Biomechanics, Sports Department, School of Physical Education, Physiotherapy and Occupational Therapy, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Mauro N O Silvério
- Medical School, Federal University of Fronteira Sul, SC 484 - Km 02, Chapecó, Santa Catarina, Brazil
| | - Juliano C H Farias
- Medical School, Federal University of Fronteira Sul, SC 484 - Km 02, Chapecó, Santa Catarina, Brazil
| | | | - Leandro H Manfredi
- Medical School, Federal University of Fronteira Sul, SC 484 - Km 02, Chapecó, Santa Catarina, Brazil.
- Graduate Program in Biomedical Sciences, UFFS, Chapecó, Santa Catarina, Brazil.
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Waters DL, Aguirre L, Gurney AB, Sinacore DR, Fowler K, Gregori G, Armamento-Villareal R, Qualls C, Villareal DT. Effect of Aerobic or Resistance Exercise, or Both, on Intermuscular and Visceral Fat and Physical and Metabolic Function in Older Adults with Obesity While Dieting. J Gerontol A Biol Sci Med Sci 2021; 77:131-139. [PMID: 33839788 DOI: 10.1093/gerona/glab111] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Obesity exacerbates age-related effects on body composition, physical and metabolic function. Which exercise mode is most effective in mitigating these deleterious changes in dieting obese older adults is unknown. METHODS In a randomized controlled trial, we performed a head-to-head comparison of aerobic (AEX), resistance (REX), or combination (COMB) exercise during matched weight loss in 160 obese older adults. Prespecified analyses compared 6-month changes in intermuscular adipose tissue (IMAT) and visceral adipose tissue (VAT) assessed using MRI, insulin sensitivity index (ISI) by oral glucose tolerance test, physical function using Modified Physical Performance Test (PPT), VO2peak, gait-speed, and knee strength by dynamometry. RESULTS IMAT and VAT decreased more in COMB than AEX and REX groups (IMAT; -41% vs. -28% and -23% and VAT: -36% vs. -19% and -21%; p=.003 to .01); IMAT and VAT decreased in all groups more than control (CON) (between-group p<.001). ISI increased more in COMB than AEX and REX groups (86% vs. 50% and 39%; p=.005 to .03). PPT improved more in COMB than AEX and REX groups, while VO2peak improved more in COMB and AEX than REX group (all p<.05). Knee strength improved more in COMB and REX than AEX group (all p<.05). Changes in IMAT and VAT correlated with PPT (r=-.28 and -.39), VO2peak (r=-.49 and -.52), gait-speed (r=-.25 and -.36), and ISI (r=-.49 and -.52) (all p<.05). CONCLUSIONS Weight loss plus combination aerobic and resistance exercise was most effective in improving ectopic fat deposition and physical and metabolic function in older adults with obesity.
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Affiliation(s)
- Debra L Waters
- Department of Internal Medicine, School of Medicine, University of New Mexico, Albuquerque, New Mexico.,Department of Medicine, School of Physiotherapy, University of Otago, Dunedin, New Zealand.,New Mexico Veterans Affairs Health Care System, Albuquerque, New Mexico
| | - Lina Aguirre
- Department of Internal Medicine, School of Medicine, University of New Mexico, Albuquerque, New Mexico.,New Mexico Veterans Affairs Health Care System, Albuquerque, New Mexico
| | - A Burke Gurney
- Division of Physical Therapy, School of Medicine, University of New Mexico, Albuquerque, New Mexico
| | - David R Sinacore
- Department of Physical Therapy, High Point University, High Point, North Carolina and Program in Physical Therapy, Washington University School of Medicine, St Louis, Missouri
| | - Kenneth Fowler
- New Mexico Veterans Affairs Health Care System, Albuquerque, New Mexico
| | - Giulia Gregori
- Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, Houston, Texas.,Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas
| | - Reina Armamento-Villareal
- Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, Houston, Texas.,Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas
| | - Clifford Qualls
- Department of Mathematics and Statistics, School of Medicine, University of New Mexico, Albuquerque, New Mexico
| | - Dennis T Villareal
- Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, Houston, Texas.,Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas
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12
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Barnouin Y, Armamento-Villareal R, Celli A, Jiang B, Paudyal A, Nambi V, Bryant MS, Marcelli M, Garcia JM, Qualls C, Villareal DT. Testosterone Replacement Therapy Added to Intensive Lifestyle Intervention in Older Men With Obesity and Hypogonadism. J Clin Endocrinol Metab 2021; 106:e1096-e1110. [PMID: 33351921 DOI: 10.1210/clinem/dgaa917] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Obesity and hypogonadism additively contribute to frailty in older men; however, appropriate treatment remains controversial. OBJECTIVE Determine whether testosterone replacement augments the effect of lifestyle therapy on physical function in older men with obesity and hypogonadism. DESIGN Randomized, double-blind, placebo-controlled trial. SETTING VA Medical Center. PARTICIPANTS 83 older (age ≥65 years) men with obesity (body mass index ≥30 kg/m2) and persistently low am testosterone (<10.4 nmol/L) associated with frailty. INTERVENTIONS Participants were randomized to lifestyle therapy (weight management and exercise training) plus either testosterone (LT+Test) or placebo (LT+Pbo) for 6 months. OUTCOME MEASURES Primary outcome was change in Physical Performance Test (PPT) score. Secondary outcomes included other frailty measures, body composition, hip bone mineral density (BMD), physical functions, hematocrit, prostate specific antigen (PSA), and sex hormones. RESULTS PPT score increased similarly in LT+Test and LT+Pbo group (17% vs. 16%; P = 0.58). VO2peak increased more in LT+Test than LT+Pbo (23% vs. 16%; P = 0.03). Despite similar -9% weight loss, lean body mass and thigh muscle volume decreased less in LT+Test than LT+Pbo (-2% vs. -3%; P = 0.01 and -2% vs -4%; P = 0.04). Hip BMD was preserved in LT+Test compared with LT+Pbo (0.5% vs -1.1%; P = 0.003). Strength increased similarly in LT+Test and LT+Pbo (23% vs 22%; P = 0.94). Hematocrit but not PSA increased more in LT+Test than LT+Pbo (5% vs 1%; P < 0.001). Testosterone levels increased more in LT+Test than LT+Pbo (167% vs 27%; P < 0.001). CONCLUSION In older, obese hypogonadal men, adding testosterone for 6 months to lifestyle therapy does not further improve overall physical function. However, our findings suggest that testosterone may attenuate the weight loss-induced reduction in muscle mass and hip BMD and may further improve aerobic capacity.
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Affiliation(s)
- Yoann Barnouin
- Center for Translational Research on Inflammatory Diseases, Michael E DeBakey VA Medical Center, Houston TX, USA
- Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, Houston, TX, USA
| | - Reina Armamento-Villareal
- Center for Translational Research on Inflammatory Diseases, Michael E DeBakey VA Medical Center, Houston TX, USA
- Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, Houston, TX, USA
| | - Alessandra Celli
- Center for Translational Research on Inflammatory Diseases, Michael E DeBakey VA Medical Center, Houston TX, USA
- Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, Houston, TX, USA
| | - Bryan Jiang
- Center for Translational Research on Inflammatory Diseases, Michael E DeBakey VA Medical Center, Houston TX, USA
- Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, Houston, TX, USA
| | - Arjun Paudyal
- Center for Translational Research on Inflammatory Diseases, Michael E DeBakey VA Medical Center, Houston TX, USA
- Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, Houston, TX, USA
| | - Vijay Nambi
- Center for Translational Research on Inflammatory Diseases, Michael E DeBakey VA Medical Center, Houston TX, USA
- Division of Atherosclerosis and Vascular Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Mon S Bryant
- Center for Translational Research on Inflammatory Diseases, Michael E DeBakey VA Medical Center, Houston TX, USA
- Pulmonary Section, Medical Care Line, Michael E DeBakey VA Medical Center
| | - Marco Marcelli
- Center for Translational Research on Inflammatory Diseases, Michael E DeBakey VA Medical Center, Houston TX, USA
- Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, Houston, TX, USA
| | - Jose M Garcia
- Geriatrics Research, Education, and Clinical Center, VA Puget Sound Health Care System, Seattle, WA, USA
- Division of Gerontology & Geriatric Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Clifford Qualls
- Department of Mathematics and Statistics, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Dennis T Villareal
- Center for Translational Research on Inflammatory Diseases, Michael E DeBakey VA Medical Center, Houston TX, USA
- Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, Houston, TX, USA
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13
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Pataky MW, Young WF, Nair KS. Hormonal and Metabolic Changes of Aging and the Influence of Lifestyle Modifications. Mayo Clin Proc 2021; 96:788-814. [PMID: 33673927 PMCID: PMC8020896 DOI: 10.1016/j.mayocp.2020.07.033] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 06/01/2020] [Accepted: 07/02/2020] [Indexed: 02/07/2023]
Abstract
Increased life expectancy combined with the aging baby boomer generation has resulted in an unprecedented global expansion of the elderly population. The growing population of older adults and increased rate of age-related chronic illness has caused a substantial socioeconomic burden. The gradual and progressive age-related decline in hormone production and action has a detrimental impact on human health by increasing risk for chronic disease and reducing life span. This article reviews the age-related decline in hormone production, as well as age-related biochemical and body composition changes that reduce the bioavailability and actions of some hormones. The impact of hormonal changes on various chronic conditions including frailty, diabetes, cardiovascular disease, and dementia are also discussed. Hormone replacement therapy has been attempted in many clinical trials to reverse and/or prevent the hormonal decline in aging to combat the progression of age-related diseases. Unfortunately, hormone replacement therapy is not a panacea, as it often results in various adverse events that outweigh its potential health benefits. Therefore, except in some specific individual cases, hormone replacement is not recommended. Rather, positive lifestyle modifications such as regular aerobic and resistance exercise programs and/or healthy calorically restricted diet can favorably affect endocrine and metabolic functions and act as countermeasures to various age-related diseases. We provide a critical review of the available data and offer recommendations that hopefully will form the groundwork for physicians/scientists to develop and optimize new endocrine-targeted therapies and lifestyle modifications that can better address age-related decline in heath.
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Affiliation(s)
- Mark W Pataky
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN
| | - William F Young
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN
| | - K Sreekumaran Nair
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN.
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14
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Horii N, Hasegawa N, Fujie S, Iemitsu K, Uchida M, Hamaoka T, Iemitsu M. Effects of Dioscorea esculenta intake with resistance training on muscle hypertrophy and strength in sprint athletes. J Clin Biochem Nutr 2020; 67:338-343. [PMID: 33293777 PMCID: PMC7705086 DOI: 10.3164/jcbn.19-124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 02/26/2020] [Indexed: 11/22/2022] Open
Abstract
Androgen hormones are important compounds related to body composition and exercise performance in athletes. The intake of Dioscorea esculenta, known as lesser yam, contains diosgenin and resistance training have been shown to normalize the secretion of androgen hormones. This study aimed to clarify the level of androgen hormone secretion and the effects of Dioscorea esculenta intake with resistance training on muscle hypertrophy and strength in athletes. First, in a cross-sectional study, we compared the serum androgen hormone [dehydroepiandrosterone (DHEA), testosterone, and 5α-dihydrotestosterone (DHT)] levels between sprint athletes (n = 15) and non-athletes (n = 15). Second, in an 8-week intervention study, sprint athletes were randomly divided into 2 groups: resistance training with placebo (n = 8) or with Dioscorea esculenta (2,000 mg/day) intake (n = 7). The serum DHEA, free testosterone, and DHT levels were lower in athletes than in non-athletes. Dioscorea esculenta intake combined with resistance training increased the arm fat-free mass, the 1 repetition maximum of deadlift and snatch, and the serum DHEA, free testosterone, and DHT levels, compared with resistance training and placebo intake. The results suggested that Dioscorea esculenta intake combined with resistance training has further effects on muscle hypertrophy and strength in athletes by restoring secretion of androgen hormones.
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Affiliation(s)
- Naoki Horii
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga 525-8577, Japan.,Research Fellow of Japan Society for the Promotion of Science, Kojimachi, Tokyo 102-0083, Japan
| | - Natsuki Hasegawa
- Research Organization of Science and Technology, Ritsumeikan University, Kusatsu, Shiga 525-8577, Japan
| | - Shumpei Fujie
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga 525-8577, Japan.,Research Fellow of Japan Society for the Promotion of Science, Kojimachi, Tokyo 102-0083, Japan.,Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - Keiko Iemitsu
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga 525-8577, Japan
| | - Masataka Uchida
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga 525-8577, Japan
| | - Takafumi Hamaoka
- Department of Sports Medicine for Health Promotion, Tokyo Medical University, Shinjuku-ku, Tokyo 160-8402, Japan
| | - Motoyuki Iemitsu
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga 525-8577, Japan
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15
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Impact of dehydroepiandrosterone (DHEA) supplementation on testosterone concentrations and BMI in elderly women: A meta-analysis of randomized controlled trials. Complement Ther Med 2020; 56:102620. [PMID: 33220453 DOI: 10.1016/j.ctim.2020.102620] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 11/10/2020] [Accepted: 11/11/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Despite the fact that numerous clinical studies have evaluated the positive effects of dehydroepiandrosterone (DHEA) supplementation on testosterone concentrations and on the body mass index (BMI), more evidence is needed to certify that DHEA is a BMI-reducing agent in the elderly. This meta-analysis aims to clarify the various incompatible results and investigate the impact of DHEA supplementation on serum testosterone levels and lean body mass in elderly women. METHODS Four scientific databases (EMBASE, PubMed/MEDLINE, Scopus and Web of Science) were searched from inception until 20 August 2020 for trials comparing DHEA with placebo. Results were presented as weighted mean differences (WMDs) and 95 % confidence intervals (CIs) based on the random effects model (DerSimonian-Laird approach). RESULTS Nine arms with 793 subjects reported testosterone as an outcome measure. The overall results demonstrated that testosterone levels increased significantly after DHEA administration in elderly women (WMD: 17.52 ng/dL, 95 % CI: 6.61, 28.43, P = 0.002). In addition, DHEA administration significantly decreased the BMI (WMD:-0.39 kg/m2, I2 = 0.0 %). CONCLUSION The results of the current meta-analysis support the use of DHEA supplementation for increasing testosterone concentrations in elderly women.
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16
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Li Y, Ren J, Li N, Liu J, Tan SC, Low TY, Ma Z. A dose-response and meta-analysis of dehydroepiandrosterone (DHEA) supplementation on testosterone levels: perinatal prediction of randomized clinical trials. Exp Gerontol 2020; 141:111110. [PMID: 33045358 DOI: 10.1016/j.exger.2020.111110] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/01/2020] [Accepted: 10/02/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Dehydroepiandrosterone (DHEA) has been aggressively sold as a dietary supplement to boost testosterone levels although the impact of DHEA supplementation on testosterone levels has not been fully established. Therefore, we performed a systematic review and meta-analysis of RCTs to investigate the effect of oral DHEA supplementation on testosterone levels. METHODS A systematic literature search was performed in Scopus, Embase, Web of Science, and PubMed databases up to February 2020 for RCTs that investigated the effect of DHEA supplementation on testosterone levels. The estimated effect of the data was calculated using the weighted mean difference (WMD). Subgroup analysis was performed to identify the source of heterogeneity among studies. RESULTS Overall results from 42 publications (comprising 55 arms) demonstrated that testosterone level was significantly increased after DHEA administration (WMD: 28.02 ng/dl, 95% CI: 21.44-34.60, p = 0.00). Subgroup analyses revealed that DHEA increased testosterone level in all subgroups, but the magnitude of increment was higher in females compared to men (WMD: 30.98 ng/dl vs. 21.36 ng/dl); DHEA dosage of ˃50 mg/d compared to ≤50 mg/d (WMD: 57.96 ng/dl vs. 19.43 ng/dl); intervention duration of ≤12 weeks compared to ˃12 weeks (WMD: 44.64 ng/dl vs. 19 ng/dl); healthy participants compared to postmenopausal women, pregnant women, non-healthy participants and androgen-deficient patients (WMD: 52.17 ng/dl vs. 25.04 ng/dl, 16.44 ng/dl and 16.47 ng/dl); and participants below 60 years old compared to above 60 years old (WMD: 31.42 ng/dl vs. 23.93 ng/dl). CONCLUSION DHEA supplementation is effective for increasing testosterone levels, although the magnitude varies among different subgroups. More study needed on pregnant women and miscarriage.
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Affiliation(s)
- Yuanyuan Li
- Perinatal Center, Shijiazhuang Fourth Hospital, Shijiazhuang, Hebei 050000, China
| | - Jie Ren
- Obstetrics Department, Shijiazhuang Fourth Hospital, Shijiazhuang, Hebei 050000, China
| | - Na Li
- Obstetrics Department, Shijiazhuang Fourth Hospital, Shijiazhuang, Hebei 050000, China
| | - Jie Liu
- Obstetrics Department, Shijiazhuang Fourth Hospital, Shijiazhuang, Hebei 050000, China
| | - Shing Cheng Tan
- UKM Medical Molecular Biology Institute, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Teck Yew Low
- UKM Medical Molecular Biology Institute, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Zhimin Ma
- Perinatal Center, Shijiazhuang Fourth Hospital, Shijiazhuang, Hebei 050000, China.
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17
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Huang K, Cai HL, Bao JP, Wu LD. Dehydroepiandrosterone and age-related musculoskeletal diseases: Connections and therapeutic implications. Ageing Res Rev 2020; 62:101132. [PMID: 32711158 DOI: 10.1016/j.arr.2020.101132] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/01/2020] [Accepted: 07/18/2020] [Indexed: 12/12/2022]
Abstract
Musculoskeletal disorders related to ageing are one of the most common causes of mortality and morbidity among elderly individuals worldwide. The typical constitutive components of the musculoskeletal system, including bone, muscle, and joints, gradually undergo a process of tissue loss and degeneration as a result of life-long mechanical and biological stress, ultimately leading to the onset of a series of age-related musculoskeletal diseases, including osteoporosis (OP), sarcopenia, and osteoarthritis (OA). Dehydroepiandrosterone (DHEA), a precursor of androgen secreted mainly by the adrenal gland, has attracted much attention as a marker for senescence due to its unique age-related changes. This pre-hormone has been publicly regarded as an "antidote for ageing" because of its favourable effect against a wide range of age-related diseases, such as Alzheimer disease, cardiovascular diseases, immunosenescence and skin senescence, though its effect on age-related musculoskeletal diseases has been explored to a lesser extent. In the present review, we summarized the action of DHEA against OP, sarcopenia and OA. Extensive detailed descriptions of the pathogenesis of each of these musculoskeletal disorders are beyond the scope of this review; instead, we aim to highlight the association of changes in DHEA with the processes of OP, sarcopenia and OA. A special focus will also be placed on the overlapping pathogeneses among these three diseases, and the molecular mechanisms underlying the action of DHEA against these diseases are discussed or postulated.
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Affiliation(s)
- Kai Huang
- Department of Orthopedic Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, People's Republic of China.
| | - Hai-Li Cai
- Department of Ultrasound, The 903rd Hospital of PLA, Hangzhou, 310012, People's Republic of China
| | - Jia-Peng Bao
- Department of Orthopedic Surgery, The Second Hospital of Medical College, Zhejiang University, Hangzhou, 310009, People's Republic of China
| | - Li-Dong Wu
- Department of Orthopedic Surgery, The Second Hospital of Medical College, Zhejiang University, Hangzhou, 310009, People's Republic of China
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18
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Xie M, Zhong Y, Xue Q, Wu M, Deng X, O Santos H, Tan SC, Kord-Varkaneh H, Jiao P. Impact of dehydroepianrosterone (DHEA) supplementation on serum levels of insulin-like growth factor 1 (IGF-1): A dose-response meta-analysis of randomized controlled trials. Exp Gerontol 2020; 136:110949. [PMID: 32304719 DOI: 10.1016/j.exger.2020.110949] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 04/11/2020] [Accepted: 04/12/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIM Inconsistencies exist with regard to the influence of dehydroepiandrosterone (DHEA) supplementation on insulin-like growth factor 1 (IGF-1) levels. The inconsistencies could be attributed to several factors, such as dosage, gender, and duration of intervention, among others. To address these inconsistencies, we conducted a systematic review and meta-analysis to combine findings from randomized controlled trials (RCTs) on this topic. METHODS Electronic databases (Scopus, PubMed/Medline, Web of Science, Embase and Google Scholar) were searched for relevant literature published up to February 2020. RESULTS Twenty-four qualified trials were included in this meta-analysis. It was found that serum IGF-1 levels were significantly increased in the DHEA group compared to the control (weighted mean differences (WMD): 16.36 ng/ml, 95% CI: 8.99, 23.74; p = .000). Subgroup analysis revealed that a statistically significant increase in serum IGF-1 levels was found only in women (WMD: 23.30 ng/ml, 95% CI: 13.75, 32.87); in participants who supplemented 50 mg/d DHEA (WMD: 15.75 ng/ml, 95% CI: 7.61, 23.89); in participants undergoing DHEA intervention for >12 weeks (WMD: 17.2 ng/ml, 95% CI: 8.02, 26.22); in participants without an underlying comorbidity (WMD: 19.11 ng/ml, 95% CI: 10.69, 27.53); and in participants over the age of 60 years (WMD: 19.79 ng/ml, 95% CI: 9.86, 29.72). CONCLUSION DHEA supplementation may increase serum IGF-I levels especially in women and older subjects. However, further studies are warranted before DHEA can be recommended for clinical use.
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Affiliation(s)
- Min Xie
- Operating Room Nursing Department, Xiangya Third Hospital of Central South University, Changsha, Hunan 400013, China
| | - Yanfa Zhong
- Department of Laboratory Medicine, Dezhou Hospital of Traditional Chinese Medicine, Dezhou, Shandong 253000, China
| | - Qing Xue
- Department of Laboratory Medicine, Dezhou Hospital of Traditional Chinese Medicine, Dezhou, Shandong 253000, China
| | - Meirong Wu
- Operating Room Nursing Department, Xiangya Third Hospital of Central South University, Changsha, Hunan 400013, China
| | - Xiaoxian Deng
- Operating Room Nursing Department, Xiangya Third Hospital of Central South University, Changsha, Hunan 400013, China
| | - Heitor O Santos
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Shing Cheng Tan
- UKM Medical Molecular Biology Institute, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hamed Kord-Varkaneh
- Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Peng Jiao
- Department of Endocrinology, Dezhou Hospital of Traditional Chinese Medicine, Dezhou, Shandong 253000, China.
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19
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Sgrò P, Sansone M, Sansone A, Sabatini S, Borrione P, Romanelli F, Di Luigi L. Physical exercise, nutrition and hormones: three pillars to fight sarcopenia. Aging Male 2019; 22:75-88. [PMID: 29451419 DOI: 10.1080/13685538.2018.1439004] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Sarcopenia is a pathophysiological condition diffused in elderly people; it represents a social issue due to the longer life expectancy and the growing aging population. It affects negatively quality of life and it represents a risk factor for other pathologies, such as diabetes, cardiovascular disease, and obesity. No silver bullet exists to hinder sarcopenia, but it may be counteracted by physical exercise, nutrition, and a proper endocrine milieu. Indeed, we aim to analyze the scientific literature to give to clinician effective advices to counteract sarcopenia. Main text: Physical exercise, proper nutrition, optimized hormonal homeostasis represent the three pillars to fight sarcopenia. Physical exercise represents the most effective remedy to face sarcopenia, in particular if it is combined with a proper diet and with an adequate endocrine milieu. Consistency in training, adequate daily protein intake and eugonadism seems to be the keys to fight sarcopenia. The combination of these three pillars might act synergistically. CONCLUSIONS Optimization of these factors may increase their efficiency; however, scientific data may be sometimes confusing so far. Therefore, we aim to give practical advices to clinician to identify and to highlight the most important aspects in each of these three factors that should be addressed.
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Affiliation(s)
- Paolo Sgrò
- a Department of Movement, Human and Health Sciences, Unit of Endocrinology , Università degli Studi di Roma "Foro Italico" , Rome , Italy
| | - Massimiliano Sansone
- b Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology , Sapienza - Università di Roma , Rome , Italy
| | - Andrea Sansone
- b Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology , Sapienza - Università di Roma , Rome , Italy
| | - Stefania Sabatini
- c Department of Movement, Human and Health Sciences, Unit of Biology, Genetics and Biochemistry , Università degli Studi di Roma "Foro Italico" , Rome , Italy
| | - Paolo Borrione
- d Department of Movement, Human and Health Sciences, Unit of Internal Medicine , Università degli Studi di Roma "Foro Italico" , Rome , Italy
| | - Francesco Romanelli
- b Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology , Sapienza - Università di Roma , Rome , Italy
| | - Luigi Di Luigi
- a Department of Movement, Human and Health Sciences, Unit of Endocrinology , Università degli Studi di Roma "Foro Italico" , Rome , Italy
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20
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Yanagita I, Fujihara Y, Kitajima Y, Tajima M, Honda M, Kawajiri T, Eda T, Yonemura K, Yamaguchi N, Asakawa H, Nei Y, Kayashima Y, Yoshimoto M, Harada M, Araki Y, Yoshimoto S, Aida E, Yanase T, Nawata H, Muta K. A High Serum Cortisol/DHEA-S Ratio Is a Risk Factor for Sarcopenia in Elderly Diabetic Patients. J Endocr Soc 2019; 3:801-813. [PMID: 30963138 PMCID: PMC6446890 DOI: 10.1210/js.2018-00271] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 02/27/2019] [Indexed: 12/25/2022] Open
Abstract
Context Elderly patients with type 2 diabetes mellitus (T2DM) have a high prevalence of frailty and/or sarcopenia. Sarcopenia is thought to be related to discordant secretions of the adrenal hormones cortisol and dehydroepiandrosterone (DHEA), as well as the sulfate ester of DHEA (DHEA-S). The current study sought to evaluate the risk factors for sarcopenia in elderly patients with T2DM. Design and Patients We enrolled 108 consecutive elderly patients aged ≥65 years with T2DM (mean age, 76.2 ± 7.3 years; 43.5% males). Sarcopenia was assessed and diagnosed based on the Asian version of the diagnostic criteria regarding muscular strength, physical function, and muscle mass. We assessed various physical parameters, blood tests, and atherosclerosis markers and statistically determined the risk factors for sarcopenia. Results Multiple regression analysis showed that the independent risk factors for sarcopenia were a serum cortisol/DHEA-S ratio ≥0.2, diastolic blood pressure <70 mm Hg, Hb concentration <13 g/dL, and an ankle brachial index <1.0. The strongest risk factor for sarcopenia was a serum cortisol/DHEA-S ratio ≥0.2. An increase in the serum cortisol/DHEA-S ratio reflected higher cortisol values and lower DHEA-S values in patients with sarcopenia compared with those in nonsarcopenic patients. The concentrations of cortisol and DHEA-S, as well as the cortisol/DHEA-S ratio, changed in accordance with the severity of sarcopenia. Conclusions A relative increase in cortisol may reflect the presence of stress and stimulate muscle catabolism, whereas a relative decrease in DHEA-S may cause a decrease in the anabolic action of DHEA on muscle; the combination of these factors may lead to sarcopenia.
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Affiliation(s)
- Ikumi Yanagita
- Muta Hospital, Fukuoka, Japan.,Department of Endocrinology and Diabetes Mellitus, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Toshihiko Yanase
- Department of Endocrinology and Diabetes Mellitus, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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Hagberg JM, Coyle EF, Baldwin KM, Cartee GD, Fontana L, Joyner MJ, Kirwan JP, Seals DR, Weiss EP. The historical context and scientific legacy of John O. Holloszy. J Appl Physiol (1985) 2019; 127:277-305. [PMID: 30730811 PMCID: PMC6732442 DOI: 10.1152/japplphysiol.00669.2018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
John O. Holloszy, as perhaps the world's preeminent exercise biochemist/physiologist, published >400 papers over his 50+ year career, and they have been cited >41,000 times. In 1965 Holloszy showed for the first time that exercise training in rodents resulted in a doubling of skeletal muscle mitochondria, ushering in a very active era of skeletal muscle plasticity research. He subsequently went on to describe the consequences of and the mechanisms underlying these adaptations. Holloszy was first to show that muscle contractions increase muscle glucose transport independent of insulin, and he studied the mechanisms underlying this response throughout his career. He published important papers assessing the impact of training on glucose and insulin metabolism in healthy and diseased humans. Holloszy was at the forefront of rodent studies of caloric restriction and longevity in the 1980s, following these studies with important cross-sectional and longitudinal caloric restriction studies in humans. Holloszy was influential in the discipline of cardiovascular physiology, showing that older healthy and diseased populations could still elicit beneficial cardiovascular adaptations with exercise training. Holloszy and his group made important contributions to exercise physiology on the effects of training on numerous metabolic, hormonal, and cardiovascular adaptations. Holloszy's outstanding productivity was made possible by his mentoring of ~100 postdoctoral fellows and substantial NIH grant funding over his entire career. Many of these fellows have also played critical roles in the exercise physiology/biochemistry discipline. Thus it is clear that exercise biochemistry and physiology will be influenced by John Holloszy for numerous years to come.
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Affiliation(s)
- James M Hagberg
- Department of Kinesiology, University of Maryland School of Public Health, College Park, Maryland
| | - Edward F Coyle
- Department of Kinesiology and Health Education, University of Texas, Austin, Texas
| | - Kenneth M Baldwin
- Department of Physiology and Biophysics, School of Medicine, University of California, Irvine, California
| | - Gregory D Cartee
- Muscle Biology Laboratory, School of Kinesiology; Department of Molecular and Integrative Physiology; and Institute of Gerontology, University of Michigan, Ann Arbor, Michigan
| | - Luigi Fontana
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri; Department of Clinical and Experimental Sciences, Brescia University Medical School, Brescia, Italy; and School of Medicine and Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | - Michael J Joyner
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota
| | - John P Kirwan
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana
| | - Douglas R Seals
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado
| | - Edward P Weiss
- Department of Nutrition and Dietetics, Doisy College of Health Science, St. Louis University, St. Louis, Missouri
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22
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Jankowski CM, Wolfe P, Schmiege SJ, Nair KS, Khosla S, Jensen M, von Muhlen D, Laughlin GA, Kritz-Silverstein D, Bergstrom J, Bettencourt R, Weiss EP, Villareal DT, Kohrt WM. Sex-specific effects of dehydroepiandrosterone (DHEA) on bone mineral density and body composition: A pooled analysis of four clinical trials. Clin Endocrinol (Oxf) 2019; 90:293-300. [PMID: 30421439 PMCID: PMC6336516 DOI: 10.1111/cen.13901] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 10/11/2018] [Accepted: 11/07/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Studies of dehydroepiandrosterone (DHEA) therapy in older adults suggest sex-specific effects on bone mineral density (BMD) and body composition, but the ability of a single study to reach this conclusion was limited. We evaluated the effects of DHEA on sex hormones, BMD, fat mass and fat-free mass in older women and men enrolled in four similar clinical trials. DESIGN Pooled analyses of data from four double-blinded, randomized controlled trials. PARTICIPANTS Women (n = 295) and men (n = 290) aged 55 years or older who took DHEA or placebo tablet daily for 12 months. MEASUREMENTS Twelve-month changes in BMD, fat mass, fat-free mass and serum DHEA sulphate (DHEAS), (17)estradiol, testosterone and insulin-like growth factor-1 (IGF-1). RESULTS Women on DHEA had increases (mean ± SD; all P < 0.001 vs placebo) in DHEAS (231 ± 164 µg/dL), testosterone (18.6 ± 20.9 µg/dL), (17)estradiol (8.7 ± 11.0 pg/mL) and IGF-1 (25.1 ± 52.3 ng/mL), and men had increases in DHEAS (269.0 ± 177 µg/dL; P < 0.01), (17)estradiol (4.8 ± 12.2 pg/m; P < 0.01) and IGF-1 (6.3 ± 41.4 ng/mL; P < 0.05). Women on DHEA had increases in lumbar spine (1.0% ± 3.4%) and trochanter (0.5% ± 3.8%) BMD and maintained total hip BMD (0.0% ± 2.8%); men had no BMD benefit and a decrease in fat mass (-0.4 ± 2.6 kg; all P < 0.01 vs placebo). CONCLUSIONS Dehydroepiandrosterone therapy may be an effective approach for preserving bone and muscle mass in women. Key questions are (a) the extent to which longer duration DHEA can attenuate the loss of bone and muscle in women, and (b) whether DHEA has a more favourable benefit-to-risk profile for women than oestrogen therapy.
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Affiliation(s)
| | - Pamela Wolfe
- University of Colorado Anschutz Medical Campus, Aurora, CO
| | | | | | | | | | | | | | | | | | | | | | | | - Wendy M. Kohrt
- University of Colorado Anschutz Medical Campus, Aurora, CO
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23
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Peng LN, Lee WJ, Liu LK, Lin MH, Chen LK. Healthy community-living older men differ from women in associations between myostatin levels and skeletal muscle mass. J Cachexia Sarcopenia Muscle 2018; 9:635-642. [PMID: 29654636 PMCID: PMC6104118 DOI: 10.1002/jcsm.12302] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 02/13/2018] [Accepted: 02/28/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Myostatin is a negative regulator of muscle growth but the relationship between serum myostatin levels and muscle mass is unclear. This study investigated the association between serum myostatin levels and skeletal muscle mass among healthy older community residents in Taiwan, to evaluate the potential of serum myostatin as a biomarker for diagnosing sarcopenia and/or evaluating the effect of its treatment. METHODS Study data were excerpted from a random subsample of the I-Lan Longitudinal Aging Study population. Serum myostatin levels were determined and categorized into tertiles (low, medium, high). Relative appendicular skeletal muscle mass (RASM) was calculated as appendicular lean body mass by dual-energy X-ray absorptiometry divided by height squared (kg/m2 ). Low muscle mass was defined as recommended by the Asian Working Group for Sarcopenia. RESULTS The analytic study sample comprised 463 adults (mean age: 69.1 years; 49.5% men). Compared with subjects with normal RASM, those with lower RASM were older and frailer, with significantly higher prevalence of malnutrition, lower serum dehydroepiandrosterone (DHEA) levels, and were more likely to have low serum myostatin status. Multivariable logistic regression analysis showed that male sex (OR 3.60, 95% CI 1.30-9.92), malnutrition (OR 4.39, 95% CI 1.56-12.36), DHEA (OR 0.99, 95% CI 0.99-1.00), and low myostatin (OR 3.23, 95% CI 1.49-7.01) were all independent risk factors for low RASM (all P < 0.05). In men, DHEA (OR 0.99, 95% CI 0.98-1.00) and low myostatin (OR 4.89, 95% CI 1.79-13.37) were significantly associated with low RASM (both P < 0.05); however, only malnutrition was associated with low RASM in women (OR 13.59, 95% CI 2.22-83.25, P < 0.05). CONCLUSIONS Among healthy community-living older adults, low serum myostatin levels were associated with low skeletal muscle mass in men, but not in women. Our results do not support using serum myostatin levels to diagnose sarcopenia, or to monitor how it responds to treatments. Further research is needed to understand why men apparently differ from women in the interrelationship between their myostatin levels and muscle mass.
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Affiliation(s)
- Li-Ning Peng
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Rd, Taipei, 11217, Taiwan.,Aging and Health Research Center, National Yang Ming University, No. 155, Sec. 2, Linong St, Taipei, 11221, Taiwan.,Department of Geriatric Medicine, National Yang Ming University School of Medicine, No. 155, Sec. 2, Linong St, Taipei, 11221, Taiwan
| | - Wei-Ju Lee
- Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, No. 386 Rongguang Rd., Yuanshan Township, Yilan County, 264, Taiwan.,Aging and Health Research Center, National Yang Ming University, No. 155, Sec. 2, Linong St, Taipei, 11221, Taiwan.,Department of Geriatric Medicine, National Yang Ming University School of Medicine, No. 155, Sec. 2, Linong St, Taipei, 11221, Taiwan
| | - Li-Kuo Liu
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Rd, Taipei, 11217, Taiwan.,Aging and Health Research Center, National Yang Ming University, No. 155, Sec. 2, Linong St, Taipei, 11221, Taiwan.,Department of Geriatric Medicine, National Yang Ming University School of Medicine, No. 155, Sec. 2, Linong St, Taipei, 11221, Taiwan
| | - Ming-Hsien Lin
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Rd, Taipei, 11217, Taiwan.,Aging and Health Research Center, National Yang Ming University, No. 155, Sec. 2, Linong St, Taipei, 11221, Taiwan.,Department of Geriatric Medicine, National Yang Ming University School of Medicine, No. 155, Sec. 2, Linong St, Taipei, 11221, Taiwan
| | - Liang-Kung Chen
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Rd, Taipei, 11217, Taiwan.,Aging and Health Research Center, National Yang Ming University, No. 155, Sec. 2, Linong St, Taipei, 11221, Taiwan.,Department of Geriatric Medicine, National Yang Ming University School of Medicine, No. 155, Sec. 2, Linong St, Taipei, 11221, Taiwan
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24
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Andrews MA, Magee CD, Combest TM, Allard RJ, Douglas KM. Physical Effects of Anabolic-androgenic Steroids in Healthy Exercising Adults. Curr Sports Med Rep 2018; 17:232-241. [DOI: 10.1249/jsr.0000000000000500] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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25
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Arbo BD, Ribeiro FS, Ribeiro MF. Astrocyte Neuroprotection and Dehydroepiandrosterone. VITAMINS AND HORMONES 2018; 108:175-203. [PMID: 30029726 DOI: 10.1016/bs.vh.2018.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Dehydroepiandrosterone (DHEA) and its sulfate ester (DHEAS) are the most abundant steroid hormones in the systemic circulation of humans. Due to their abundance and reduced production during aging, these hormones have been suggested to play a role in many aspects of health and have been used as drugs for a multiple range of therapeutic actions, including hormonal replacement and the improvement of aging-related diseases. In addition, several studies have shown that DHEA and DHEAS are neuroprotective under different experimental conditions, including models of ischemia, traumatic brain injury, spinal cord injury, glutamate excitotoxicity, and neurodegenerative diseases. Since astrocytes are responsible for the maintenance of neural tissue homeostasis and the control of neuronal energy supply, changes in astrocytic function have been associated with neuronal damage and the progression of different pathologies. Therefore, the aim of this chapter is to discuss the neuroprotective effects of DHEA against different types of brain and spinal cord injuries and how the modulation of astrocytic function by DHEA could represent an interesting therapeutic approach for the treatment of these conditions.
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Affiliation(s)
- Bruno D Arbo
- Instituto de Ciências Biológicas, Universidade Federal do Rio Grande (FURG), Rio Grande, Brazil; Programa de Pós-Graduação em Ciências Biológicas: Farmacologia e Terapêutica, ICBS, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
| | - Felipe S Ribeiro
- Laboratório de Interação Neuro-Humoral, ICBS, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Maria F Ribeiro
- Laboratório de Interação Neuro-Humoral, ICBS, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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26
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Beaudart C, Rabenda V, Simmons M, Geerinck A, Araujo De Carvalho I, Reginster JY, Amuthavalli Thiyagarajan J, Bruyère O. Effects of Protein, Essential Amino Acids, B-Hydroxy B-Methylbutyrate, Creatine, Dehydroepiandrosterone and Fatty Acid Supplementation on Muscle Mass, Muscle Strength and Physical Performance in Older People Aged 60 Years and Over. A Systematic Review on the Literature. J Nutr Health Aging 2018; 22:117-130. [PMID: 29300431 DOI: 10.1007/s12603-017-0934-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVES The objective of this study was to perform a systematic review to investigate the effects protein, essential amino acids (EAA), β-hydroxy β-methylbutyrate (HMB), creatine, dehydroepiandrosterone (DHEA) and fatty acid supplementation on muscle mass, muscle strength and physical performance of elderly subjects. METHODS Using the electronic databases MEDLINE and EMBASE we identified RCTs published until February 2016 which assessed the effects of these nutrient supplementation on muscle strength, muscle mass or physical performance. Study selection and data extraction were performed by two independent reviewers. RESULTS Search strategy allowed us to identify 23 RCTs. Among them, four used proteins as nutritional supplement, seven EAAs, six creatine, four DHEA and finally, two HMB. From our systematic review, it seems that the effects of these supplementations on muscle health are rather limited. Only consistent effects of EAA supplementation on physical performance (3 out of the 4 RCTs using EAA supplementation found significant effect of this supplementation on physical performance) and HMB supplementation on muscle mass (all the 2 identified RCTs using HMB supplementation found significant effect of this supplementation on muscle mass) have been found across studies. No consistent effects were found for the other types of dietary supplementation. Because of the important limitations in study design, inconsistency and lack of directness, the overall quality of the evidence was judged to be low or very low using the GRADE system. CONCLUSION This systematic review showed a limited effect of nutritional supplementation on muscle mass, muscle power and physical function. Inconsistent positive effects were observed for some specific supplementations but the results only concerned one aspect of the muscle. Well designed and appropriately powered RCTs are needed to provide evidence for appropriate clinical recommendations.
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Affiliation(s)
- C Beaudart
- Olivier Bruyère, PhD, Research Unit in Public Health, Epidemiology and Health Economics, University of Liège, Belgium, Quartier hôpital, avenue hippocrate, 13, 4000 Liège, Tel.: +32 4 366 25 81, E-mail:
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27
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The Role of Dehydroepiandrosterone (DHEA) in Skeletal Muscle. DEHYDROEPIANDROSTERONE 2018; 108:205-221. [DOI: 10.1016/bs.vh.2018.03.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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28
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Fougère B, Morley JE, Little MO, De Souto Barreto P, Cesari M, Vellas B. Interventions Against Disability in Frail Older Adults: Lessons Learned from Clinical Trials. J Nutr Health Aging 2018; 22:676-688. [PMID: 29806856 DOI: 10.1007/s12603-017-0987-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
As the population ages, the number of older people with frailty is expected to increase worldwide with consequent rising of expenditures for healthcare and long-term care. Effective methods for preventing or delaying the onset of disability are urgently required. Frailty is a common and important geriatric condition characterized by age-associated declines in multiple physiological mechanisms, leading to increased vulnerability to stressors and higher risk for adverse health outcomes. Significant advancements have been made in the understanding of the frailty pathophysiological background. Given its multidimensional nature, reversing frailty requires a comprehensive approach. In this context, several studies testing the effects of pharmacological approach, physical activity, nutritional intervention, or cognitive training showed evidence of efficacy in frail older adults. Important innovations in ongoing trials include the development of multidomain interventions. Challenges include the use of trial designs, the development of standardized, sensitive outcome measures, and the need for interventions that can be implemented in resource-poor settings. In this viewpoint paper, based on recent literature, our aim was to identify relevant studies performed to reverse or delay disability in frail older adults.
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Affiliation(s)
- B Fougère
- Bertrand Fougère, Institut du Vieillissement, Gérontopôle, Université Toulouse III Paul Sabatier, 37 Allées Jules Guesde, 31000 Toulouse, France. Tel: +33561145657 ; fax: +33561145640. E-mail:
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Jacob MH, Fernandes RO, Bonetto JH, Mendes RH, Araujo ASDR, Belló-Klein A, Ribeiro MF. DHEA Treatment Effects on Redox Environment in Skeletal Muscle of Young and Aged Healthy Rats. Curr Aging Sci 2018; 11:126-132. [PMID: 30073935 PMCID: PMC6388512 DOI: 10.2174/1874609811666180803125723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Revised: 05/28/2018] [Accepted: 07/04/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Dehydroepiandrosterone (DHEA) is an important precursor of active steroid hormone, produced abundantly by the adrenal cortex with an age-dependent pattern. OBJECTIVE We investigated whether chronic DHEA administration impacts on redox status and on Akt protein activation in skeletal muscle during the aging process (3 and 24 months-old rats). METHODS Rats received one weekly dose/5 weeks of DHEA (10 mg/kg) or vehicle. Gastrocnemius muscle was removed to evaluate glutathione system, hydrogen peroxide, antioxidant enzymes, and expression of Akt kinase protein. RESULTS In the 3-months-old rats DHEA induced an increase in hydrogen peroxide when compared both to its control (276%) and the 24-months-old DHEA group (485%). Moreover, in the 24- months-old rats DHEA caused an increase in GSSG (41 and 28%), a decrease in reduced-GSH (55 and 51%), and a more oxidized redox status (reduction in GSH/GSSG ratio, 47 and 65 %) when compared to 3-month-old DHEA and to 24-months-old control groups, respectively. Both older groups had increased G6PDH (2.7 fold) and GST (1.7 fold) activities when compared to younger groups, independently of any DHEA treatment. However, there was no modulation of Akt protein (phosphorylated/total isoform). CONCLUSION The results show that chronic DHEA administration to 3 and 24-months-old rats may not present positive effects regarding the redox environment in skeletal muscle without modulation of pro-survival Akt kinase. Due to the large-scale self-administration of DHEA as an "anti-aging" dietary supplement, it is crucial to investigate its molecular mechanisms over oxidative stressinduced related diseases.
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Affiliation(s)
- Maria H.V.M. Jacob
- Address correspondence to this author at the UFRGS, ICBS - Rua Sarmento Leite, 500. Porto Alegre/RS/Brazil CEP 90050-170, Brazil;
E-mail:
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Nutritional Considerations in Preventing Muscle Atrophy. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1088:497-528. [DOI: 10.1007/978-981-13-1435-3_23] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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31
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Colleluori G, Napoli N, Phadnis U, Armamento-Villareal R, Villareal DT. Effect of Weight Loss, Exercise, or Both on Undercarboxylated Osteocalcin and Insulin Secretion in Frail, Obese Older Adults. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2017; 2017:4807046. [PMID: 28951766 PMCID: PMC5603129 DOI: 10.1155/2017/4807046] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 06/25/2017] [Accepted: 07/06/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Obesity exacerbates age-related decline in glucometabolic control. Undercarboxylated osteocalcin (UcOC) regulates pancreatic insulin secretion. The long-term effect of lifestyle interventions on UcOC and insulin secretion has not been investigated. METHODS One hundred seven frail, obese older adults were randomized into the control (N = 27), diet (N = 26), exercise (N = 26), and diet-exercise (N = 28) groups for 1 year. Main outcomes included changes in UcOC and disposition index (DI). RESULTS UcOC increased in the diet group (36 ± 11.6%) but not in the other groups (P < 0.05 between groups). Although similar increases in DI occurred in the diet-exercise and diet groups at 6 months, DI increased more in the diet-exercise group (92.4 ± 11.4%) than in the diet group (61.9 ± 15.3%) at 12 months (P < 0.05). UcOC and body composition changes predicted DI variation in the diet group only (R2 = 0.712), while adipocytokines and physical function changes contributed to DI variation in both the diet (∆R2 = 0.140 and 0.107) and diet-exercise (∆R2 = 0.427 and 0.243) groups (P < 0.05 for all). CONCLUSIONS Diet, but not exercise or both, increases UcOC, whereas both diet and diet-exercise increase DI. UcOC accounts for DI variation only during active weight loss, while adipocytokines and physical function contribute to diet-exercise-induced DI variation, highlighting different mechanisms for lifestyle-induced improvements in insulin secretion. This trial was registered with ClinicalTrials.gov number NCT00146107.
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Affiliation(s)
- Georgia Colleluori
- Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, Houston, TX 77030, USA
- Center for Translational Research on Inflammatory Diseases (CTRID), Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
- University Campus-Biomedico, 00128, Rome, Italy
| | | | - Uma Phadnis
- Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, Houston, TX 77030, USA
- Center for Translational Research on Inflammatory Diseases (CTRID), Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
| | - Reina Armamento-Villareal
- Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, Houston, TX 77030, USA
- Center for Translational Research on Inflammatory Diseases (CTRID), Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
| | - Dennis T. Villareal
- Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, Houston, TX 77030, USA
- Center for Translational Research on Inflammatory Diseases (CTRID), Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
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32
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Park J, Kwon Y, Park H. Effects of 24-Week Aerobic and Resistance Training on Carotid Artery Intima-Media Thickness and Flow Velocity in Elderly Women with Sarcopenic Obesity. J Atheroscler Thromb 2017; 24:1117-1124. [PMID: 28674320 PMCID: PMC5684477 DOI: 10.5551/jat.39065] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Aim: Sarcopenic obesity (SO) is closely associated with cardiovascular disease (CVD) in elderly women. Increases in body fat and decreases in muscle mass are closely associated with increased carotid intima-media thickness (CIMT). The aim of this study was to examine the influence of a 24-week aerobic and resistance training program on carotid parameters in SO. Methods: Fifty elderly women (74.1 ± 6.1 years) with SO were randomly divided into an exercise group and a control group. The exercise group performed combined exercise over 24 weeks, consisting of resistance and aerobic training for 50–80 min, 5 times a week. Carotid variables were measured using B-mode ultrasound. The differences in the carotid variables and the relative changes between baseline and after 24 weeks were evaluated. Results: In the analysis of variance (ANOVA) results, CIMT (p = 0.013), systolic flow velocity (p = 0.007), diastolic flow velocity (p = 0.006), and wall shear rate (p = 0.010) showed significant interactions. In paired t-test results of the exercise group, CIMT significantly decreased (p < 0.01) and systolic flow velocity (p < 0.01), diastolic flow velocity (p < 0.001), and wall shear rate (p < 0.05) significantly increased after 24 weeks. Conclusion: The 24-week combined exercise effectively decreased CIMT and increased carotid flow velocity and wall shear ratio. Therefore, combined exercise is thought to contribute to the improvement of the risk of CVD in elderly women with SO.
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Affiliation(s)
- Jinkee Park
- Department of Sport Rehabilitation, Dong Ju College, Busan
| | - Yoochan Kwon
- Institute of Taekwondo for Health and Culture, Dong-A University.,Department of Taekwondo, Dong-A University
| | - Hyuntea Park
- Department of Health Care & Science, Dong-A University.,Institute of Convergence Bio-Health, Dong-A University
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Kim YJ, Tamadon A, Park HT, Kim H, Ku SY. The role of sex steroid hormones in the pathophysiology and treatment of sarcopenia. Osteoporos Sarcopenia 2016; 2:140-155. [PMID: 30775480 PMCID: PMC6372754 DOI: 10.1016/j.afos.2016.06.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 06/09/2016] [Accepted: 06/17/2016] [Indexed: 12/18/2022] Open
Abstract
Sex steroids influence the maintenance and growth of muscles. Decline in androgens, estrogens and progesterone by aging leads to the loss of muscular function and mass, sarcopenia. These steroid hormones can interact with different signaling pathways through their receptors. To date, sex steroid hormone receptors and their exact roles are not completely defined in skeletal and smooth muscles. Although numerous studies focused on the effects of sex steroid hormones on different types of cells, still many unexplained molecular mechanisms in both skeletal and smooth muscle cells remain to be investigated. In this paper, many different molecular mechanisms that are activated or inhibited by sex steroids and those that influence the growth, proliferation, and differentiation of skeletal and smooth muscle cells are reviewed. Also, the similarities of cellular and molecular pathways of androgens, estrogens and progesterone in both skeletal and smooth muscle cells are highlighted. The reviewed signaling pathways and participating molecules can be targeted in the future development of novel therapeutics.
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Affiliation(s)
- Yong Jin Kim
- Department of Obstetrics and Gynecology, Korea University Guro Hospital, South Korea
| | - Amin Tamadon
- Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, South Korea
| | - Hyun Tae Park
- Department of Obstetrics and Gynecology, Korea University Anam Hospital, Korea University College of Medicine, South Korea
| | - Hoon Kim
- Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, South Korea
| | - Seung-Yup Ku
- Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, South Korea
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DHEA-induced modulation of renal gluconeogenesis, insulin sensitivity and plasma lipid profile in the control- and dexamethasone-treated rabbits. Metabolic studies. Biochimie 2016; 121:87-101. [DOI: 10.1016/j.biochi.2015.11.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 11/19/2015] [Indexed: 12/13/2022]
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Chen WC, Chen YM, Huang CC, Tzeng YD. Dehydroepiandrosterone Supplementation Combined with Whole-Body Vibration Training Affects Testosterone Level and Body Composition in Mice. Int J Med Sci 2016; 13:730-740. [PMID: 27766021 PMCID: PMC5069407 DOI: 10.7150/ijms.16132] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 08/19/2016] [Indexed: 11/05/2022] Open
Abstract
Dehydroepiandrosterone (DHEA), the most abundant sex steroid, is primarily secreted by the adrenal gland and a precursor hormone used by athletes for performance enhancement. Whole-body vibration (WBV) is a well-known light-resistance exercise by automatic adaptations to rapid and repeated oscillations from a vibrating platform, which is also a simple and convenient exercise for older adults. However, the potential effects of DHEA supplementation combined with WBV training on to body composition, exercise performance, and hormone regulation are currently unclear. The objective of the study is to investigate the effects of DHEA supplementation combined with WBV training on body composition, exercise performance, and physical fatigue-related biochemical responses and testosterone content in young-adult C57BL/6 mice. In this study, male C57BL/6 mice were divided into four groups (n = 8 per group) for 6-weeks treatment: sedentary controls with vehicle (SC), DHEA supplementation (DHEA, 10.2 mg/kg), WBV training (WBV; 5.6 Hz, 2 mm, 0.13 g), and WBV training with DHEA supplementation (WBV+DHEA; WBV: 5.6 Hz, 2 mm, 0.13 g and DHEA: 10.2 mg/kg). Exercise performance was evaluated by forelimb grip strength and exhaustive swimming time, as well as changes in body composition and anti-fatigue levels of serum lactate, ammonia, glucose, creatine kinase (CK), and blood urea nitrogen (BUN) after a 15-min swimming exercise. In addition, the biochemical parameters and the testosterone content were measured at the end of the experiment. Six-week DHEA supplementation alone significantly increased mice body weight (BW), muscle weight, testosterone level, and glycogen contents (liver and muscle) when compared with SC group. DHEA supplementation alone had no negative impact on all tissue and biochemical profiles, but could not improve exercise performance. However, WBV+DHEA supplementation also significantly decreased BW, testosterone level and glycogen content of liver, as well as serum lactate and ammonia levels after the 15-min swimming exercise when compared with DHEA supplementation alone. Although DHEA supplementation alone had no beneficial effect in the exercise performance of mice, the BW, testosterone level and glycogen content significantly increased. On the other hand, WBV training combined with DHEA decreased the BW gain, testosterone level and glycogen content caused by DHEA supplementation. Therefore, WBV training could inhibit DHEA supplementation to synthesis the testosterone level or may decrease the DHEA supplement absorptive capacity in young-adult mice.
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Affiliation(s)
- Wen-Chyuan Chen
- Center for General Education, Chang Gung University of Science and Technology, Taoyuan 33301, Taiwan;; Department of Otorhinolaryngology-Head and Neck Surgery, Sleep Center, Linkou-Chang Gung Memorial Hospital, Taoyuan 33301, Taiwan
| | - Yi-Ming Chen
- Center for General Education, Chang Gung University of Science and Technology, Taoyuan 33301, Taiwan;; Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan 33301, Taiwan
| | - Chi-Chang Huang
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan 33301, Taiwan
| | - Yen-Dun Tzeng
- Division of General Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, 813 Kaohsiung, Taiwan
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Yabuki Y, Shinoda Y, Izumi H, Ikuno T, Shioda N, Fukunaga K. Dehydroepiandrosterone administration improves memory deficits following transient brain ischemia through sigma-1 receptor stimulation. Brain Res 2015; 1622:102-13. [PMID: 26119915 DOI: 10.1016/j.brainres.2015.05.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 05/02/2015] [Accepted: 05/05/2015] [Indexed: 12/20/2022]
Abstract
Dehydroepiandrosterone (DHEA) is the most abundant neurosteroid synthesized de novo in the central nervous system. Oral DHEA administration elicits neuroprotection and cognitive improvement, but mechanisms underlying these functions in cerebral ischemia have remained unclear. Since DHEA is the endogenous ligand for the sigma-1 receptor (σ1R), we determined whether oral DHEA administration prevents neuronal cell death and improves cognition via σ1R stimulation in brain ischemia using a 20-min bilateral common carotid artery occlusion (BCCAO) mouse model. Twenty-four hours after BCCAO ischemia, mice were administered DHEA (15 or 30mg/kg p.o.) daily for 11 consecutive days. Memory deficits following brain ischemia were improved by DHEA administration dose-dependently. Accordingly, DHEA administration significantly prevented neuronal cell death in the hippocampal CA1 region in BCCAO mice. Interestingly, DHEA administration rescued decreases in Ca(2+)/calmodulin-dependent protein kinase II (CaMKII) autophosphorylation and phosphorylation of extracellular signal-regulated kinase (ERK) and protein kinase B (Akt) in the CA1 region. Moreover, DHEA administration significantly ameliorated decreases in adenosine 5'-triphosphate (ATP) levels and decreased σ1R expression levels in CA1 following BCCAO ischemia. Finally, co-treatment of mice with the σ1R antagonist NE-100 (1mg/kg, p.o.) blocked DHEA effects on memory improvement and neuroprotection in ischemic mice. Taken together, DHEA prevents neuronal cell death and activates CaMKII via σ1R stimulation, thereby improving cognitive deficits following brain ischemia.
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Affiliation(s)
- Yasushi Yabuki
- Department of Pharmacology, Graduate School of Pharmaceutical Sciences, Tohoku University, Aramaki-Aoba Aoba-ku, Sendai 980-8578, Japan
| | - Yasuharu Shinoda
- Department of Pharmacology, Graduate School of Pharmaceutical Sciences, Tohoku University, Aramaki-Aoba Aoba-ku, Sendai 980-8578, Japan
| | - Hisanao Izumi
- Department of Pharmacology, Graduate School of Pharmaceutical Sciences, Tohoku University, Aramaki-Aoba Aoba-ku, Sendai 980-8578, Japan
| | - Tatuya Ikuno
- Department of Pharmacology, Graduate School of Pharmaceutical Sciences, Tohoku University, Aramaki-Aoba Aoba-ku, Sendai 980-8578, Japan
| | - Norifumi Shioda
- Department of Pharmacology, Graduate School of Pharmaceutical Sciences, Tohoku University, Aramaki-Aoba Aoba-ku, Sendai 980-8578, Japan
| | - Kohji Fukunaga
- Department of Pharmacology, Graduate School of Pharmaceutical Sciences, Tohoku University, Aramaki-Aoba Aoba-ku, Sendai 980-8578, Japan.
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Hebert SL, Marquet-de Rougé P, Lanza IR, McCrady-Spitzer SK, Levine JA, Middha S, Carter RE, Klaus KA, Therneau TM, Highsmith EW, Nair KS. Mitochondrial Aging and Physical Decline: Insights From Three Generations of Women. J Gerontol A Biol Sci Med Sci 2015; 70:1409-17. [PMID: 26297939 DOI: 10.1093/gerona/glv086] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 05/22/2015] [Indexed: 02/07/2023] Open
Abstract
Decline in mitochondrial DNA (mtDNA) copy number, function, and accumulation of mutations and deletions have been proposed to contribute to age-related physical decline, based on cross sectional studies in genetically unrelated individuals. There is wide variability of mtDNA and functional measurements in many population studies and therefore we assessed mitochondrial function and physical function in 18 families of grandmothers, mothers, and daughters who share the same maternally inherited mtDNA sequence. A significant age-related decline in mtDNA copy number, mitochondrial protein expression, citrate synthase activity, cytochrome c oxidase content, and VO2 peak were observed. Also, a lower abundance of SIRT3, accompanied by an increase in acetylated skeletal muscle proteins, was observed in grandmothers. Muscle tissue-based full sequencing of mtDNA showed greater than 5% change in minor allele frequency over a lifetime in two locations, position 189 and 408 in the noncoding D-loop region but no changes were noted in blood cells mtDNA. The decline in oxidative capacity and muscle function with age in three generations of women who share the same mtDNA sequence are associated with a decline in muscle mtDNA copy number and reduced protein deacetylase activity of SIRT3.
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Affiliation(s)
| | | | | | | | | | - Sumit Middha
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, 200 First Street SW, Joseph 5-194, Rochester, Minnesota 55905
| | - Rickey E Carter
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, 200 First Street SW, Joseph 5-194, Rochester, Minnesota 55905
| | | | - Terry M Therneau
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, 200 First Street SW, Joseph 5-194, Rochester, Minnesota 55905
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Maggio M, Lauretani F, De Vita F, Basaria S, Lippi G, Butto V, Luci M, Cattabiani C, Ceresini G, Verzicco I, Ferrucci L, Ceda GP. Multiple hormonal dysregulation as determinant of low physical performance and mobility in older persons. Curr Pharm Des 2015; 20:3119-48. [PMID: 24050169 DOI: 10.2174/13816128113196660062] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 09/13/2013] [Indexed: 12/16/2022]
Abstract
Mobility-disability is a common condition in older individuals. Many factors, including the age-related hormonal dysregulation, may concur to the development of disability in the elderly. In fact, during the aging process it is observed an imbalance between anabolic hormones that decrease (testosterone, dehydroepiandrosterone sulphate (DHEAS), estradiol, insulin like growth factor-1 (IGF-1) and Vitamin D) and catabolic hormones (cortisol, thyroid hormones) that increase. We start this review focusing on the mechanisms by which anabolic and catabolic hormones may affect physical performance and mobility. To address the role of the hormonal dysregulation to mobility-disability, we start to discuss the contribution of the single hormonal derangement. The studies used in this review were selected according to the period of time of publication, ranging from 2002 to 2013, and the age of the participants (≥65 years). We devoted particular attention to the effects of anabolic hormones (DHEAS, testosterone, estradiol, Vitamin D and IGF-1) on both skeletal muscle mass and strength, as well as other objective indicators of physical performance. We also analyzed the reasons beyond the inconclusive data coming from RCTs using sex hormones, thyroid hormones, and vitamin D (dosage, duration of treatment, baseline hormonal values and reached hormonal levels). We finally hypothesized that the parallel decline of anabolic hormones has a higher impact than a single hormonal derangement on adverse mobility outcomes in older population. Given the multifactorial origin of low mobility, we underlined the need of future synergistic optional treatments (micronutrients and exercise) to improve the effectiveness of hormonal treatment and to safely ameliorate the anabolic hormonal status and mobility in older individuals.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Gian Paolo Ceda
- Department of Clinical and Experimental Medicine, Section of Geriatrics via Gramsci 14, 43100, Parma, Italy.
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Fragala MS, Dam TTL, Barber V, Judge JO, Studenski SA, Cawthon PM, McLean RR, Harris TB, Ferrucci L, Guralnik JM, Kiel DP, Kritchevsky SB, Shardell MD, Vassileva MT, Kenny AM. Strength and function response to clinical interventions of older women categorized by weakness and low lean mass using classifications from the Foundation for the National Institute of Health sarcopenia project. J Gerontol A Biol Sci Med Sci 2014; 70:202-9. [PMID: 25135999 DOI: 10.1093/gerona/glu110] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The Foundation for the National Institutes of Health Sarcopenia Project developed data-driven cut-points for clinically meaningful weakness and low lean body mass. This analysis describes strength and function response to interventions based on these classifications. METHODS In data from four intervention studies, 378 postmenopausal women with baseline and 6-month data were evaluated for change in grip strength, appendicular lean mass corrected for body mass index, leg strength and power, and short physical performance battery (SPPB). Clinical interventions included hormones, exercise, and nutritional supplementation. Differences in outcomes were evaluated between (i) those with and without weakness and (ii) those with weakness and low lean mass or with one but not the other. We stratified analyses by slowness (walking speed ≤ 0.8 m/s) and by treatment assignment. RESULTS The women (72±7 years; body mass index of 26±5kg/m(2)) were weak (33%), had low lean mass (14%), or both (6%). Those with weakness increased grip strength, lost less leg power, and gained SPPB score (p < .05) compared with nonweak participants. Stratified analyses were similar for grip strength and SPPB. With lean mass in the analysis, individuals with weakness had larger gains in grip strength and SPPB scores regardless of low lean mass (p < .01). CONCLUSIONS Older women with clinically meaningful muscle weakness increased grip strength and SPPB, regardless of the presence of low lean mass following treatment with interventions for frailty. Thus, results suggest that muscle weakness, as defined by the Foundation for the National Institutes of Health Sarcopenia Project, appears to be a treatable symptom.
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Affiliation(s)
| | - Thuy-Tien L Dam
- Columbia University College of Physicians and Surgeons, New York
| | | | | | | | - Peggy M Cawthon
- California Pacific Medical Center Research Institute, San Francisco
| | - Robert R McLean
- Hebrew Senior Life Institute for Aging Research, Boston, Massachusetts. Harvard Medical School, Boston, Massachusetts
| | - Tamara B Harris
- National Institute of Aging, National Institutes of Health, Bethesda, Maryland
| | - Luigi Ferrucci
- National Institute of Aging, National Institutes of Health, Bethesda, Maryland
| | | | - Douglas P Kiel
- Hebrew Senior Life Institute for Aging Research, Boston, Massachusetts. Harvard Medical School, Boston, Massachusetts
| | | | | | - Maria T Vassileva
- Foundation for the National Institutes of Health, Bethesda, Maryland
| | - Anne M Kenny
- University of Connecticut Health Center, Farmington.
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Napoli N, Shah K, Waters DL, Sinacore DR, Qualls C, Villareal DT. Effect of weight loss, exercise, or both on cognition and quality of life in obese older adults. Am J Clin Nutr 2014; 100:189-98. [PMID: 24787497 PMCID: PMC4144098 DOI: 10.3945/ajcn.113.082883] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Obesity impairs cognition and health-related quality of life (HRQOL) in older adults; however, the appropriate treatment of obese older adults remains controversial. OBJECTIVE The objective was to determine the independent and combined effects of weight loss and exercise on cognition, mood, and HRQOL in obese older adults. DESIGN One hundred seven frail, obese older adults were randomly assigned to a control, weight-management (diet), exercise, or weight-management-plus-exercise (diet-exercise) group for 1 y. In this secondary analysis, main outcomes were Modified Mini-Mental State Examination (3MS) and total Impact of Weight on Quality of Life-Lite (IWQOL) scores. Other outcomes included Word Fluency Test, Trail Making Test Parts A and B, and Geriatric Depression Scale (GDS) scores. RESULTS Scores on the 3MS improved more in the diet (mean ± SE: 1.7 ± 0.4), exercise (2.8 ± 0.4), and diet-exercise (2.9 ± 0.4) groups than in the control group (0.1 ± 0.4) (between-group P = 0.0001-0.04); scores in the diet-exercise group improved more than in the diet group but not more than in the exercise group. Scores on the Word Fluency Test improved more in the exercise (4.1 ± 0.8) and diet-exercise (4.2 ± 0.7) groups than in the control group (-0.8 ± 0.8; both P = 0.001). For the Trail Making Test Part A, scores in the diet-exercise group (-11.8 ± 1.9) improved more than in the control group (-0.8 ± 1.9) (P = 0.001); a similar finding was observed for the Trail Making Test Part B. Scores on the IWQOL improved more in the diet (7.6 ± 1.6), exercise (10.1 ± 1.6), and diet-exercise (14.0 ± 1.4) groups than in the control group (0.3 ± 1.6) (P = 0.0001-0.03); scores in the diet-exercise group improved more than in the diet group but not more than in the exercise group. In the diet-exercise group, peak oxygen consumption and strength changes were independent predictors of 3MS changes; weight and strength changes were independent predictors of IWQOL changes. GDS scores did not change. CONCLUSIONS Weight loss and exercise each improve cognition and HRQOL, but their combination may provide benefits similar to exercise alone. These findings could inform practice guidelines with regard to optimal treatment strategies for obese older adults. This trial was registered atclinicaltrials.govas NCT00146107.
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Affiliation(s)
- Nicola Napoli
- From the Division of Endocrinology, University Campus Bio-Medico Di Roma, Rome, Italy (NN); the Division of Geriatrics and Aging, University of Rochester School of Medicine, Rochester, NY (KS); the Department of Preventive and Social Medicine, University of Otago, Dunedin School of Medicine, Dunedin, New Zealand (DLW); the Division of Geriatrics and Nutritional Science (DRS and DTV) and the Program in Physical Therapy (DRS), Washington University School of Medicine, St Louis, MO; the Department of Mathematics and Statistics (CQ) and the Division of Geriatrics (DTV), University of New Mexico School of Medicine, Albuquerque, NM; and the Section of Geriatrics, New Mexico VA Health Care System, Albuquerque, NM (DTV)
| | - Krupa Shah
- From the Division of Endocrinology, University Campus Bio-Medico Di Roma, Rome, Italy (NN); the Division of Geriatrics and Aging, University of Rochester School of Medicine, Rochester, NY (KS); the Department of Preventive and Social Medicine, University of Otago, Dunedin School of Medicine, Dunedin, New Zealand (DLW); the Division of Geriatrics and Nutritional Science (DRS and DTV) and the Program in Physical Therapy (DRS), Washington University School of Medicine, St Louis, MO; the Department of Mathematics and Statistics (CQ) and the Division of Geriatrics (DTV), University of New Mexico School of Medicine, Albuquerque, NM; and the Section of Geriatrics, New Mexico VA Health Care System, Albuquerque, NM (DTV)
| | - Debra L Waters
- From the Division of Endocrinology, University Campus Bio-Medico Di Roma, Rome, Italy (NN); the Division of Geriatrics and Aging, University of Rochester School of Medicine, Rochester, NY (KS); the Department of Preventive and Social Medicine, University of Otago, Dunedin School of Medicine, Dunedin, New Zealand (DLW); the Division of Geriatrics and Nutritional Science (DRS and DTV) and the Program in Physical Therapy (DRS), Washington University School of Medicine, St Louis, MO; the Department of Mathematics and Statistics (CQ) and the Division of Geriatrics (DTV), University of New Mexico School of Medicine, Albuquerque, NM; and the Section of Geriatrics, New Mexico VA Health Care System, Albuquerque, NM (DTV)
| | - David R Sinacore
- From the Division of Endocrinology, University Campus Bio-Medico Di Roma, Rome, Italy (NN); the Division of Geriatrics and Aging, University of Rochester School of Medicine, Rochester, NY (KS); the Department of Preventive and Social Medicine, University of Otago, Dunedin School of Medicine, Dunedin, New Zealand (DLW); the Division of Geriatrics and Nutritional Science (DRS and DTV) and the Program in Physical Therapy (DRS), Washington University School of Medicine, St Louis, MO; the Department of Mathematics and Statistics (CQ) and the Division of Geriatrics (DTV), University of New Mexico School of Medicine, Albuquerque, NM; and the Section of Geriatrics, New Mexico VA Health Care System, Albuquerque, NM (DTV)
| | - Clifford Qualls
- From the Division of Endocrinology, University Campus Bio-Medico Di Roma, Rome, Italy (NN); the Division of Geriatrics and Aging, University of Rochester School of Medicine, Rochester, NY (KS); the Department of Preventive and Social Medicine, University of Otago, Dunedin School of Medicine, Dunedin, New Zealand (DLW); the Division of Geriatrics and Nutritional Science (DRS and DTV) and the Program in Physical Therapy (DRS), Washington University School of Medicine, St Louis, MO; the Department of Mathematics and Statistics (CQ) and the Division of Geriatrics (DTV), University of New Mexico School of Medicine, Albuquerque, NM; and the Section of Geriatrics, New Mexico VA Health Care System, Albuquerque, NM (DTV)
| | - Dennis T Villareal
- From the Division of Endocrinology, University Campus Bio-Medico Di Roma, Rome, Italy (NN); the Division of Geriatrics and Aging, University of Rochester School of Medicine, Rochester, NY (KS); the Department of Preventive and Social Medicine, University of Otago, Dunedin School of Medicine, Dunedin, New Zealand (DLW); the Division of Geriatrics and Nutritional Science (DRS and DTV) and the Program in Physical Therapy (DRS), Washington University School of Medicine, St Louis, MO; the Department of Mathematics and Statistics (CQ) and the Division of Geriatrics (DTV), University of New Mexico School of Medicine, Albuquerque, NM; and the Section of Geriatrics, New Mexico VA Health Care System, Albuquerque, NM (DTV)
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Effect of regular yogic training on growth hormone and dehydroepiandrosterone sulfate as an endocrine marker of aging. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 2014:240581. [PMID: 24899906 PMCID: PMC4034508 DOI: 10.1155/2014/240581] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Revised: 02/17/2014] [Accepted: 02/18/2014] [Indexed: 11/30/2022]
Abstract
Growth hormone (GH) and dehydroepiandrosterone sulfate (DHEAS) secretion decline with advancing age and are associated with the symptoms of aging. Yogic texts claimed that regular practice of yoga may restore and maintain general endocrinological properties in the human body. Objective of the Study. To observe the effect of yogic training for twelve weeks on basal level of GH and DHEAS in middle aged group. Method. Forty-five untrained volunteers were divided into two groups, that is, yoga practicing (experimental: male 15, age 42.80 ± 7.43 yrs; female 8, age 44.75 ± 8.40 yrs) and waitlisted control group (male 15, age 41.67 ± 7.87 yrs; female 7, age 45.43 ± 7.00 yrs). The experimental group underwent combined yogic practices daily in the morning for 6 days/week for 12 weeks, whereas control group continued their usual routine activities. Standing height, body weight, body mass index, and basal level of GH and DHEAS were measured before commencement and after six and twelve weeks of yogic training period. The repeated measure ANOVA was used for data analysis. Results. 12 weeks of yogic training produces a significant increase in GH and DHEAS for both male and female groups as compared to their baseline data, whereas no as such changes were observed in the control group. Conclusion. Combined approach of graded yogic training may be beneficial for maintaining the basal level of GH and DHEAS in the human body, thus promoting healthy aging.
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Armamento-Villareal R, Aguirre L, Napoli N, Shah K, Hilton T, Sinacore DR, Qualls C, Villareal DT. Changes in thigh muscle volume predict bone mineral density response to lifestyle therapy in frail, obese older adults. Osteoporos Int 2014; 25:551-8. [PMID: 23892583 PMCID: PMC3903658 DOI: 10.1007/s00198-013-2450-2] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 06/14/2013] [Indexed: 12/14/2022]
Abstract
UNLABELLED We studied the relationships among strength, muscle mass, and bone mineral density (BMD) with lifestyle change. Lifestyle therapy consisted of exercise, diet, and diet plus exercise. Diet was by caloric restriction to induce and maintain a weight loss of 10 % from baseline body weight. Exercise attenuated weight loss-induced muscle and bone losses. Exercise improved strength despite muscle loss in patients on diet and exercise. Changes in strength did not correlate with changes in BMD. However, changes in thigh muscle volume correlated with, and predicted changes in hip BMD. INTRODUCTION Losses of hip BMD and lean body mass are major complications of lifestyle therapy in frail, obese older adults; however, the contribution of mechanical strain loss from muscle loss is poorly defined. We determined the effect of changes in thigh muscle volume and muscle strength on BMD in frail, obese older adults undergoing lifestyle therapy aimed at intentional weight loss with or without exercise. METHODS One hundred seven obese older adults were randomized to control, diet, exercise, and diet-exercise groups for 1 year. Thigh muscle volume was measured by magnetic resonance imaging, BMD by DXA, knee strength by dynamometry, total strength by one-repetition maximum (1-RM), and bone markers by immunoassay. RESULTS Thigh muscle volume decreased in the diet group (-6.2 ± 4.8 %) and increased in the exercise group (2.7 ± 3.1 %), while it was not significantly different from the control in the diet-exercise group. Changes in hip BMD followed similar pattern as those in thigh muscle volume. Knee extension and flexion increased in the exercise group (23 ± 20 %; 25 ± 19 %) and diet-exercise group (20 ± 19 %; 20.6 ± 27 %) but were unchanged in the control and diet groups. Changes in thigh muscle volume correlated with changes in hip BMD (r = 0.55, P = <0.001) and were an independent predictor of changes in hip BMD (β = 0.12, P = 0.03) in the multiple regression analyses after accounting for demographic factors and changes in weight and physical activity. There were no correlations between BMD changes and knee strength, 1-RM, and sclerostin changes. CONCLUSIONS Changes in thigh muscle volume predict hip BMD changes in obese older patients undergoing lifestyle therapy. The effect of exercise in attenuating thigh muscle loss when added to diet may in part account for the reduction in weight loss-induced bone loss in the diet-exercise group.
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Affiliation(s)
- R. Armamento-Villareal
- New Mexico VA Health Care System, Albuquerque, NM, USA
- University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - L. Aguirre
- New Mexico VA Health Care System, Albuquerque, NM, USA
| | - N. Napoli
- Campus Biomedico, Rome, Italy
- Washington University School of Medicine, St. Louis, MO, USA
| | - K. Shah
- University of Rochester School of Medicine, Rochester, NY, USA
| | | | - D. R. Sinacore
- Washington University School of Medicine, St. Louis, MO, USA
| | - C. Qualls
- University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - D. T. Villareal
- New Mexico VA Health Care System, Albuquerque, NM, USA,
- University of New Mexico School of Medicine, Albuquerque, NM, USA
- Washington University School of Medicine, St. Louis, MO, USA
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Sato K, Iemitsu M, Matsutani K, Kurihara T, Hamaoka T, Fujita S. Resistance training restores muscle sex steroid hormone steroidogenesis in older men. FASEB J 2014; 28:1891-7. [DOI: 10.1096/fj.13-245480] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Koji Sato
- Faculty of Sport and Health ScienceRitsumeikan UniversityKusatsuShigaJapan
| | - Motoyuki Iemitsu
- Faculty of Sport and Health ScienceRitsumeikan UniversityKusatsuShigaJapan
| | - Kenji Matsutani
- Faculty of Sport and Health ScienceRitsumeikan UniversityKusatsuShigaJapan
| | - Toshiyuki Kurihara
- Faculty of Sport and Health ScienceRitsumeikan UniversityKusatsuShigaJapan
| | - Takafumi Hamaoka
- Faculty of Sport and Health ScienceRitsumeikan UniversityKusatsuShigaJapan
| | - Satoshi Fujita
- Faculty of Sport and Health ScienceRitsumeikan UniversityKusatsuShigaJapan
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Aguirre LE, Jan IZ, Fowler K, Waters DL, Villareal DT, Armamento-Villareal R. Testosterone and Adipokines are Determinants of Physical Performance, Strength, and Aerobic Fitness in Frail, Obese, Older Adults. Int J Endocrinol 2014; 2014:507395. [PMID: 25165472 PMCID: PMC4140116 DOI: 10.1155/2014/507395] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 06/04/2014] [Indexed: 01/11/2023] Open
Abstract
In this study, we evaluated the independent and combined effects of baseline circulating gonadal, anabolic hormones and adipokines on physical function in 107 frail, obese (BMI ≥ 30 kg/m(2)), and older (≥65 yr) subjects. Our results showed significant positive correlations between circulating testosterone and insulin growth factor-1 (IGF-1) with knee flexion, knee extension, one-repetition maximum (1-RM), and peak oxygen consumption (VO2 peak), while no correlation was observed with estradiol. Among the adipokines, high sensitivity C-reactive protein (Hs-CRP) and leptin negatively correlated with the modified physical performance testing (PPT), knee flexion, knee extension, 1-RM, and VO2 peak. Interleukin-6 ( Il-6) negatively correlated with knee flexion and VO2 peak and soluble tumor necrosis factors receptor-1 (sTNFr1) correlated with PPT, 1-RM, and VO2 peak. Adiponectin correlated negatively with 1-RM. Multiple regression analysis revealed that, for PPT, sTNFr1 was the only independent predictor. Independent predictors included adiponectin, leptin, and testosterone for knee flexion; leptin and testosterone for knee extension; adiponectin, leptin, and testosterone for 1-RM; and IGF-1, IL-6, leptin, and testosterone for VO2 peak. In conclusion, in frail obese older adults, circulating levels of testosterone, adiponectin, and leptin appear to be important predictors of physical strength and fitness, while inflammation appears to be a major determinant of physical frailty.
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Affiliation(s)
- Lina E. Aguirre
- New Mexico VA Health Care System, 1501 San Pedro SE, Albuquerque, NM 87108, USA
- Biomedical Research Institute of New Mexico, Albuquerque, NM 87108, USA
- *Lina E. Aguirre:
| | - Irum Zeb Jan
- New Mexico VA Health Care System, 1501 San Pedro SE, Albuquerque, NM 87108, USA
| | - Kenneth Fowler
- New Mexico VA Health Care System, 1501 San Pedro SE, Albuquerque, NM 87108, USA
- Biomedical Research Institute of New Mexico, Albuquerque, NM 87108, USA
| | - Debra L. Waters
- University of Otago, Dunedin 9016, New Zealand
- University of New Mexico School of Medicine, Albuquerque, NM 87131, USA
| | - Dennis T. Villareal
- New Mexico VA Health Care System, 1501 San Pedro SE, Albuquerque, NM 87108, USA
- University of New Mexico School of Medicine, Albuquerque, NM 87131, USA
| | - Reina Armamento-Villareal
- New Mexico VA Health Care System, 1501 San Pedro SE, Albuquerque, NM 87108, USA
- University of New Mexico School of Medicine, Albuquerque, NM 87131, USA
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Optimizing the benefits of exercise on physical function in older adults. PM R 2013; 6:528-43. [PMID: 24361365 DOI: 10.1016/j.pmrj.2013.11.009] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Revised: 11/13/2013] [Accepted: 11/14/2013] [Indexed: 01/10/2023]
Abstract
As the number of older adults continues to rise worldwide, the prevention of physical disability among seniors is an increasingly important public health priority. Physical exercise is among the best known methods of preventing disability, but accumulating evidence indicates that considerable variability exists in the responsiveness of older adults to standard training regimens. Accordingly, a need exists to develop tailored interventions to optimize the beneficial effects of exercise on the physical function of older adults at risk for becoming disabled. The present review summarizes the available literature related to the use of adjuvant or alternative strategies intended to enhance the efficacy of exercise in improving the physical function of older adults. Within this work, we also discuss potential future research directions in this area.
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Hwang AC, Liu LK, Lee WJ, Chen LY, Lin MH, Peng LN, Won CW, Chen LK. Association of Androgen with Skeletal Muscle Mass and Muscle Function Among Men and Women Aged 50 Years and Older in Taiwan: Results from the I-Lan Longitudinal Aging Study. Rejuvenation Res 2013; 16:453-9. [DOI: 10.1089/rej.2013.1442] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- An-Chun Hwang
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan
- Institute of Public Health, National Yang Ming University, Taipei, Taiwan
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Li-Kuo Liu
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wei-Ju Lee
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan
- Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, I-Lan, Taiwan
| | - Liang-Yu Chen
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan
- Institute of Public Health, National Yang Ming University, Taipei, Taiwan
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ming-Hsien Lin
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Li-Ning Peng
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan
- Institute of Public Health, National Yang Ming University, Taipei, Taiwan
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chang Won Won
- Department of Family Medicine, Kyung Hee University School of Medicine, Seoul, South Korea
| | - Liang-Kung Chen
- Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Family Medicine, Kyung Hee University School of Medicine, Seoul, South Korea
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Stewart VH, Saunders DH, Greig CA. Responsiveness of muscle size and strength to physical training in very elderly people: a systematic review. Scand J Med Sci Sports 2013; 24:e1-10. [PMID: 24151875 DOI: 10.1111/sms.12123] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2013] [Indexed: 01/03/2023]
Abstract
The purpose of this review was to determine whether very elderly muscle (>75 years) hypertrophies in response to physical training. The databases MEDLINE; EMBASE; CINAHL Plus and SPORTDiscus were systematically literature searched with reference lists of all included studies and relevant reviews. Controlled trials (inactive elderly control group) involving healthy elderly participants over 75 years participating in an intervention complying with an established definition of physical training were included. Data extraction and quality assessment were performed using the PEDro scale. Data analysis was performed on muscle size and strength using RevMan (software version 5.1). Four studies were included of which four of four measured changes in gross muscle size. Training induced increases in muscle size from 1.5%-15.6% were reported in three of four studies, and one of four studies reported a decrease in muscle size (3%). The greatest gain in muscle mass was observed in a study of whole body vibration training. Meta-analysis of three studies found an increase of thigh muscle cross-sectional area (mean difference 2.31 cm(2) or 0.2%, 95% confidence interval (CI): 0.62 to 4.00; P = 0.008) and muscle strength (standardized mean difference 1.04, 95% CI: 0.65 to 1.43; P < 0.001). Physical training when delivered as resistance training has the ability to elicit hypertrophy and increase muscle strength in very elderly muscle.
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Affiliation(s)
- V H Stewart
- Department of Clinical and Surgical Sciences (Surgery), School of Clinical Sciences and Community Health, University of Edinburgh, Edinburgh, UK
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Abstract
PURPOSE OF REVIEW The increasing prevalence of sarcopenic obesity in older adults has heightened interest in identifying the most effective treatment. This review highlights recent progress in the management, with an emphasis on lifestyle interventions and pharmacologic therapy aimed at reversing sarcopenic obesity. RECENT FINDINGS Whereas weight loss and exercise independently reverse sarcopenic obesity, they act synergistically in combination to improve body composition and physical function, beyond which is observed with either intervention alone. Optimizing protein intake appears to have beneficial effects on net muscle protein accretion in older adults. Myostatin inhibition is associated with favorable changes in body composition in animal studies, although experience in humans is relatively limited. Testosterone and growth hormone offer improvements in body composition, but the benefits must be weighed against potential risks of therapy. GHRH-analog therapy shows promise, but further studies are needed in older adults. SUMMARY At present, lifestyle interventions incorporating both diet-induced weight loss and regular exercise appear to be the optimal treatment for sarcopenic obesity. Maintenance of adequate protein intake is also advisable. Ongoing studies will determine whether pharmacologic therapy such as myostatin inhibitors or GHRH analogs have a role in the treatment of sarcopenic obesity.
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Affiliation(s)
- Matthew F Bouchonville
- Division of Endocrinology, Diabetes, and Metabolism, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
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Abstract
PURPOSE OF REVIEW Sarcopenia is a geriatric syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength with a risk of adverse outcomes such as physical disability, poor quality of life, and death. Sarcopenia is a multifactorial process involving the decline of androgens, including dehydroepiandrosterone sulphate (DHEAS) and testosterone. The aim of this review is to highlight the effects of DHEAS and testosterone treatment to counteract sarcopenia, especially in older men. RECENT FINDINGS DHEAS and, more importantly, testosterone treatment are associated with increased muscle mass, whereas the effects on muscle function and physical performance are less clear. The results of recent randomized placebo controlled trials with DHEAS in older men and women and testosterone in men with mobility limitation are discussed. The novel current and future scenarios to attenuate the detrimental effects and to optimize the efficacy of sex hormone treatment are also addressed. SUMMARY DHEAS and testosterone are important options in the armamentarium of sarcopenia treatment in older men. Future studies are needed to address new approaches by using selective compounds, targeting the correct form and dosage, tailoring the correct patient to treat, and taking into account the multifactorial origin and the new definition of sarcopenia.
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Affiliation(s)
- Marcello Maggio
- Department of Clinical and Experimental Medicine, Section of Geriatrics, University of Parma, Parma, Italy.
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Yan H, Guo Y, Yang TL, Zhao LJ, Deng HW. A family-based association study identified CYP17 as a candidate gene for obesity susceptibility in Caucasians. GENETICS AND MOLECULAR RESEARCH 2012; 11:1967-74. [PMID: 22653668 DOI: 10.4238/2012.may.22.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The cytochrome P450c17α gene (CYP17) encodes a key biosynthesis enzyme of estrogen, which is critical in regulating adipogenesis and adipocyte development in humans. We therefore hypothesized that CYP17 is a candidate gene for predicting obesity. In order to test this hypothesis, we performed a family-based association test to investigate the relationship between the CYP17 gene and obesity phenotypes in a large sample comprising 1873 subjects from 405 Caucasian nuclear families of European origin recruited by the Osteoporosis Research Center of Creighton University, USA. Both single SNPs and haplotypes were tested for associations with obesity-related phenotypes, including body mass index (BMI) and fat mass. We identified three SNPs to be significantly associated with BMI, including rs3740397, rs6163, and rs619824. We further characterized the linkage disequilibrium structure for CYP17 and found that the whole CYP17 gene was located in a single-linkage disequilibrium block. This block was observed to be significantly associated with BMI. A major haplotype in this block was significantly associated with both BMI and fat mass. In conclusion, we suggest that the CYP17 gene has an effect on obesity in the Caucasian population. Further independent studies will be needed to confirm our findings.
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Affiliation(s)
- H Yan
- Key Laboratory of Biomedical Information Engineering, Ministry of Education and Institute of Molecular Genetics, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China
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