Low-dose testosterone and evoked resistance exercise after spinal cord injury on cardio-metabolic risk factors: An open-label randomized clinical trial

Ashraf S. Gorgey, Refka E. Khalil, Ranjodh Gill, David R. Gater, Timothy D. Lavis, Christopher P. Cardozo, Robert A. Adler

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

The purpose of the work is to investigate the effects of low-dose testosterone replacement therapy (TRT) and evoked resistance training (RT) on body composition and metabolic variables after spinal cord injury (SCI). Twenty-two individuals with chronic motor complete SCI (ages 18-50 years) were randomly assigned to either TRT+RT (n = 11) or TRT (n = 11) for 16 weeks following a 4 -week delayed entry period. TRT+RT men underwent twice weekly progressive RT using electrical stimulation with ankle weights. TRT was administered via testosterone patches (2-6 mg/day). Body composition was tested using anthropometrics, dual energy x-ray absorptiometry, and magnetic resonance imaging. After an overnight fast, basal metabolic rate (BMR), lipid panel, serum testosterone, adiponectin, inflammatory and anabolic biomarkers (insulin-like growth factor-1 and insulin-like growth factor-binding protein 3 [IGFBP-3]), glucose effectiveness (Sg), and insulin sensitivity (Si) were measured. Total body lean mass (LM; 2.7 kg, p < 0.0001), whole muscle (p < 0.0001), and whole muscle knee extensor cross-sectional areas (CSAs; p < 0.0001) increased in the TRT+RT group, with no changes in the TRT group. Visceral adiposity decreased (p = 0.049) in the TRT group, with a trend in the TRT+RT (p = 0.07) group. There was a trend (p = 0.050) of a 14-17% increase in BMR following TRT+RT. Sg showed a trend (p = 0.07) to improvement by 28.5-31.5% following both interventions. IGFBP-3 increased (p = 0.0001) while IL-6 decreased (p = 0.039) following both interventions, and TRT+RT suppressed adiponectin (p = 0.024). TRT+RT resulted in an increase in LM and whole thigh and knee extensor muscle CSAs, with an increase in BMR and suppressed adiponectin. Low-dose TRT may mediate modest effects on visceral adipose tissue, Sg, IGFBP-3, and IL-6, independent of changes in LM.

Original languageEnglish (US)
Pages (from-to)2631-2645
Number of pages15
JournalJournal of neurotrauma
Volume36
Issue number18
DOIs
StatePublished - Sep 15 2019
Externally publishedYes

Keywords

  • BMR
  • body composition
  • glucose effectiveness
  • inflammatory and anabolic biomarkers
  • NMES
  • resistance training
  • spinal cord injury
  • testosterone
  • VAT

ASJC Scopus subject areas

  • Clinical Neurology

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