Effects of pharmacological doses of nandrolone decanoate and progressive resistance training in immunodeficient patients infected with human immunodeficiency virus

This nonplacebo-controlled, open label, randomized study was conducted to t est the hypotheses that pharmacological doses of nandrolone decanoate would increase lean body tissue, muscle mass, and strength in immunodeficient hu man immunodeficiency virus-infected men, and that these effects would be en hanced Kith progressive resistance training(PRT). Thirty human immunodefici ency virus-positive men with fewer than 400 CD4 lymphocytes/mm(3) were rand omly assigned to receive weekly injections of nandrolone alone or in combin ation with supervised PRT at 80% of the one-repetition maximum three times weekly for 12 weeks. Total body weight increased significantly in both grou ps (3.2 +/- 2.7 and 4.0 +/- 2.0 kg, respectively; P < 0.001), with increase s due primarily to augmentation of lean tissue. Lean body mass determined b y dual energy x-ray absorptiometry increased significantly more in the PRT group (3.9 +/- 2.3 vs. 5.2 +/- 5.7 kg, respectively; P = 0.03). Body cell m ass by bioelectrical impedance analysis increased significantly (P < 0.001) in both groups (2.6 +/- 1.0 vs. 2.9 +/- 0.8 kg), but to a similar magnitud e (P = NS). Significant increases in cross-sectional area by magnetic reson ance imaging of total thigh muscles (1538 +/- 767 and 1480 +/- 532 mm(2)), quadriceps (705 +/- 365 and 717 +/- 288 mm(2)), and hamstrings (842 +/- 409 and 771 +/- 295 mm(2)) occurred with both treatment strategies (P < 0.001 for the three muscle areas); these increases were similar in both groups (P = NS). By the one-repetition method? strength increased in both upper and lower body exercises, with gains ranging from 10.3-31% in the nandrolone gr oup and from 14.4-53.0% in the PRT group (P < 0.006 with one exception). Ga ins in strength were of significantly greater magnitude in the PRT group (P less than or equal to 0.005 for all comparisons), even after correction fo r lean body mass. Thus, pharmacological doses of nandrolone decanoate yield ed significant gains in total weight, lean body mass, body cell mass, muscl e size, and strength. The increases in lean body mass and muscular strength were significantly augmented with PRT.