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      Short-Term Exercise Training Inconsistently Influences Basal Testosterone in Older Men: A Systematic Review and Meta-Analysis

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          Abstract

          Background: The age-associated decrease in testosterone is one mechanism suggested to accelerate the aging process in males. Therefore, approaches to increase endogenous testosterone may be of benefit. The aim of this paper was to undertake a Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA)-accordant meta-analysis concerning the effect of exercise on total (TT), bioavailable (bio-T), free (free-T), and salivary (sal-T) testosterone in older males.

          Methods: Databases were searched up to and including 20th February 2018 for the terms “testosterone AND exercise AND aging AND males,” “testosterone AND exercise AND old AND males,” “testosterone AND training AND aging AND males,” and “testosterone AND training AND old AND males”. From 1259 originally identified titles, 22 studies (randomized controlled trials; RCTs; n = 9, and uncontrolled trials; UCTs; n = 13) were included which had a training component, participants ≥60 years of age, and salivary or serum testosterone as an outcome measure. Meta-analyses were conducted on change to testosterone following training using standardized difference in means (SDM) and random effects models.

          Results: The overall SDM for endurance training, resistance training, and interval training was 0.398 (95% CI = 0.034–0.761; P = 0.010), −0.003 (95% CI = −0.330–0.324; P = 0.986), and 0.283 (95% CI = 0.030–0.535; P = 0.028), respectively. Resistance training exhibited a qualitative effect of hormone fraction whereby free-T resulted in the greatest SDM (0.253; 95% CI = −0.043–0.549; P = 0.094), followed by TT (0.028; 95% CI = −0.204–0.260; P = 0.813), and resistance training negatively influenced bio-T (−0.373; 95% CI = −0.789–0.042; P = 0.078). Due to the small number of studies, subgroup analysis was not possible for endurance training and interval training studies.

          Conclusions: Data from the present investigation suggests that resistance training does not significantly influence basal testosterone in older men. Magnitude of effect was influenced by hormone fraction, even within the same investigation. Aerobic training and interval training did result in small, significant increases in basal testosterone. The magnitude of effect is small but the existing data are encouraging and may be an avenue for further research.

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          Most cited references62

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          Adverse events associated with testosterone administration.

          Testosterone supplementation has been shown to increase muscle mass and strength in healthy older men. The safety and efficacy of testosterone treatment in older men who have limitations in mobility have not been studied. Community-dwelling men, 65 years of age or older, with limitations in mobility and a total serum testosterone level of 100 to 350 ng per deciliter (3.5 to 12.1 nmol per liter) or a free serum testosterone level of less than 50 pg per milliliter (173 pmol per liter) were randomly assigned to receive placebo gel or testosterone gel, to be applied daily for 6 months. Adverse events were categorized with the use of the Medical Dictionary for Regulatory Activities classification. The data and safety monitoring board recommended that the trial be discontinued early because there was a significantly higher rate of adverse cardiovascular events in the testosterone group than in the placebo group. A total of 209 men (mean age, 74 years) were enrolled at the time the trial was terminated. At baseline, there was a high prevalence of hypertension, diabetes, hyperlipidemia, and obesity among the participants. During the course of the study, the testosterone group had higher rates of cardiac, respiratory, and dermatologic events than did the placebo group. A total of 23 subjects in the testosterone group, as compared with 5 in the placebo group, had cardiovascular-related adverse events. The relative risk of a cardiovascular-related adverse event remained constant throughout the 6-month treatment period. As compared with the placebo group, the testosterone group had significantly greater improvements in leg-press and chest-press strength and in stair climbing while carrying a load. In this population of older men with limitations in mobility and a high prevalence of chronic disease, the application of a testosterone gel was associated with an increased risk of cardiovascular adverse events. The small size of the trial and the unique population prevent broader inferences from being made about the safety of testosterone therapy. (ClinicalTrials.gov number, NCT00240981.) 2010 Massachusetts Medical Society
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            High-Intensity Strength Training in Nonagenarians

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              Sarcopenia Is Recognized as an Independent Condition by an International Classification of Disease, Tenth Revision, Clinical Modification (ICD-10-CM) Code.

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                Author and article information

                Contributors
                Journal
                Front Physiol
                Front Physiol
                Front. Physiol.
                Frontiers in Physiology
                Frontiers Media S.A.
                1664-042X
                14 January 2019
                2018
                : 9
                : 1878
                Affiliations
                [1] 1Active Ageing Research Group, Department of Medical and Sport Sciences, University of Cumbria , Lancaster, United Kingdom
                [2] 2Translational Physiology Research Group, School of Life Sciences, University of Westminster , London, United Kingdom
                Author notes

                Edited by: Hassane Zouhal, University of Rennes 2–Upper Brittany, France

                Reviewed by: Anthony C. Hackney, University of North Carolina at Chapel Hill, United States; Stuart Phillips, McMaster University, Canada

                *Correspondence: Lawrence D. Hayes lawrence.hayes@ 123456cumbria.ac.uk

                This article was submitted to Exercise Physiology, a section of the journal Frontiers in Physiology

                Article
                10.3389/fphys.2018.01878
                6339914
                50b9a6fe-645d-40f4-ac49-9c46e7715db5
                Copyright © 2019 Hayes and Elliott.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 04 June 2018
                : 11 December 2018
                Page count
                Figures: 7, Tables: 3, Equations: 2, References: 76, Pages: 14, Words: 8874
                Categories
                Physiology
                Systematic Review

                Anatomy & Physiology
                endurance,endocrine,exercise,hiit,interval,resistance,testosterone,weight training
                Anatomy & Physiology
                endurance, endocrine, exercise, hiit, interval, resistance, testosterone, weight training

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