FEMALE HORMONE REPLACEMENT

22% muscle loss prevented with testosterone
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Two articles on loss of muscle mass (sarcopenia) in the elderly.  The study found that the loss is associated with loss of strength, quality of life, and health.  They also found that estrogen replacement is does not prevent sarcopenia.  Recommendations are diet, exercise, and testosterone replacement for both men and women.  Not mentioned below, but supported in medical literature, is that sarcopenia is associated with bone fractures from falling--jk. 

http://biomedgerontology.oxfordjournals.org/content/57/12/M772.short J Gerontol A Biol Sci Med Sci (2002) 57 (12): M772-M777  The Journal of Gerontology, Oxford Journals

Anne M. Kenny, Center on Aging, MC-5215, University of Connecticut Health Center, Farmington, CT 06030-5215 E-mail: kenny@nso1.uchc.edu.

Prevalence of Sarcopenia and Predictors of Skeletal Muscle Mass in Healthy, Older Men and Women

Abstract

Background. Sarcopenia refers to the loss of skeletal muscle mass with age. The objective of this study was to determine the prevalence of sarcopenia in a population of older, community-dwelling research volunteers.

Methods. Appendicular skeletal muscle mass was measured by dual x-ray absorptiometry in 195 women aged 64 to 93 years and 142 men aged 64 to 92 years. We defined sarcopenia as appendicular skeletal muscle mass/height2 (square meters) less than 2 standard deviations* below the mean for young, healthy reference populations. We used two different reference populations and compared prevalence in our population to that reported in previous studies. Body mass index (BMI) was calculated and physical activity and performance were measured with the Physical Activity Scale for the Elderly, the Short Physical Performance Battery, and the Physical Performance Test. We measured health-related quality of life by using the SF-36 general health survey. Serum estrone, estradiol, sex hormone-binding globulin, parathyroid hormone, and 25-hydroxy vitamin D were measured in all participants and bioavailable testosterone was measured only in men. Leg press strength and leg press power were determined in men.

Results. The prevalence of sarcopenia [sacro—flesh or muscle + penia loss of] in our cohort was 22.6% in women and 26.8% in men. A subgroup analysis of women and men 80 years or older revealed prevalence rates of 31.0% and 52.9%, respectively. In women, skeletal muscle mass correlated significantly with BMI and levels of serum estrone, estradiol, and 25-hydroxy vitamin D; in men, it correlated significantly with BMI, single leg stance time, leg press strength, leg press power, SF-36 general health score, Physical Performance Test total score, and bioavailable testosterone levels. With the use of linear regression analysis, BMI was the only predictor of appendicular skeletal muscle mass in women, accounting for 47.9% of the variance (p < .05). In men, BMI accounted for 50.1%, mean strength accounted for 10.3%, mean power accounted for 4.1%, and bioavailable testosterone accounted for 2.6% of the variance in appendicular skeletal muscle mass (p < .05).

Conclusions.Sarcopenia is common in adults over the age of 65 years and increases with age. BMI is a strong predictor of skeletal muscle mass in women and men. Strength, power, and bioavailable testosterone are further contributors in men. These data suggest that interventions to target nutrition, strength training, and testosterone replacement therapy should be further investigated for their role in preventing muscle loss with age.

 

*   Two standard deviations means that 95% of the reference groups (young men when comparing to their test group of elderly men, and like with women).  Thus a man whose strength was found to be equal to or less than the weakest 2.5% of the reference group of healthy young men was considered to suffer from sarcopenia (and the same for comparing elderly women to healthy young women).   

 

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Journal of Gerontology:     Oxford Journals,   Life Sciences & Medicine,   The Journals of Gerontology: Series A,   Volume 58, Issue 5,   Pp. M436-M440, Gerontol A Biol Sci Med Sci (2003) 58 (5): M436-M440. doi: 10.1093/gerona/58.5.M436     http://biomedgerontology.oxfordjournals.org/content/58/5/M436.short

Prevalence of Sarcopenia and Predictors of Skeletal Muscle Mass in Non-obese Women Who Are Long-Term Users of Estrogen-Replacement Therapy

Abstract

Background.  Sarcopenia refers to the loss of skeletal muscle mass with age. We have found a prevalence of sarcopenia of 22.6% in older postmenopausal women not receiving estrogen. The objective of this study was to determine the prevalence of sarcopenia in a population of older, nonobese, community-dwelling women who had been long-term users of estrogen replacement therapy (ERT).

Methods. We measured appendicular skeletal muscle mass by dual x-ray absorptiometry (DXA) in 189 women aged 59 to 78 years old who had been using ERT for at least 2 years (mean SD duration, 12.7 8.2 years). We defined sarcopenia as an adjusted appendicular skeletal muscle mass (ASM) (mass divided by height squared) more than 2 SDs below the mean for a young healthy reference population. Health and menopause history were obtained. Body mass index (BMI) was calculated, and physical activity and performance were measured using the Physical Activity Scale in the Elderly, the chair rise time, the 6-minute walk, and measures of lower extremity strength and power. Serum estrone, estradiol, testosterone, and sex hormone binding globulin were measured.

Results. The prevalence of sarcopenia in nonobese, community-dwelling women who were long-term ERT users was 23.8%. Skeletal muscle mass correlated significantly with BMI, age at the time of starting ERT, hand grip strength, lower extremity strength and power, and testosterone level, but not with estradiol level. In linear regression analysis, BMI, leg press strength, and testosterone level contributed to adjusted ASM, accounting for 48.7% of the variance (p <.001).

Conclusions.  Sarcopenia is as common in non-obese women who are long-term ERT users as in community-dwelling women not using ERT, suggesting that ERT does not protect against the muscle loss of aging. BMI, strength, and testosterone level contributed to appendicular skeletal mass in women. These data suggest that interventions to target nutrition, strength training, and testosterone replacement should be further investigated for their role in preventing muscle loss with age.

 

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