男性肝硬化睾酮治疗增加肌肉质量

StephenW

Testosterone therapy increases muscle mass in men with cirrhosis

Sinclair M, et al. J Hepatol. 2016;doi:10.1016/j.jhep.2016.06.007.
June 20, 2016

   
Administering testosterone to men with cirrhosis and low testosterone safely and effectively increased muscle and bone mass, suggesting testosterone may increase survival for this patient population, according to results of a placebo-controlled trial.


“This trial demonstrates for the first time that testosterone therapy can safely increase muscle mass in men with cirrhosis who have low baseline testosterone levels and thus represents the first evidence-based therapy for sarcopenia in cirrhosis,” Marie Sinclair, MD, of the Liver Transplant Unit, Austin Health, Melbourne, Australia, and colleagues wrote.

The researchers at a single tertiary center randomly assigned 101 men with established cirrhosis and low serum testosterone either placebo (n = 51) or testosterone (n = 50) for 1 year. Body composition was measured at baseline, 6 and 12 months in each patient using dual-energy X-ray absorptiometry.

After 1 year, appendicular lean mass was higher in men treated with testosterone (mean adjusted difference [MAD] = 1.69 kg; 95% CI, 0.4-2.97). Men treated with testosterone also had a higher total lean mass (MAD = 4.74 kg; 95% CI, 1.75-7.74), matched by reduced fat mass (MAD = –4.34 kg; 95% CI, –6.65 to –2.04).

In addition, total bone mass (MAD = 0.08 kg; 95% CI, 0.01-0.15) and bone mineral density at the femoral neck (MAD = 0.287 points; 95% CI, 0.14-0.434) increased in patients treated with testosterone.

After testosterone therapy, hemoglobin was higher (MAD = 10.2 g/L; 95% CI, 1.5-18.9) and hemoglobin A1c was lower (MAD = –0.35%; 95% CI, –0.05 to –0.54).

Neither group experienced cardiovascular events, infection or bleeding at injection site, nor was there any increase in adverse events in the patients treated with testosterone.

Mortality was lower in men treated with testosterone. However, the researchers note that it was insignificantly lower compared with men treated with placebo (16% vs. 25.5%; P = .352).

The researchers concluded: “Both low testosterone and muscle wasting are associated with increased risk of death in men with severe liver disease. … Testosterone has non-muscle beneficial effects which may be able to increase survival in this population.” – by Melinda Stevens

Disclosure: Sinclair reports no relevant financial disclosures. Please see the full study for a list of all other researchers’ relevant financial disclosures.

StephenW

睾酮治疗增加肌肉质量的男性肝硬化

辛克莱M，等。肝脏病学杂志。 2016年，DOI：10.1016 / j.jhep.2016.06.007。
2016年6月20日
男性肝硬化睾酮治疗增加肌肉质量的男性肝硬化
   
管理睾酮男性肝硬化和睾丸激素水平低安全有效地增加肌肉和骨量，提示睾丸激素可能会增加生存这一患者群体，根据安慰剂对照试验结果。


“这项试验表明，第一次，睾丸激素治疗可以安全地增加肌肉质量的男性肝硬化谁低基线睾酮水平，从而代表肝硬化的肌肉衰减症的第一个证据为基础的疗法，”玛丽·辛克莱，MD，肝脏移植的单位，卫生甸澳大利亚墨尔本，和同事写道。

在一个单一的三级医疗中心研究人员随机分配101人既定的肝硬化和低血清睾酮或者安慰剂（n = 51）或睾酮（N = 50）为1年。体组合物在基线，第6和在使用双能X线骨密度每个患者12月计。

1年后，阑尾瘦体重是与睾丸激素治疗男性高（平均调整差异[MAD] =1.69千克; 95％CI，0.4-2.97）。睾酮治疗的男性也有较高的总瘦体重（MAD =4.74千克; 95％CI，1.75-7.74），通过减少脂肪量相匹配（MAD = -4.34公斤; 95％CI，-6.65至-2.04）。

此外，总骨量（MAD = 0.08公斤; 95％CI，0.01-0.15）和骨密度股骨颈（MAD = 0.287分; 95％CI，0.14-0.434）增加患者的睾丸激素治疗。

睾丸激素治疗后，血红蛋白较高（MAD = 10.2Hz克/升; 95％CI，1.5-18.9）和糖化血红蛋白明显降低（MAD = -0.35％; 95％CI，-0.05 -0.54到）。

既不组经历心血管事件，感染或注射部位的出血，也没有在用睾酮治疗的患者的不良事件的任何增加。

死亡率与睾酮治疗的男性低。不过，研究人员指出，这与安慰剂治疗男性相比无显着被降低（16％比25.5％，P = 0.352）。

研究人员得出结论：“无论是低睾酮和肌肉萎缩都与男性严重肝病死亡的风险增加有关。 ...睾酮具有可以是能够增加在该人群生存非肌肉有益效果。“ - 由梅林达史蒂文斯

披露：报告辛克莱没有相关财务披露。请参阅其他研究者的相关财务信息披露的名单充分研究。