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Effects of Testosterone Replacement and/or Resistance Exercise on the Composition of Megestrol Acetate Stimulated Weight Gain in Elderly Men: A Randomized Controlled Trial

Nutrition, Metabolism, and Exercise Laboratory, Donald W. Reynolds Center on Aging (C.P.L., S.A.F., W.J.E.), Department of Radiology (D.M.L.), The University of Arkansas for Medical Sciences and the Geriatric Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System (C.P.L., D.H.S., S.A.F., W.J.E.), Little Rock, Arkansas 72205

Address all correspondence and requests for reprints to: William J. Evans, Ph.D., Nutrition, Metabolism, and Exercise Laboratory, Donald W. Reynolds Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205. E-mail: . EvansWilliamJ{at}uams.edu

Abstract

Megestrol acetate (MA) (Bristol-Myers Squibb Co., Princeton, NJ) increases weight gain in AIDS and cancer patients and in age-related cachexia; however, the weight gain is predominately fat. We determined if adding resistance exercise and/or testosterone (T) replacement to MA administration would result in a more favorable body composition change than MA alone. Thirty older men (aged 67.0 ± 5.8) completed this 12-wk study. All subjects received MA and were randomly assigned to one of the following groups: placebo (P) injections, resistance training (RT) and P (RT + P), weekly injections of T (100 mg/wk) or, RT and T (RT + T). The mean increase in body weight for all groups combined was 3.8 kg (P < 0.0001), but this increase was not different between groups. There was a significant interaction for the change in thigh muscle cross-sectional area (P = 0.0006). Thigh muscle cross-sectional area was significantly reduced from baseline by 5.20 [1.62] cm² (P = 0.05) in P which was not prevented in T [-4.44 (1.66) cm² from baseline; P = 0.04]. RT prevented this decline [+0.61 (1.41) cm² from baseline]. Muscle cross-sectional area increased 4.51 (1.69) cm² from baseline in RT + T (P = 0.002 vs. P and P = 0.002 vs. T). Despite significant weight gain, MA appears to have an antianabolic effect on muscle size even when combined with T replacement. Resistance exercise attenuated this reduction in muscle mass and when combined with T had an anabolic effect on muscle mass.

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