Nelson Vergel
Founder, ExcelMale.com
Abstract
Objective
Age-related declines in muscle and bone, alongside a shift towards greater adiposity, contribute to falls and fracture risk. Testosterone is osteogenic, myogenic, and catabolic to fat. As such, we examined the effects of testosterone therapy on musculoskeletal health and clinical outcomes in men.
Methods
Electronic databases (Medline, Embase, Web of Science, Central) were systematically searched for randomized controlled trials (RCTs) reporting on the effects of testosterone therapy versus placebo on any primary outcome (bone density, muscle mass, fat mass, muscle strength/physical performance) or secondary outcome (falls, fractures, disability, adverse events) in men (≥18 years). A random effects meta-regression examined the effects of testosterone on pre-specified outcomes.
Results
1728 men across 16 RCTs were included (mean age: 77.1±7.6 years). Baseline mean serum testosterone ranged from 7.5±0.3 to 18.9±1.2 nmol/L. Compared to placebo, six months of testosterone therapy increased hip bone density and total lean mass, but effects for handgrip and total fat mass did not reach statistical significance. No significant effects of testosterone therapy on musculoskeletal outcomes were evident at twelve months. The limited number of RCTs reporting on adverse events/clinical outcomes, and the low incidence of these events across RCTs, prohibited statistical comparisons.
Conclusion
After 6 months, testosterone effectively increases hip bone density and total lean mass in men, but its effects are unclear for lumbar spine bone density and handgrip strength. Further RCTs are needed to clarify the safety and efficacy of testosterone on musculoskeletal health and clinical outcomes.
Objective
Age-related declines in muscle and bone, alongside a shift towards greater adiposity, contribute to falls and fracture risk. Testosterone is osteogenic, myogenic, and catabolic to fat. As such, we examined the effects of testosterone therapy on musculoskeletal health and clinical outcomes in men.
Methods
Electronic databases (Medline, Embase, Web of Science, Central) were systematically searched for randomized controlled trials (RCTs) reporting on the effects of testosterone therapy versus placebo on any primary outcome (bone density, muscle mass, fat mass, muscle strength/physical performance) or secondary outcome (falls, fractures, disability, adverse events) in men (≥18 years). A random effects meta-regression examined the effects of testosterone on pre-specified outcomes.
Results
1728 men across 16 RCTs were included (mean age: 77.1±7.6 years). Baseline mean serum testosterone ranged from 7.5±0.3 to 18.9±1.2 nmol/L. Compared to placebo, six months of testosterone therapy increased hip bone density and total lean mass, but effects for handgrip and total fat mass did not reach statistical significance. No significant effects of testosterone therapy on musculoskeletal outcomes were evident at twelve months. The limited number of RCTs reporting on adverse events/clinical outcomes, and the low incidence of these events across RCTs, prohibited statistical comparisons.
Conclusion
After 6 months, testosterone effectively increases hip bone density and total lean mass in men, but its effects are unclear for lumbar spine bone density and handgrip strength. Further RCTs are needed to clarify the safety and efficacy of testosterone on musculoskeletal health and clinical outcomes.
