-
Journal of the American Geriatrics... Nov 2006To review published, randomized trials examining the effect of androgen treatment on muscle strength in older men. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To review published, randomized trials examining the effect of androgen treatment on muscle strength in older men.
DESIGN
Systematic review using meta-analysis procedures.
SETTING
Computerized and manual searches.
PARTICIPANTS
MEDLINE, EMBASE, CINAHL, and the Cochrane Register were searched for trials. Key words included testosterone, androgen, sarcopenia, muscle loss, aged, aging, elderly, older, geriatric, randomized controlled trials, and controlled clinical trials. Sixty-five nonoverlapping studies were found. Meta-analysis methods were used to evaluate the 11 randomized, double-blind trials.
INTERVENTION
Testosterone or dihydrotestosterone (DHT) replacement therapy in healthy men aged 65 and older.
MEASUREMENTS
Tests of muscle strength.
RESULTS
The studies included 38 statistical comparisons. The mean g-index (g(i)) adjusted for sample size was 0.53 (95% confidence interval (CI) = 0.21-0.86). Subanalyses revealed larger effects for measures of lower extremity muscle strength (g(i) = 0.63, 95% CI = 0.03-1.28) than for upper extremity muscle strength (g(i) = 0.47, 95% CI = 0.12-0.84). A larger mean g-index was found for injected (g(i) = 0.95, 95% CI = 0.33-1.58) than topical (g(i) = 0.26, 95% CI = 0.08-0.42) or oral (g(i) = -0.21, 95% CI = -1.40-1.02) administration of testosterone/DHT. Effect sizes were related to study characteristics such as subject attrition and design-quality ratings. Sensitivity analyses revealed that the elimination of one study reduced the mean g-index from 0.53 to 0.23.
CONCLUSION
The results suggest that testosterone/DHT therapy produced a moderate increase in muscle strength in men participating in 11 randomized trials. One study influenced the mean effect size.
Topics: Aged; Dihydrotestosterone; Hormone Replacement Therapy; Humans; Male; Muscle Strength; Randomized Controlled Trials as Topic; Testosterone
PubMed: 17087692
DOI: 10.1111/j.1532-5415.2006.00938.x