Biomechanical Leg Muscle Function During Stair Ambulation in Men Receiving Androgen Deprivation Therapy.


Journal

The journals of gerontology. Series A, Biological sciences and medical sciences
ISSN: 1758-535X
Titre abrégé: J Gerontol A Biol Sci Med Sci
Pays: United States
ID NLM: 9502837

Informations de publication

Date de publication:
16 09 2020
Historique:
received: 01 05 2019
pubmed: 17 7 2019
medline: 11 2 2021
entrez: 17 7 2019
Statut: ppublish

Résumé

The role of testosterone in maintaining functional performance in older men remains uncertain. We conducted a 12-month prospective, observational case-control study including 34 men newly commencing androgen deprivation therapy for prostate cancer and 29 age-matched prostate cancer controls. Video-based motion capture and ground reaction force data combined with computational musculoskeletal modeling, and data were analyzed with a linear mixed model. Compared with controls over 12 months, men receiving androgen deprivation therapy had a mean reduction in circulating testosterone from 14.1 nmol/L to 0.4 nmol/L, associated with reductions in peak knee extension torque, mean adjusted difference (MAD) -0.07 Nm/kg (95% confidence interval [CI]: -0.18, 0.04), p = .009, with a corresponding more marked decrease in quadriceps force MAD -0.11 × body weight (BW) [-0.27, 0.06], p = .045 (equating to a 9 kg force reduction for the mean body weight of 85 kg), and decreased maximal contribution of quadriceps to upward propulsion, MAD -0.47 m/s2 [-0.95, 0.02], p = .009. We observed between-group differences in several other parameters, including increased gluteus maximus force in men receiving androgen deprivation therapy, MAD 0.11 × BW [0.02, 0.20], p = .043, which may be compensatory. Severe testosterone deprivation over 12 months is associated with selective deficits in lower-limb function evident with an important task of daily living.

Sections du résumé

BACKGROUND
The role of testosterone in maintaining functional performance in older men remains uncertain.
METHODS
We conducted a 12-month prospective, observational case-control study including 34 men newly commencing androgen deprivation therapy for prostate cancer and 29 age-matched prostate cancer controls. Video-based motion capture and ground reaction force data combined with computational musculoskeletal modeling, and data were analyzed with a linear mixed model.
RESULTS
Compared with controls over 12 months, men receiving androgen deprivation therapy had a mean reduction in circulating testosterone from 14.1 nmol/L to 0.4 nmol/L, associated with reductions in peak knee extension torque, mean adjusted difference (MAD) -0.07 Nm/kg (95% confidence interval [CI]: -0.18, 0.04), p = .009, with a corresponding more marked decrease in quadriceps force MAD -0.11 × body weight (BW) [-0.27, 0.06], p = .045 (equating to a 9 kg force reduction for the mean body weight of 85 kg), and decreased maximal contribution of quadriceps to upward propulsion, MAD -0.47 m/s2 [-0.95, 0.02], p = .009. We observed between-group differences in several other parameters, including increased gluteus maximus force in men receiving androgen deprivation therapy, MAD 0.11 × BW [0.02, 0.20], p = .043, which may be compensatory.
CONCLUSIONS
Severe testosterone deprivation over 12 months is associated with selective deficits in lower-limb function evident with an important task of daily living.

Identifiants

pubmed: 31310271
pii: 5532659
doi: 10.1093/gerona/glz169
doi:

Substances chimiques

Androgen Antagonists 0
Testosterone 3XMK78S47O

Types de publication

Journal Article Observational Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1715-1722

Informations de copyright

© The Author(s) 2019. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Auteurs

Ada S Cheung (AS)

Department of Medicine (Austin Health), Victoria.
Department of Endocrinology, Heidelberg, Victoria, Australia.

Hans A Gray (HA)

Department of Mechanical Engineering, The University of Melbourne, Victoria.

Anthony G Schache (AG)

Department of Mechanical Engineering, The University of Melbourne, Victoria.

Rudolf Hoermann (R)

Department of Medicine (Austin Health), Victoria.

Jarrod Bicknell (J)

Department of Medicine (Austin Health), Victoria.

Daryl Lim Joon (DL)

Department of Radiation Oncology, Austin Health, Heidelberg, Victoria, Australia.

Jeffrey D Zajac (JD)

Department of Medicine (Austin Health), Victoria.
Department of Endocrinology, Heidelberg, Victoria, Australia.

Marcus G Pandy (MG)

Department of Mechanical Engineering, The University of Melbourne, Victoria.

Mathis Grossmann (M)

Department of Medicine (Austin Health), Victoria.
Department of Endocrinology, Heidelberg, Victoria, Australia.

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