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From the Clinical Research Centers |
Department of Medicine, Division of Infectious Diseases (F.R.S., C.O., M.P.D.) and Endocrinology (C.M., R.H.), Department of Biokinesiology and Physical Therapy (S.V.J., E.T.S.), and Department of Preventive Medicine (S.A.), University of Southern California School of Medicine, Los Angeles County-University of Southern California Medical Center, Los Angeles, California 90033
Address all correspondence and requests for reprints to: Dr. Fred R. Sattler, Los Angeles County-University of Southern California Medical Center, 1300 North Mission Road, Los Angeles, California 90033.
This nonplacebo-controlled, open label, randomized study was conducted
to test the hypotheses that pharmacological doses of nandrolone
decanoate would increase lean body tissue, muscle mass, and strength in
immunodeficient human immunodeficiency virus-infected men, and that
these effects would be enhanced with progressive resistance training
(PRT). Thirty human immunodeficiency virus-positive men with fewer than
400 CD4 lymphocytes/mm3 were randomly assigned to receive
weekly injections of nandrolone alone or in combination with supervised
PRT at 80% of the one-repetition maximum three times weekly for 12
weeks. Total body weight increased significantly in both groups
(3.2 ± 2.7 and 4.0 ± 2.0 kg, respectively;
P < 0.001), with increases due primarily to
augmentation of lean tissue. Lean body mass determined by 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 mass 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 magnitude (P = NS).
Significant increases in cross-sectional area by magnetic resonance
imaging of total thigh muscles (1538 ± 767 and 1480 ± 532
mm2), quadriceps (705 ± 365 and 717 ± 288
mm2), and hamstrings (842 ± 409 and 771 ± 295
mm2) 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
group and from 14.4–53.0% in the PRT group (P <
0.006 with one exception). Gains in strength were of significantly
greater magnitude in the PRT group (P 
0.005 for
all comparisons), even after correction for lean body mass. Thus,
pharmacological doses of nandrolone decanoate yielded significant gains
in total weight, lean body mass, body cell mass, muscle size, and
strength. The increases in lean body mass and muscular strength were
significantly augmented with PRT.
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