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Effects of androgen therapy on adipose tissue and metabolism in older men
E Todd Schroeder1, Ling Zheng, Michelle D Ong
1Department of Medicine and Division of Infectious Diseases, University of Southern California, Los Angeles, California 90033, USA.
Abstract:
We investigated the effects of oxandrolone on regional fat compartments and markers of metabolism. Thirty-two 60- to 87-yr-old men (body mass index, 28.1 +/- 3.4 kg/m(2)) were randomized to oxandrolone (20 mg/d; n = 20) or matching placebo (n = 12) treatment for 12 wk. Oxandrolone reduced total (-1.8 +/- 1.0 kg; P < 0.001), trunk (-1.2 +/- 0.6 kg; P < 0.001), and appendicular (-0.6 +/- 0.6 kg; P < 0.001) fat, as determined by dual energy x-ray absorptiometry. The changes in total and trunk fat were greater (P < 0.001) than the changes with placebo. By magnetic resonance imaging, visceral adipose tissue decreased (-20.9 +/- 12 cm(2); P < 0.001), abdominal sc adipose tissue (SAT) declined (-10.7 +/- 12.1 cm(2); P = 0.043), the ratio VAT/SAT declined from 0.57 +/- 0.23 to 0.49 +/- 0.19 (P = 0.002), and proximal and distal thigh SC fat declined [-8.3 +/- 6.7 cm(2) (P < 0.001) and -2.2 +/- 3.0 kg (P = 0.004), respectively]. Changes in proximal and distal thigh SC fat with oxandrolone were different than with placebo (P = 0.018 and P = 0.059). A marker of insulin sensitivity (quantitative insulin sensitivity check index) improved with oxandrolone by 0.0041 +/- 0.0071 (P = 0.018) at study wk 12. Changes in total fat, abdominal SAT, and proximal extremity SC fat were correlated with changes in fasting insulin from baseline to study wk 12 (r >or= 0.45; P < 0.05). Losses of total fat and SAT were greater in men with baseline testosterone of 10.4 nmol/liter or less (
Insights
Oxandrolone treatment in older men significantly reduced body fat, including visceral and subcutaneous adipose tissue, and improved insulin sensitivity. These fat reductions were largely sustained after treatment cessation.
Area of Science:
- Endocrinology
- Metabolic Health
- Gerontology
Background:
- Aging is associated with increased adiposity and metabolic dysfunction.
- Low testosterone levels in older men can contribute to adverse body composition and metabolic profiles.
Purpose of the Study:
- To investigate the effects of oxandrolone on regional fat distribution and metabolic markers in older men.
- To assess the durability of fat reduction and changes in lipid profiles after oxandrolone treatment cessation.
Main Methods:
- Randomized, placebo-controlled trial involving 32 older men (60-87 years) treated with oxandrolone (20 mg/d) or placebo for 12 weeks.
- Body composition assessed by dual-energy x-ray absorptiometry and magnetic resonance imaging.
- Metabolic markers, including insulin sensitivity and lipid profiles, were measured.
Main Results:
- Oxandrolone significantly reduced total, trunk, and appendicular fat, as well as visceral and subcutaneous adipose tissue.
- Insulin sensitivity improved, and fat loss was greater in men with lower baseline testosterone levels.
- Lipid profiles showed a decrease in HDL and an increase in LDL and non-HDL cholesterol during treatment, which were reversible.
Conclusions:
- Oxandrolone therapy leads to significant and durable reductions in regional fat depots in older men.
- These effects are associated with improvements in insulin sensitivity, particularly in men with low testosterone.
- While transient adverse lipid changes occurred, oxandrolone may be beneficial for metabolic syndrome components in select older men.
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