PDF(Pubmed)
Abstract：
BACKGROUND: Based on the largely untested premise that it is a restorative hormone that may reverse the detrimental impacts of aging, prescription of testosterone (T) has increased in recent decades despite no new clinical indications. It is apparent that middle-aged and older men with low-normal serum T levels are considering T supplementation as an anti-aging strategy. At the same time, there is evidence that physical activity (PA) is at historical lows in the Western world. In this review, we compare the impacts of T treatment aimed at achieving physiological T concentrations in middle-aged and older men, alongside the impacts of ecologically relevant forms of exercise training. The independent, and possible combined, effects of T and exercise therapy on physiological outcomes such as aerobic fitness, body composition and muscular strength are addressed.
METHODS: Our findings suggest that both T treatment and exercise improve lean body mass in healthy older men. If improvement in lean body mass is the primary aim, then T treatment could be considered, and the combination of T and exercise may be more beneficial than either in isolation. In terms of muscle strength in older age, an exercise program is likely to be more beneficial than T treatment (where the dose is aimed at achieving physiological concentrations), and the addition of such T treatment does not provide further benefit beyond that of exercise alone. For aerobic fitness, T at doses aimed at achieving physiological concentrations has relatively modest impacts, particularly in comparison to exercise training, and there is limited evidence as to additive effects. Whilst higher doses of T, particularly by intramuscular injection, may have larger impacts on lean body mass and strength, this must be balanced against potential risks.
CONCLUSIONS: Knowing the impacts of T treatment and exercise on variables such as body composition, strength and aerobic fitness extends our understanding of the relative benefits of physiological and pharmacological interventions in aging men. Our review suggests that T has impacts on strength, body composition and aerobic fitness outcomes that are dependent upon dose, route of administration, and formulation. T treatment aimed at achieving physiological T concentrations in middle-aged and older men can improve lean body mass, whilst exercise training enhances lean body mass, aerobic fitness and strength. Men who are physically able to exercise safely should be encouraged to do so, not only in terms of building lean body mass, strength and aerobic fitness, but for the myriad health benefits that exercise training confers.
METHODS: Our findings suggest that both T treatment and exercise improve lean body mass in healthy older men. If improvement in lean body mass is the primary aim, then T treatment could be considered, and the combination of T and exercise may be more beneficial than either in isolation. In terms of muscle strength in older age, an exercise program is likely to be more beneficial than T treatment (where the dose is aimed at achieving physiological concentrations), and the addition of such T treatment does not provide further benefit beyond that of exercise alone. For aerobic fitness, T at doses aimed at achieving physiological concentrations has relatively modest impacts, particularly in comparison to exercise training, and there is limited evidence as to additive effects. Whilst higher doses of T, particularly by intramuscular injection, may have larger impacts on lean body mass and strength, this must be balanced against potential risks.
CONCLUSIONS: Knowing the impacts of T treatment and exercise on variables such as body composition, strength and aerobic fitness extends our understanding of the relative benefits of physiological and pharmacological interventions in aging men. Our review suggests that T has impacts on strength, body composition and aerobic fitness outcomes that are dependent upon dose, route of administration, and formulation. T treatment aimed at achieving physiological T concentrations in middle-aged and older men can improve lean body mass, whilst exercise training enhances lean body mass, aerobic fitness and strength. Men who are physically able to exercise safely should be encouraged to do so, not only in terms of building lean body mass, strength and aerobic fitness, but for the myriad health benefits that exercise training confers.
摘要：
背景：基于很大程度上未经测试的前提，即它是一种恢复性激素，可以逆转衰老的有害影响，尽管没有新的临床适应症，但近几十年来睾酮（T）的处方有所增加。显然，正常血清T水平低的中年和老年男性正在考虑补充T作为抗衰老策略。同时,有证据表明，体力活动（PA）在西方世界处于历史低点。在这次审查中,我们比较了在中年和老年男性中实现生理T浓度的T治疗的影响，以及与生态相关的运动训练形式的影响。独立的,和可能的组合，T和运动疗法对有氧健身等生理结果的影响，身体成分和肌肉力量得到解决。
方法：我们的研究结果表明，T治疗和运动都能改善健康老年男性的瘦体重。如果改善瘦体重是主要目标，然后可以考虑T治疗，T和运动的组合可能比单独使用更有益。在老年人的肌肉力量方面，锻炼计划可能比T治疗（剂量旨在达到生理浓度）更有益，并且这种T治疗的增加并不能提供超出单独运动的进一步益处。对于有氧健身，T在旨在达到生理浓度的剂量具有相对适度的影响，特别是与运动训练相比，关于加性效应的证据有限。虽然较高剂量的T，特别是肌肉注射，可能会对瘦体重和力量产生更大的影响，这必须与潜在风险保持平衡。
结论：了解T治疗和运动对身体成分等变量的影响，力量和有氧健身扩展了我们对衰老男性生理和药物干预的相对益处的理解。我们的审查表明，T对力量有影响，身体成分和有氧健身结果取决于剂量，给药途径,和配方。旨在实现中老年男性生理T浓度的T治疗可以改善瘦体重，而运动训练增强瘦体重，有氧健身和力量。应该鼓励身体上能够安全运动的男人这样做，不仅在建立瘦体重方面，力量和有氧健身，而是运动训练赋予的无数健康益处。
方法：我们的研究结果表明，T治疗和运动都能改善健康老年男性的瘦体重。如果改善瘦体重是主要目标，然后可以考虑T治疗，T和运动的组合可能比单独使用更有益。在老年人的肌肉力量方面，锻炼计划可能比T治疗（剂量旨在达到生理浓度）更有益，并且这种T治疗的增加并不能提供超出单独运动的进一步益处。对于有氧健身，T在旨在达到生理浓度的剂量具有相对适度的影响，特别是与运动训练相比，关于加性效应的证据有限。虽然较高剂量的T，特别是肌肉注射，可能会对瘦体重和力量产生更大的影响，这必须与潜在风险保持平衡。
结论：了解T治疗和运动对身体成分等变量的影响，力量和有氧健身扩展了我们对衰老男性生理和药物干预的相对益处的理解。我们的审查表明，T对力量有影响，身体成分和有氧健身结果取决于剂量，给药途径,和配方。旨在实现中老年男性生理T浓度的T治疗可以改善瘦体重，而运动训练增强瘦体重，有氧健身和力量。应该鼓励身体上能够安全运动的男人这样做，不仅在建立瘦体重方面，力量和有氧健身，而是运动训练赋予的无数健康益处。
