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Anabolic and Inflammatory Responses to Short-Term Testosterone Administration in Older Men

Information source: The University of Texas Medical Branch, Galveston
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Sarcopenia

Intervention: Testosterone injection (Drug); Testosterone gel (Drug)

Phase: Phase 4

Status: Recruiting

Sponsored by: The University of Texas Medical Branch, Galveston

Official(s) and/or principal investigator(s):
Randall J Urban, M.D., Principal Investigator, Affiliation: The University of Texas Medical Branch at Galveston

Overall contact:
Randall J Urban, M.D., Phone: (409) 772-1176, Email: rurban@utmb.edu

Summary

Skeletal muscle loss is a common consequence of aging and in some individuals reaches a level that compromises health and quality of life. Age-associated increases in cytokine and inflammatory signaling may be important contributors to this process. In this project the investigators will test the hypotheses that 1) testosterone will inhibit cytokine and inflammatory signaling in skeletal muscles of older adults and 2) will augment the anabolic response to increased skeletal muscle activity. The investigators will also assess the practical question of whether testosterone injection and gel application elicit similar responses. Resistance exercise will be used as a means of stimulating both inflammatory and anabolic responses in skeletal muscle. In order to assess the effects of testosterone on these responses, fourteen subjects will perform resistance exercise on two occasions separated by 7 days. The first session will be performed prior to the initiation of testosterone therapy and the second session will be performed after receiving testosterone for 7 days.

Clinical Details

Official title: Anabolic and Inflammatory Responses to Short-Term Testosterone Administration in Older Men

Study design: Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Primary outcome:

Muscle protein synthesis and breakdown with and without testosterone treatment following resistance exercise

Serum and skeletal muscle cytokine levels and inflammatory signaling will be measured before and after a standardized bout of resistance exercise, both with and without testosterone treatment

Secondary outcome: Comparison of anabolic response and inflammatory response in muscle treated with injected testosterone versus testosterone gel

Detailed description: In this project we will study the acute response to testosterone treatment between two groups of seven subjects each, comparing two methods of administration (injection vs. topical gel) in a sequential fashion in order to obtain pilot information for a subsequent, randomized, blinded long-term investigation. The first session will be performed prior to the initiation of testosterone therapy and the second session will be performed after receiving testosterone for 7 days. Because dietary intake, particularly protein intake, can influence muscle metabolism, subjects will be placed on standardized diets for the twenty four hour period preceding muscle metabolism studies in order to reduce the likelihood of skewed results due to variations in nutritional intake just prior to these studies. In addition, subjects will be asked to maintain a food intake diary for the three day period prior to metabolism studies in order to document dietary intake in the days leading up to muscle metabolism studies. Subjects will also be asked to complete a fatigue questionnaire at baseline and at the final study to assess perceived changes in fatigue between the two treatment groups over the treatment period. Subjects will also collect their urine over a twenty four hour period prior to baseline and final studies to measure cortisol levels, which can influence the rate of protein breakdown.

Eligibility

Minimum age: 60 Years. Maximum age: 85 Years. Gender(s): Male.

Criteria:

Inclusion Criteria:

- Age: 60-85

- Gender: Male

Exclusion Criteria:

- Exclusionary medications will be an anticoagulant (Coumadin) because of the risk of

bleeding during the biopsy procedure. Additional medications which will be disallowed for participation include: anabolic steroids, nitrates, antihistamines, and glucocorticoids.

- The subjects must be able to successfully complete an exercise stress test using the

Bruce protocol . Subjects will be excluded without exercise testing, with a history of angina that occurs with exertion or at rest, or a myocardial infarction within the last 12 months. Subjects that demonstrate ³0. 1 milliVolts (mV) horizontal or downsloping ST segment depression, a drop in systolic blood pressure of ³10 mm Hg, and/or frequent or repetitive arrhythmias (defined as ³10 premature ventricular contractions (PVC)/min, or couplets) during the stress test will be excluded.

- Subjects with LDL cholesterol above 200 mg/dL will be excluded .

- Any man with a history of breast cancer or prostate cancer, or any indication of an

occult carcinoma from an elevation of prostate specific antigen (PSA) above 4. 0 mg/L (53), or severe benign prostatic hypertrophy (BPH) by history (frequent urination, reduced stream) will be excluded.

- Subjects with liver dysfunction evidenced by a history of hepatitis B or hepatitis C,

or by a three-fold elevation of liver enzymes (Alk phos, alanine aminotransferase (ALT), aspartate amino-transferase (AST) above normal on screening will be excluded from the study.

- Any subject with a blood pressure on three consecutive measurements taken at one week

intervals that has a systolic pressure ³ 140 or a diastolic blood pressure ³ 90 will be excluded.

- Any subject who has a major medical illness such as diabetes, chronic obstructive

pulmonary disease, or sleep apnea will be excluded. Moreover, subjects will not have a recent history of smoking tobacco. Morbidly obese older men (BMI > 35) will also be excluded.

- Subjects will evidence of kidney disease (serum creatinine > 2. 0mg/dl) will be

excluded from participation.

- Any subject with thyroid disease as determined by an abnormal thyroid stimulating

hormone (TSH) level will be excluded from participation.

- Any subject testing positive for HIV will be excluded .

- Allergy to iodine, a component of Betadine which is used to prepare the subject's

skin for invasive procedures, will be cause for exclusion from this study.

- Men with serum total testosterone concentrations greater than 500 ng/dL will be

excluded.

- Subjects who engage in high intensity resistance training on a regular basis will be

excluded.

- Subjects with a known coagulation disorder or with clinical evidence indicative of a

bleeding disorder (easy bruising, "free bleeders") will not be enrolled in this study due to potential problems that could arise from muscle biopsy procedures.

Locations and Contacts

Randall J Urban, M.D., Phone: (409) 772-1176, Email: rurban@utmb.edu

The University of Texas Medical Branch at Galveston, Galveston, Texas 77555-0567, United States; Recruiting
Randall J Urban, M.D., Phone: 409-772-1176, Email: rurban@utmb.edu
Charles R Gilkison, RN,MSN, Phone: (409) 772-2065, Email: cgilkiso@utmb.edu
Melinda Sheffield-Moore, Ph.D., Sub-Investigator
William Durham, Ph.D., Sub-Investigator
Additional Information

Starting date: August 2009
Last updated: January 13, 2015

Page last updated: August 23, 2015

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