Effects of testosterone and progressive resistance training in eugonadal men with AIDS wasting - A randomized, controlled trial

Background: Substantial loss of muscle mass occurs among men with AIDS wast ing. Objective: To investigate the independent effects of testosterone therapy a nd progressive resistance training in eugonadal men with AIDS wasting. Design: Randomized, controlled trial. Setting: University hospital. Patients: 54 eugonadal men with AIDS wasting (weight < 90% ideal body weigh t or weight loss > 10%). Intervention: In a 2 x 2 factorial design, patients were assigned to receiv e testosterone enanthate (200 mg/wk) or placebo injections and progressive resistance training (three times weekly) or no training for 12 weeks. Measurements: Cross-sectional muscle area and other indices of muscle mass. Results: Cross-sectional muscle area increased in response to training comp ared with nontraining (change in arm muscle mass, 499 +/- 349 mm(2) vs. 206 +/- 264 mm(2) [P = 0.004]; change in leg muscle mass, 1106 +/- 854 mm(2) v s. 523 +/- 872 mm(2) [P = 0.045]) and in response to testosterone therapy c ompared with placebo (change in arm muscle mass, 512 +/- 371 mm(2) vs. 194 +/- 215 mm(2) [P < 0.001]; change in leg muscle mass, 1236 +/- 881 mm(2) vs . 399 +/- 729 mm(2) [P = 0.002]). Levels of high-density lipoprotein choles terol decreased in response to testosterone therapy compared with placebo ( -0.03 +/- 0.13 mmol/L vs. 0.05 +/- 0.13 mmol/L [-1 +/- 5 mg/dL vs. 2 +/- 5 mg/dL]; P = 0.011) and increased in response to training compared with nont raining (0.05 +/- 0.13 mmol/L vs. 0.00 +/- 0.16 mmol/L [2 +/- 5 mg/dL vs. 0 +/- 6 mg/dL]; P = 0.052). Conclusions: In contrast to anabolic therapies that may have adverse effect s on metabolic variables, supervised exercise effectively increases muscle mass and is associated with significant positive health benefits in eugonad al men with AIDS wasting.