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Published on: July 5, 2017
Androgen treatment and muscle strength in elderly men: A meta-analysis
Kenneth J Ottenbacher1, Margaret E Ottenbacher, Allison J Ottenbacher
1Division of Rehabilitation Sciences, Sealy Center on Aging, Houston, Texas, USA. kottenba@utmb.edu
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.
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