The Effects of Growth Hormone and Sex Steroid on Lean Body Mass, Fat Mass, Muscle Strength, Cardiovascular Endurance and Adverse Events in Healthy Elderly Women and Men Increased Adrenal Androgen Levels in Patients with Prader-Willi Syndrome Are Associated with Insulin, IGF-I, and Leptin, but Not with Measures of Obesity Caloric Restriction Effect on Proinflammatory Cytokines, Growth Hormone, and Steroid Hormone Concentrations during Exercise in Judokas Recombinant human growth hormone in abstinent androgenic-anabolic steroid use: psychological, endocrine and trophic factor effects. Different effects of tibolone and continuous combined estrogen plus progestogen hormone therapy on sex hormone binding globulin and free testosterone levels – an association with mammographic density The effects of creatine supplementation on muscular performance and body composition responses to short-term resistance training overreaching Effects of protein supplementation on muscular performance and resting hormonal changes in college football players. Body mass index, circulating levels of sex-steroid hormones, IGF-I and IGF-binding protein-3: a cross-sectional study in healthy women. Short-term recombinant human growth hormone administration improves respiratory function in abstinent anabolic-androgenic steroid users. Effect of growth hormone treatment on hormonal parameters, body composition and strength in athletes. Growth Hormone Replacement in Healthy Older Men Improves Body Composition but Not Functional Ability Physical Effects of Short-Term Recombinant Human Growth Hormone Administration in Abstinent Steroid Dependency Effects of nandrolone decanoate therapy in borderline hypogonadal men with HIV-associated weight loss. Direct actions of androgens on the survival, growth and secretion of steroids and anti-Müllerian hormone by individual macaque follicles during three-dimensional culture. A randomized pilot study of monthly cycled testosterone replacement or continuous testosterone replacement versus placebo in older men. Resistance training increases SHBG in overweight/obese, young men. Ketoconazole therapy: hormonal and clinical effects in non-tumoral hyperandrogenism. Resistance training and reduction of treatment side effects in prostate cancer patients. Interrelationships between plasma testosterone, SHBG, IGF-I, insulin and leptin in prostate cancer cases and controls Growth hormone and sex steroid administration in healthy aged women and men: a randomized controlled trial. Effect of short-term treatment with an anabolic steroid (methandienone) and dehydroepiandrosterone sulphate on plasma hormones, red cell volume and 2,3-diphosphoglycerate in athletes. Impaired pituitary hormonal response to exhaustive exercise in overtrained endurance athletes. Body composition and hormonal responses to a carbohydrate-restricted diet.
Decreases in growth hormone ( GH ) and insulin-like growth factor I occur with age , in addition to oestrogen deficiency in women and a reduction in the levels of testosterone in men . These age-related hormonal changes may contribute to reductions in lean body mass , muscle strength and cardiac endurance , which can be partially reversed in elderly people with GH treatment , and testosterone supplements and oestrogen/progestin hormone replacement therapy in men and women , respectively . These treatments are , however , thought to have potentially serious adverse effects . We conducted a study to evaluate the separate and interactive effects of GH and sex steroids on body composition , muscle strength and cardiac endurance as well as the rate of adverse events in healthy elderly people . The results of the study showed that although there were beneficial effects with GH and sex steroid treatment , a high percentage of adverse effects occurred after 26 weeks of treatment , demonstrating a need for more research on the safety of hormonal therapy in the elderly population Background / Aim : Since hyper and rogenism in simple obesity is assumed to arise from hyperinsulinism and /or increased insulin-like growth factor I ( IGF-I ) or leptin levels , we examined how in patients with Prader-Willi syndrome ( PWS ) , the most frequent form of syndromal obesity , the accelerated adrenarche can be explained despite hypothalamic-pituitary insufficiency with low levels of insulin and IGF-I. Methods : In 23 children with PWS and a mean age of 5.6 years , height , weight , fat mass , fasting insulin concentration , insulin resistance ( by HOMA-R ; see text ) , and leptin and IGF-I levels were determined to test whether they explain the variance of the levels of dehydroepi and rosterone ( DHEA ) and its sulfate ( DHEAS ) , of and rostenedione , and of cortisol before and during 42 months of therapy with growth hormone . Results : The baseline DHEAS , DHEA , and and rostenedione concentrations were increased as compared with age-related reference values , whereas the cortisol level was always normal . During growth hormone treatment , the DHEA concentration further rose , and the cortisol level decreased significantly . The insulin and IGF-I concentrations were low before therapy , while fat mass and leptin level were elevated . The hormonal covariates provided alone or together between 24 and 60 % of the explanation for the variance of adrenal and rogen levels , but the anthropometric variables did not correlate with them . Conclusions : In children with PWS , elevated and rogen levels correlate with hormones that are usually associated with adiposity . However , the lack of direct correlations between disturbed body composition and and rogen levels as well as the increased sensitivity to insulin and IGF-I are abnormalities specific to PWS , potentially caused by the underlying hypothalamic defect The aim of this study was to evaluate the effect of caloric restriction on the immune and hormonal responses during exercise in judo athletes . In a r and omised order , 11 male judokas ( age : 20.45 ± 0.51 ; height : 1.71 ± 0.3 m ; and body weight : 75.9 ± 3.1 kg ) participate in this study during a period of weight maintenance ( baseline ) and after 7 days of caloric restriction ( CR ) . All subjects performed the Special Judo Fitness Test ( SJFT ) during the two conditions . Values for nutrient intakes were obtained from a 7 d food record kept during a period of weight maintenance and after a 7-day food restriction ( −5~6 MJ/day ) . Our results showed that CR result ed in significant decreases in body weight ( P < 0.05 ) and performance ( P < 0.05 ) . However , heart rate and SJFT index ( P < 0.05 ) increase significantly during CR in comparison to baseline . Moreover , exercise leads to a significant increase in testosterone , cortisol , growth hormone ( GH ) , leukocytes , neutrophils , TNF-α , and IL-6 , in both CR and baseline conditions . Compared to baseline , TNF-α and IL-6 were significantly higher during CR condition ( P < 0.05 ) . Additionally , CR leads to an increase in cortisol and GH ( P < 0.05 ) and a decrease in testosterone concentrations ( P < 0.05 ) This study examined whether six days recombinant human growth hormone ( rhGH ) affected psychological profile in an abstinent and rogenic-anabolic steroid ( AAS ) abusing group , compared with an abstinent AAS control group . Male subjects ( n = 48 ) were assigned in a r and om fashion into one of two groups : ( 1 ) : ( n=24 ) control group ( C ) ; ( 2 ) : ( n=24 ) rhGH group ( GH ) . A hospital anxiety scale ( HADS ) question naire was completed by all subjects . Physiological responses investigated included anthropometry . Biochemical markers examined included ; serum glucose , sodium , urea , lipid profile , high sensitivity C-reactive protein ( hsCRP ) , homocysteine ( HCY ) , tetra-iodothyronine ( T4 ) , thyroid stimulating ( TSH ) , luteinising ( LH ) and follicle stimulating ( FSH ) hormones , testosterone ( T ) , prolactin ( PRL ) , cortisol and insulin like growth factor-1 ( IGF-I ) . HADS question naire significantly decreased in both anxiety ( A ) and depression ( D ) symptoms within GH ( P<0.017 ) and compared with C ( P<0.05 ) . Body mass index ( BMI ) and fat-free mass index ( FFMI ) significantly increased ( both P<0.017 ) while body fat significantly decreased within GH ( P<0.017 ) . IGF-I significantly increased within GH ( P<0.017 ) and significantly increased compared with C ( P<0.05 ) . Serum sodium significantly increased ( P<0.017 ) and serum HCY , hsCRP , TSH and T4 , significantly decreased within GH ( all P<0.017 ) . PRL significantly increased and T4 significantly decreased compared with C ( both P<0.05 ) . The findings of this study suggest that short term use of rhGH has beneficial effects on mental state  in individuals who were previous abusers of AAS and appeared to have a beneficial effect on cardiovascular risk markers associated with adverse mental health Objective To compare the effects of tibolone and continuous combined hormone therapy on circulating sex steroids and their binding proteins and their relationship to  mammographic density .  Study design A prospect i ve , double-blind placebo-controlled study . A total of 166 postmenopausal women were equally r and omized to receive tibolone 2.5 mg , estradiol 2 mg/norethisterone acetate 1 mg ( E2/NETA ) or placebo . Serum analyses of sex steroids , insulin-like growth factor ( IGF-I ) and binding proteins and assessment of mammographic breast density were performed at baseline and after 6 months of treatment . Results Estrogens were markedly increased and and rogens decreased by E2/NETA . In contrast , tibolone had only a minor influence on circulating estrogens . Sex hormone binding globulin ( SHBG ) levels were reduced by 50 % , while levels of and rogens increased . Baseline values of estrone sulfate ( E1S ) , around 1.0–1.1 nmol/l , were increased to 44.7 nmol/l by E2/NETA and to only 1.7 nmol/l by tibolone ( p < 0.001 ) . Mammographic breast density displayed a negative correlation with age and body mass index and a positive association with SHBG . After 6 months there was also a negative correlation with levels of free testosterone . Conclusion We found that tibolone and E2/NETA caused distinct differences in estrogen/ and rogen status and blood levels of possible breast mitogens . The negative association between free testosterone and mammographic density could be a possible explanation for tibolone having less influence on the breast To determine the effects of creatine supplementation during short-term resistance training overreaching on performance , body composition , and resting hormone concentrations , 17 men were r and omly assigned to supplement with 0.3 g/kg per day of creatine monohydrate ( CrM : n=9 ) or placebo ( P : n=8 ) while performing resistance exercise ( 5 days/week for 4 weeks ) followed by a 2-week taper phase . Maximal squat and bench press and explosive power in the bench press were reduced during the initial weeks of training in P but not CrM. Explosive power in the bench press , body mass , and lean body mass ( LBM ) in the legs were augmented to a greater extent in CrM ( P≤0.05 ) by the end of the 6-week period . A tendency for greater 1-RM squat improvement ( P=0.09 ) was also observed in CrM. Total testosterone ( TT ) and the free and rogen index ( TT/SHBG ) decreased in CrM and P , reaching a nadir at week 3 , whereas sex hormone binding globulin ( SHBG ) responded in an opposite direction . Cortisol significantly increased after week 1 in CrM ( + 29 % ) , and returned to baseline at week 2 . Insulin was significantly depressed at week 1 ( −24 % ) and drifted back toward baseline during weeks 2–4 . Growth hormone and IGF-I levels were not affected . Therefore , some measures of muscular performance and body composition are enhanced to a greater extent following the rebound phase of short-term resistance training overreaching with creatine supplementation and these changes are not related to changes in circulating hormone concentrations obtained in the resting , postabsorptive state . In addition , creatine supplementation appears to be effective for maintaining muscular performance during the initial phase of high-volume resistance training overreaching that otherwise results in small performance decrements The effect of protein supplementation on athletic performance and hormonal changes was examined in 21 experienced collegiate strength/power athletes participating in a 12-week resistance training program . Subjects were r and omly assigned to either a protein supplement ( PR ; n = 11 ) or a placebo ( PL ; n = 10 ) group . During each testing session subjects were assessed for strength ( one repetition maximum [ 1-RM ] bench press and squat ) , power ( Wingate anaerobic power test ) and body composition . Resting blood sample s were analyzed at weeks 0 ( PRE ) , 6 ( MID ) and 12 ( POST ) for total testosterone , cortisol , growth hormone , and IGF-1 . No difference was seen in energy intake between PR and PL ( 3034 ± 209 kcal and 3130 ± 266 kcal , respectively ) , but a significant difference in daily protein intake was seen between PR ( 2.00 g·kg body mass[BM](-1)·d(-1 ) ) and PL ( 1.24 g·kgBM(-1)·d(-1 ) ) . A greater change ( p < 0.05 ) in the ∆ 1-RM squat was seen in PR ( 23.5 ± 13.6 kg ) compared to PL ( 9.1 ± 11.9 kg ) . No other significant strength or power differences were seen between the groups . Cortisol concentrations were significantly lower at MID for PL and this difference was significantly different than PR . No significant changes were noted in resting growth hormone or IGF-1 concentrations in either group . Although protein supplementation appeared to augment lower body strength development , similar upper body strength , anaerobic power and lean tissue changes do not provide clear evidence supporting the efficacy of a 12-week protein supplementation period in experienced resistance trained athletes . Key pointsCollegiate strength/power athletes may not meet daily recommended energy or protein needs . When athletes are provided a protein supplement they appear to meet the recommended daily protein intake for strength/power athletes . Protein supplementation did augment lower body strength development in experienced strength/power athletes .  Results of upper body strength , anaerobic power and lean tissue changes did not support the efficacy of a 12-week protein supplementation period in experienced resistance trained athletes OBJECTIVE Excess weight has been associated with increased risk of cancer at several organ sites . In part , this effect may be modulated through alterations in the metabolism of sex steroids and IGF-I related peptides . The objectives of the study were to examine the association of body mass index ( BMI ) with circulating and rogens ( testosterone , and rostenedione and dehydroepi and rosterone sulfate ( DHEAS ) ) , estrogens ( estrone and estradiol ) , sex hormone-binding globulin ( SHBG ) , IGF-I and IGF-binding protein (IGFBP)-3 , and the relationship between sex steroids , IGF-I and IGFBP-3 . DESIGN AND METHODS A cross-sectional analysis was performed using  hormonal and question naire data of 620 healthy women ( 177 pre- and 443 post-menopausal ) . The laboratory measurements of the hormones of interest were available from two previous case-control studies on endogenous hormones and cancer risk . RESULTS In the pre-menopausal group , BMI was not related to and rogens and IGF-I. In the post-menopausal group , estrogens , testosterone and and rostenedione increased with increasing BMI . The association with IGF-I was non-linear , with the highest mean concentrations observed in women with BMI between 24 and 25 . In both pre- and post-menopausal subjects , IGFBP-3 did not vary across BMI categories and SHBG decreased with increasing BMI . As for the correlations between peptide and steroid hormones , in the post-menopausal group , IGF-I was positively related to and rogens , inversely correlated with SHBG , and not correlated with estrogens . In the pre-menopausal group , similar but weaker correlations between IGF-I and and rogens were observed . CONCLUSIONS These observations offer evidence that obesity may influence the levels of endogenous sex-steroid and IGF-related hormones in the circulation , especially after menopause . Circulating IGF-I , and rogens and SHBG appear to be related to each other in post-menopausal women OBJECTIVES To determine whether 6 days recombinant human growth hormone ( rhGH ) administration , in an abstinent anabolic- and rogenic steroid ( AAS ) using group had any respiratory , endurance exercise and biochemical effects compared with an abstinent AAS control group . METHODS Male subjects ( n=48 ) were r and omly divided , using a single blind procedure into two groups : ( 1 )  control group ( C ) n=24 , means+/-SD , age 32+/-11 years ; height 1.8+/-0.06 m ; ( 2 ) rhGH using group ( 0.019 mg kg(-1 ) day(-1 ) ) ( GH ) n=24 , means+/-SD , age 32+/-9 years ; height 1.8+/-0.07 m.  Anthropometry , respiratory muscle function and endurance exercise were investigated . Respiratory measurements examined , were forced expiratory volume in one second , forced vital capacity , maximum inspiratory pressure and maximum expiratory pressure . Endurance exercise was assessed by measuring peak oxygen uptake ( VO(2)peak ) . Biochemical analysis included ; haemoglobin , packed cell volume , glucose , sodium , urea , creatinine , total protein , albumin , testosterone and insulin like growth factor-I ( IGF-I ) . RESULTS Forced expiratory volume in one second/forced vital capacity , maximum inspiratory pressure , maximum expiratory pressure , and IGF-I significantly increased compared with the control group ( all P<0.05 ) . Body mass index , fat free mass index , peak oxygen uptake , maximum inspiratory pressure , maximum expiratory pressure , IGF-I and serum sodium significantly increased , whilst body fat , total protein and albumin , significantly decreased within the GH group ( all P<0.017 ) . CONCLUSION The findings of this study indicated that short-term high dose rhGH increased aerobic performance and respiratory muscle strength in former AAS users The effect of recombinant GH on strength , body composition and endocrine parameters in power athletes was investigated in a controlled study . Twenty-two healthy , non-obese males ( age 23.4 + /- 0.5 years ; ideal body weight 122 + /- 3.1 % , body fat 10.1 + /- 1.0 % ; mean + /- SEM ) were included . Prob and s were assigned in a double-blind manner to either GH treatment ( 0.09U ( kg BW)-1 day-1 sc ) or placebo for a period of six weeks . To exclude concurrent treatment with and rogenic-anabolic steroids urine specimens were tested at regular intervals for these substances . Serum was assayed for GH , IGF-I , IGF-binding proteins , insulin and thyroxine before the onset of the study and at two-weekly intervals thereafter . Maximal voluntary strength of the biceps and quadriceps muscles was measured on a strength training apparatus . Fat mass and lean body mass were derived from measurements of skinfolds at ten sites with a caliper . For final evaluation only data of those 8 and 10 subjects in the two groups who completed the study were analyzed . GH , IGF-I and IGF-binding protein were in the normal range before therapy and increased significantly in the GH-treated group . Fasting insulin concentrations increased insignificantly and thyroxine levels decreased significantly in the GH-treated prob and s. There was no effect of GH treatment on maximal strength during concentric contraction of the biceps and quadriceps muscles . Body weight and body fat were not changed significantly during treatment . We conclude that the anabolic , lipolytic effect of GH therapy in adults depends on the degree of fat mass and GH deficiency . ( ABSTRACT TRUNCATED AT 250 WORDS Aging is associated with alterations in body composition and a decline in functional status . Healthy older persons have decreased muscle mass , increased fat mass , and decreased strength [ 1 - 3 ] . The muscle strength of 70-year-old men is about half that of young adults [ 3 ] . The risk for falls , fractures , and frailty increases with age-related decreases in muscle strength [ 4 - 6 ] . Pituitary secretion of growth hormone and circulating levels of insulin-like growth factor 1 decrease with aging [ 7 ] ; these events are called somatopause . Growth hormone is both anabolic and lipolytic [ 8 - 10 ] , and the action of growth hormone on peripheral tissues is mediated , in part , by circulating insulin-like growth factor 1 [ 11 ] . Growth hormone deficiency results in body composition changes that are similar to the changes seen with aging [ 1 , 7 ] . Growth hormone replacement in patients with hypopituitarism and in older men reverses some of the body composition changes associated with both growth hormone deficiency and aging [ 12 - 14 ] . In a study by Rudman and colleagues [ 14 ] on the effects of growth hormone replacement therapy on body composition , the administration of growth hormone to 12 men 61 to 73 years of age for 6 months increased lean body mass by 9 % and decreased adipose tissue mass by 15 % ( P < 0.005 ) . Circulating insulin-like growth factor 1 levels increase similarly in young and old men after exogenous administration of either growth hormone or growth hormone-releasing hormone [ 7 , 11 ] . Therefore , low insulin-like growth factor 1 levels reflect decreased growth hormone secretion rather than a loss of hepatic responsiveness to the hormone . On the basis of these data , it has been proposed that diminished secretion of growth hormone is responsible , in part , for the somatic changes of aging [ 14 ] . Growth hormone replacement has been shown to improve muscle volume , isometric strength , and exercise capacity in young adults with hypopituitarism [ 12 , 13 ] . In one study of growth hormone-deficient young adults treated with growth hormone [ 12 ] , thigh muscle volume increased by 6 % ( P < 0.01 ) , and isometric strength increased by 8 % ( P = 0.08 ) compared with controls . Increases in isometric strength were associated with increases in muscle volume ( r = 0.75 ; P < 0.001 ) . Exercise capacity also increased by 12 % ( P < 0.05 ) . Such data on the effects of growth hormone replacement therapy on strength or function are not available for older persons . To test the hypothesis that the muscle weakness and functional decline associated with aging are in part due to decreased growth hormone secretion , we conducted a 6-month r and omized , controlled , double-blind trial comparing recombinant human growth hormone therapy with placebo in 56 elderly men whose baseline insulin-like growth factor 1 levels were less than the tenth percentile found in younger healthy adults . Methods Participants We recruited healthy , ambulatory , community-dwelling men older than 69 years of age . Because growth hormone secretion is pulsatile and diurnal , a more convenient measure of growth hormone secretion is insulin-like growth factor 1 , which has constant and nonpulsatile plasma levels [ 1 , 7 , 15 , 16 ] . Inclusion criteria included two fasting morning plasma insulin-like growth factor 1 levels ( assayed after plasma was extracted with acid ethanol by the Nichols Institute [ 17 ] ) less than 161 ng/mL that were obtained at least 2 weeks apart , a fasting blood glucose level less than 8.4 mmol/L ( 140 mg/dL ) , stable body weight between 80 % and 120 % of ideal body weight [ 18 ] during the previous year , and a normal complete blood count at baseline . Participants had to be able to follow the study instructions and perform the strength measurements . Exclusion criteria included diseases that might contraindicate the use of growth hormone ( such as carcinoma within the previous 5 years , diabetes mellitus , and the carpal tunnel syndrome ) , uncontrolled hypertension ( blood pressure more than 180/100 mm Hg ) , oral corticosteroid use within the previous year , or a recent change in ambulatory status ( for example , as the result of a stroke ) . Design After the participants gave informed written consent , the following baseline measurements were obtained : question naires ( demographic characteristics and medical conditions ) ; fasting blood chemistry ( levels of electrolytes , urea nitrogen , creatinine , glucose , calcium , phosphate , and albumin ) ; complete blood count ; serum and rogen levels ( total and free testosterone and dehydroepi and rosterone ) ; fasting lipoprotein levels ( total cholesterol , high-density lipoprotein cholesterol , low-density lipoprotein cholesterol , and triglycerides ) and thyroid-stimulating hormone and free thyroxine levels ; 24-hour urinary calcium excretion ; and creatinine clearance . At baseline , we also measured the body composition , strength , and functional ability of all participants . We then used a computer-generated r and omization table to assign each participant to receive either growth hormone or placebo . Participants , investigators who had contact with the participants , and laboratory personnel were blinded to treatment status . Treatment consisted of recombinant human growth hormone ( somatropin [ Nutropin , Genentech ] ) , 0.03 mg/kg of body weight , or an equivalent placebo volume ( supplied in identical vials by Genentech ) injected subcutaneously three times per week in the morning for 6 months . We evaluated the participants after 2 , 4 , 8 , 12 , 18 , and 24 weeks of treatment to determine whether side effects developed and to ensure compliance . Participants were examined and specifically asked about the presence of the following side effects : malaise , fatigue , edema , arthralgias , arthritis , the carpal tunnel syndrome , muscle discomfort , dyspnea , depression , polydipsia , polyuria , nocturia , and tender or enlarged breasts . At each visit , we measured fasting morning plasma insulin-like growth factor 1 levels 48 hours after the last treatment dose and repeated most of the baseline blood and urinary tests . We adjusted the dose of recombinant human growth hormone to maintain serum insulin-like growth factor 1 levels between 190 and 350 ng/mL ( the 25th to 75th percentiles of a young adult population ) 48 hours after a dose . To preserve blinding , each growth hormone recipient was paired with a placebo recipient . An unblinded physician who had not had contact with the participants review ed insulin-like growth factor 1 levels during the trial . If the levels were less than 190 ng/mL or greater than 350 ng/mL , the unblinded physician instructed study personnel to make identical dose adjustments for both participants in the pair . The dose was also decreased in any participant who reported troublesome side effects that were potentially attributable to growth hormone . We repeated all study outcome measurements after 6 months of treatment . We also measured fasting plasma renin activity , cortisol and aldosterone levels , and 24-hour urine aldosterone excretion . The investigational review boards of the University of California , San Francisco , and the Department of Veterans Affairs Medical Center , San Francisco , approved the study protocol . Measurements Body Composition We used dual-energy x-ray absorptiometry ( Lunar DPX-Plus , Madison , Wisconsin ) total-body composition scans to measure lean tissue mass and fat mass , and we used anterior-posterior lumbar scans to measure bone mineral content . We measured skin thickness using ultrasonography with a 10-MHz transducer ( Diasonics , Milpitas , California ) that was positioned transversely 5 cm below the umbilicus . Using the same transducer , we made two ultrasonographic measurements on each participant . The average of the two measurements was used for analysis . The study radiologist , who was blinded to the participants ' treatment status , interpreted all test results . Muscle Strength The study 's physical therapist measured the muscle strength of the participants ' knee flexor and extensor muscles using an isokinetic dynamometer ( Cybex 340 , Lumex , Bay Shore , New York ) . Using a st and ard protocol , we measured peak torque of knee flexion and extension at joint speeds of 90 , 120 , and 180 degrees per second . We measured h and grip strength according to a st and ardized protocol using a grip dynamometer ( Smedley Grip Dynamometer , JA Preston , Jackson , Mississippi ) . The greater of the two measurements was used for analysis . Systemic Endurance To assess systemic endurance , we measured maximal oxygen consumption ( Vo 2 max ) during exercise cycle testing . Upright exercise testing was done using an electronically braked cycle ergometer ( Erich Jaeger , Rockford , Illinois ) . Exercise was initially done unloaded and was then increased by 25 watts every 2 minutes . Participants continued to exercise until they were exhausted or unable to maintain critical pedal frequency ( greater than 50 revolutions per minute ) . During exercise cycle testing , we continuously measured respiratory gas exchange to determine Vo 2 max ( Ergopneumotest , Erich Jaeger ) . Physical Performance The study 's physical therapist used the Physical Performance Test [ 19 ] to assess the participants ' performance on nine physical functions . Participants were asked to write a prescribed sentence , transfer kidney beans using a teaspoon , place a heavy book on a shelf , remove a jacket , pick up a penny from the floor , turn 360 degrees , walk a 50-foot walking test course , and climb stairs to determine speed and the number of flights climbed before the development of fatigue . The test score is based on the time required to complete each task . Higher scores ( the best performance is a maximum score of 36 ) are associated with the shortest time required to complete a task and with better functional status . Cognitive Function and Mood Each participant completed the Trails B Test , the Mini-Mental State Examination , the Digit Symbol Substitution Test , and the Geriatric Depression Scale [ 20 - 23 ] . The Trails B Test ( from the Halstead-Reitan Neuropsychological Test Background / Aims : Recombinant human growth hormone ( rhGH ) as opposed to cadaver pituitary GH is misused for physical improvement . Six days ’ rhGH administration , in abstinent anabolic- and rogenic steroid dependents , was compared with controls . Method : Male subjects ( n = 48 ) were r and omly divided into two groups : ( 1 ) : control group ( C ) , n = 24 , mean ± SD , age 32 ± 11 years , height 1.8 ± 0.06 m ; ( 2 ) :  rhGH-using group  ( 0.058 IU·kg–1·day–1 ) ( GH ) , n = 24 , mean ± SD , age 32 ± 9 years , height 1.8 ± 0.07 m. Physiological measurements included anthropometry , strength , power and peak oxygen uptake ( VO2 peak ) . Biochemical measurements included haemoglobin , packed cell volume , glucose , sodium , potassium , urea , creatinine , total protein , albumin , thyroid function , testosterone , prolactin , cortisol , GH and insulin-like growth factor-I ( IGF-I ) . Results : Strength , peak power output and IGF-I significantly increased and total protein , albumin and free tetra-iodothyronine significantly decreased compared to controls ( p < 0.05 ) and within the GH group ( p < 0.017 ) . Fat-free mass index and VO2 peak significantly increased , while body fat and thyroid-stimulating hormone significantly decreased within the GH group ( p < 0.017 ) . Conclusions : Short-term rhGH  increased strength and power . Of therapeutic value is the possibility that muscle bulk and strength could be increased in patients with muscle-wasting conditions Serum testosterone concentrations are frequently in the low-normal range ( lowest quartile , < 500 ng/dl ) in men with AIDS-wasting syndrome ( AWS ) and in other chronic wasting disorders . The response of patients in this group to and rogen treatment has not been determined , however . Eighteen men with AWS ( mean + /- st and ard error [ SE ] : 87 % + /- 1 % usual body weight ; CD4 count 90 + /- 24 ) and borderline low serum testosterone concentrations ( 382 + /- 33 ng/dl ) completed a 21-day placebo-controlled inpatient metabolic ward study comparing intramuscular ( i.m . ) placebo ( n = 7 ) with low-dose ( 65 mg/week ; n = 4 ) and high-dose ( 200 mg/week ; n = 7 ) n and rolone decanoate , a testosterone analogue .  Nitrogen balance , stable isotope-mass spectrometric measurement of de novo lipogenesis ( DNL ) , resting energy expenditure , and gonadal hormone levels were measured . Both low-dose and high-dose n and rolone result ed in significant nitrogen retention ( 33 - 52 g nitrogen/14 days , representing gains of 0.5 to 0.9 kg lean tissue/week ) compared with placebo ( loss of 11 g nitrogen/week ) . This was reflected biochemically in a borderline significant reduction of high DNL ( p < .06 ) . Serum testosterone and gonadotropins were suppressed whereas resting energy expenditure was unchanged by n and rolone treatment . In 10 study subjects completing a 12-week open-label follow-up phase , body weight increased by 4.9 + /- 1.2 kg , including 3.1 + /- 0.5 kg lean body mass , and treadmill exercise performance also improved . In summary , n and rolone decanoate therapy in the absence of an exercise program in borderline hypogonadal men with AWS caused substantial nitrogen retention compared with placebo , similar in extent to the nitrogen retention previously achieved with recombinant growth hormone . It is reasonable to exp and the criteria for and rogen treatment in AWS to include at least patients in the lowest quartile of serum testosterone STUDY QUESTION What are the direct effects of and rogens on primate follicular development and function at specific stages of folliculogenesis ? SUMMARY ANSWER And rogen addition altered primate  follicle survival , growth , steroid and anti-Müllerian hormone ( AMH ) production , and oocyte quality in vitro , in a dose- and stage-dependent manner . WHAT IS KNOWN ALREADY And rogens have local actions in the ovary , particularly in the developing follicles . It is hypothesized that and rogen promotes early follicular growth , but becomes detrimental to the antral follicles in primates . STUDY DESIGN , SIZE , DURATION In vitro follicle maturation was performed using rhesus macaques . Secondary ( 125 - 225 µm ) follicles were mechanically isolated from 14 pairs of ovaries , encapsulated into alginate ( 0.25 % w/v ) , and cultured for 40 days . PARTICIPANTS / MATERIAL S , SETTING , METHODS Individual follicles were cultured in a 5 % O2 environment , in alpha minimum essential medium supplemented with recombinant human FSH . Follicles were r and omly assigned to experiments of steroid ablation by trilostane ( TRL ) , testosterone ( T ) replacement and dihydrotestosterone ( DHT ) replacement .  Follicle survival and growth were assessed . Follicles with diameters ≥500 μm at Week 5 were categorized as fast-grow follicles . Pregnenolone ( P5 ) , progesterone ( P4 ) , estradiol ( E2 ) and AMH concentrations in media were measured . Meiotic maturation and fertilization of oocytes from recombinant human chorionic gonadotrophin-treated follicles were assessed at the end of culture . MAIN RESULTS AND THE ROLE OF CHANCE Compared with controls , TRL exposure reduced ( P < 0.05 ) follicle survival , antrum formation rate and follicle diameters at Week 5 . While P5 concentrations increased ( P < 0.05 ) following TRL treatment , P4 levels decreased ( P < 0.05 ) in fast-grow follicles at Week 5 . Few healthy oocytes were retrieved from antral follicles developed in the presence of TRL . T replacement with TRL  increased ( P < 0.05 ) follicle survival and antrum formation at Week 5 , compared with TRL alone , to levels comparable to controls . However , high-dose T with TRL decreased ( P < 0.05 ) diameters of fast-grow follicles . Although P4 concentrations produced by fast-grow follicles were not altered by T in the presence of TRL , there was a dose-dependent increase ( P < 0.05 ) in E2 levels at Week 5 . High-dose T with TRL decreased ( P < 0.05 ) AMH production by fast-grow follicles at Week 3 . More healthy oocytes were retrieved from antral follicles developed in TRL+T compared with TRL alone . DHT had the similar effects to those of high-dose T , except that DHT replacement decreased ( P < 0.05 ) E2 concentrations produced by fast-grow follicles at Week 5 regardless of TRL treatment . LIMITATION , REASONS FOR CAUTION This study reports T and DHT actions on in vitro-developed individual primate ( macaque ) follicles , which are limited to the interval from the secondary to small antral stage . WIDER IMPLICATION OF THE FINDINGS The above findings provide novel information on the role(s ) of and rogens in primate follicular development and oocyte maturation . We hypothesize that and rogens promote pre-antral follicle development , but inhibit antral follicle growth and function in primates . While and rogens can act positively , excess levels of and rogens may have negative impacts on primate folliculogenesis . STUDY FUNDING /COMPETING INTERESTS NIH U54 RR024347/RL1HD058294/PL1EB008542 ( Oncofertility Consortium ) , NIH U54 HD071836 ( SCCPIR ) , NIH ORWH/NICHD 2K12HD043488 ( BIRCWH ) , NIH FIC TW/HD-00668 , ONPRC 8P51OD011092 . There are no conflicts of interest CONTEXT Cycling and rogens has been reported by athletes to improve physical performance by enhancing muscle mass and strength , a paradigm that has not been studied , and may have clinical value in older men being treated with testosterone .  OBJECTIVE We investigated the efficacy of a monthly cycled testosterone regimen that uses half the testosterone dose as the current st and ard of care continuous therapy on body composition and muscle strength in older men . DESIGN , SETTING , AND PATIENTS Twenty-four community-dwelling older men 70 ± 2 yr of age with total testosterone levels below 500 ng/dl were r and omized at the Institute for Translational Sciences- Clinical Research Center into a 5-month double-blind placebo-controlled trial . INTERVENTION Subjects were dosed weekly for 5 months , receiving continuous testosterone ( TE , n = 8 ; 100 mg testosterone enanthate , i m injection ) , monthly cycled testosterone ( MO , n = 8 ; alternating months of testosterone and placebo ) , or placebo ( PL , n = 8) . MAIN OUTCOME MEASURES Main outcomes included body composition by dual-energy x-ray absorptiometry and upper and lower body muscle strength . Secondary outcomes included body weight , serum hormones , and mixed-muscle protein fractional synthesis rate ( FSR ) . RESULTS Total lean body mass was increased and percent fat was reduced after 5 months in TE and MO ( P < 0.05 ) . Upper body muscle strength increased in TE , and lower body muscle strength increased in TE and MO ( P < 0.05 ) . FSR increased in TE and MO ( P < 0.05 ) but not in PL . CONCLUSIONS Cycled testosterone  improved body composition and increased muscle strength compared with placebo and increased FSR similarly to continuous testosterone OBJECTIVE Evidence suggests that SHBG affects glycemic control , predicts both T2D and metabolic syndrome , and is low in obese subjects . We sought to determine if resistance exercise training ( RT ) can increase sex hormone-binding globulin ( SHBG ) and ameliorate levels of related steroid hormones in overweight/obese , sedentary young men . MATERIAL S/ METHODS 36 participants ( BMI 31.4 kg/m(2 ) , age 22 years ) were r and omized into an RT ( 12 weeks of training , 3/week ) or control group ( C , 12 weeks no training ) , and assessed for changes in SHBG , cortisol , testosterone , free testosterone ( FT ) and free and rogen index ( FAI ) . In addition , body composition and oral glucose tolerance testing was performed . RESULTS 12 weeks of RT  increased SHBG ( P=0.01 ) and decreased FAI ( P<0.05 ) and cortisol ( P<0.05 ) compared to C. FT decreased in RT ( P=0.01 ) . Total testosterone did not change in either group . These changes were noted without weight loss , and in concert with increases in lean body mass ( P=0.0002 vs C ) and decreases in glucose area under the curve ( AUC ) ( P=0.004 ) , insulin AUC ( P=0.03 ) , and total ( P=0.002 ) and trunk ( P=0.003 ) fat mass in RT . CONCLUSION In overweight/obese young men , RT increases SHBG and lowers FAI in obese young adult men The aim of this study was to assess the usefulness of ketoconazole as a therapeutic alternative to polycystic ovary syndrome . The study group comprised 37 women with signs of hyper and rogenism ( hirsutism , acne ) and oligomenorrhea . A low dose ( 400 mg/day ) of ketoconazole was tested in a 9-month prospect i ve clinical study . Clinical response ( Ferriman & Gallway score , acne ) and modifications in hormone pattern ( luteinizing hormone , follicle-stimulating hormone , estradiol , testosterone , prolactin , 17-hydroxy-progesterone , and rostenedione , steroid hormone-binding globulin , dehydroepi and rosterone sulfate , cortisol , adrenocorticotropin ( ACTH ) and free testesterone index ) were measured , and ACTH stimulation tests were performed . Tolerance and side-effect also were assessed . After 9 months of ketoconazole treatment , the patients ' Ferriman & Gallway scores ( 18.26 + /- 4.6 vs 12.4 + /- 4.1 ; p < 0.001 ) and acne had improved markedly . Hormone patterns also became more favorable , with decreases in and rogenic steroids ( testosterone , and rostenedione , free testosterone index and dehydroepi and rosterone sulfate ; p < 0.01 ) and increases in estradiol ( p < 0.01 ) . Basal cortisol levels and cortisol after ACTH stimulation were not changed significantly , remaining within the reference range . Increases in ACTH were observed only in the 3rd month ( p < 0.01 ) . Initial levels of and rogenic steroids were correlated inversely with their percentage decrease in successive samplings . Decreases in adrenal and rogenic steroids were associated with an increase in steroid hormone-binding globulin . The side-effects of treatment , although not severe , caused some discomfort and led to a high drop-out rate ( 30 % ) . ( ABSTRACT TRUNCATED AT 250 WORDS PURPOSE To examine the effect of progressive resistance training on muscle function , functional performance , balance , body composition , and muscle thickness in men receiving and rogen deprivation for prostate cancer . METHODS Ten men aged 59 - 82 yr on and rogen deprivation for localized prostate cancer undertook progressive resistance training for 20 wk at 6- to 12-repetition maximum ( RM ) for 12 upper- and lower-body exercises in a university exercise rehabilitation clinic . Outcome measures included muscle strength and muscle endurance for the upper and lower body , functional performance ( repeated chair rise , usual and fast 6-m walk , 6-m backwards walk , stair climb , and 400-m walk time ) , and balance by sensory organization test . Body composition was measured by dual-energy x-ray absorptiometry and muscle thickness at four anatomical sites by B-mode ultrasound . Blood sample s were assessed for prostate specific antigen ( PSA ) , testosterone , growth hormone ( GH ) , cortisol , and hemoglobin . RESULTS Muscle strength ( chest press , 40.5 % ; seated row , 41.9 % ; leg press , 96.3 % ; P < 0.001 ) and muscle endurance ( chest press , 114.9 % ; leg press , 167.1 % ; P < 0.001 ) increased significantly after training . Significant improvement ( P < 0.05 ) occurred in the 6-m usual walk ( 14.1 % ) , 6-m backwards walk ( 22.3 % ) , chair rise ( 26.8 % ) , stair climbing ( 10.4 % ) , 400-m walk ( 7.4 % ) , and balance ( 7.8 % ) . Muscle thickness increased ( P < 0.05 ) by 15.7 % at the quadriceps site . Whole-body lean mass was preserved with no change in fat mass . There were no significant changes in PSA , testosterone , GH , cortisol , or hemoglobin . CONCLUSIONS Progressive resistance exercise has beneficial effects on muscle strength , functional performance and balance in older men receiving and rogen deprivation for prostate cancer and should be considered to preserve body composition and reduce treatment side effects Despite strong indirect evidence that and rogens stimulate prostate cancer development , data from most analytical studies on this association have been negative . To further investigate this issue , we studied the interrelationships between and rogenicity and insulin-like growth factor I ( IGF-I ) , insulin and leptin . Within a prospect i ve cohort study , we measured  testosterone , sex hormone-binding globulin ( SHBG ) and IGF-I , IGF-binding protein (IGFBP)-1 , IGFBP-3 , insulin and leptin , in plasma from 149 cases and 298 controls .  Testosterone correlated positively with SHBG , whereas testosterone and SHBG correlated inversely with IGF-I , IGFBP-3 , insulin , leptin and body mass index ( BMI ) . Indices of free testosterone showed an inverse linear correlation with leptin ( P<0.01 ) , and a strong drop in the 5th quintile of BMI . However , levels of free testosterone showed non-linear relationships over quintiles of insulin and IGF-I , with a significant increase in the second quintile of IGF-I compared with other levels . The absence of an association between plasma levels of  and rogens and prostate cancer risk in analytical studies , despite the strong indirect evidence of their tumour-stimulating effects , may reflect the complex and mostly inverse associations of and rogenicity to IGF-I , insulin and leptin which are hormones that have also been implicated as risk factors for prostate cancer CONTEXT Hormone administration to elderly individuals can increase lean body mass ( LBM ) and decrease fat , but interactive effects of growth hormone ( GH ) and sex steroids and their influence on strength and endurance are unknown . OBJECTIVE To evaluate the effects of recombinant human GH and /or sex steroids on body composition , strength , endurance , and adverse outcomes in aged persons . DESIGN , SETTING , AND PARTICIPANTS A 26-week r and omized , double-blind , placebo-controlled parallel-group trial in healthy , ambulatory , community-dwelling US women ( n = 57 ) and men ( n = 74 ) aged 65 to 88 years recruited between June 1992 and July 1998 . INTERVENTIONS Participants were r and omized to receive GH ( starting dose , 30 micro g/kg , reduced to 20 micro g/kg , subcutaneously 3 times/wk ) + sex steroids ( women : transdermal estradiol , 100 micro g/d , plus oral medroxyprogesterone acetate , 10 mg/d , during the last 10 days of each 28-day cycle [ HRT ] ; men : testosterone enanthate , biweekly intramuscular injections of 100 mg ) ( n = 35 ) ; GH + placebo sex steroid ( n = 30 ) ; sex steroid + placebo GH ( n = 35 ) ; or placebo GH + placebo sex steroid ( n = 31 ) in a 2 x 2 factorial design . MAIN OUTCOME MEASURES Lean body mass , fat mass , muscle strength , maximum oxygen uptake ( VO(2)max ) during treadmill test , and adverse effects . RESULTS In women , LBM increased by 0.4 kg with placebo , 1.2 kg with HRT ( P = .09 ) , 1.0 kg with GH ( P = .001 ) , and 2.1 kg with GH + HRT ( P<.001 ) . Fat mass decreased significantly in the GH and GH + HRT groups . In men , LBM increased by 0.1 kg with placebo , 1.4 kg with testosterone ( P = .06 ) , 3.1 kg with GH ( P<.001 ) , and 4.3 kg with GH + testosterone ( P<.001 ) . Fat mass decreased significantly with GH and GH + testosterone . Women 's strength decreased in the placebo group and increased nonsignificantly with HRT ( P = .09 ) , GH ( P = .29 ) , and GH + HRT ( P = .14 ) . Men 's strength also did not increase significantly except for a marginally significant increase of 13.5 kg with GH + testosterone ( P = .05 ) . Women 's VO(2)max declined by 0.4 mL/min/kg in the placebo and HRT groups but increased with GH ( P = .07 ) and GH + HRT ( P = .06 ) . Men 's VO(2)max declined by 1.2 mL/min/kg with placebo and by 0.4 mL/min/kg with testosterone ( P = .49 ) but increased with GH ( P = .11 ) and with GH + testosterone ( P<.001 ) . Changes in strength ( r = 0.355 ; P<.001 ) and in VO(2)max ( r = 0.320 ; P = .002 ) were directly related to changes in LBM . Edema was significantly more common in women taking GH ( 39 % vs 0 % ) and GH + HRT ( 38 % vs 0 % ) . Carpal tunnel symptoms were more common in men taking GH + testosterone ( 32 % vs 0 % ) and arthralgias were more common in men taking GH ( 41 % vs 0 % ) . Diabetes or glucose intolerance occurred in 18 GH-treated men vs 7 not receiving GH ( P = .006 ) . CONCLUSIONS In this study , GH with or without sex steroids in healthy , aged women and men increased LBM and decreased fat mass .  Sex steroid + GH increased muscle strength marginally and VO ( 2)max in men , but women had no significant change in strength or cardiovascular endurance . Because adverse effects were frequent ( importantly , diabetes and glucose intolerance ) , GH interventions in the elderly should be confined to controlled studies The effects of a one-month course of treatment with a potent anabolic steroid , meth and ienone ( 5 and 10 mg daily ) , and a very weak and rogen and hormone precursor , dehydroepi and rosterone sulphate ( DHEAS , 20 and 40 mg daily ) and placebo on plasma testosterone , LH and FSH levels , red cell volume and red cell 2,3-diphosphoglycerate ( 2,3-DPG ) concentration in endurance sportsmen were studied using a double-blind test system . A highly significant decrease in mean plasma testosterone was observed after the 5 and 10 mg meth and ienone regimen ( 66 and 73 % ) . Treatment with 40 mg of DHEAS decreased mean testosterone levels by 41 % ( not statistically significant ) . Pre-test testosterone levels were reattained about 10 days after the end of the treatment period with the higher doses of both compounds , while 2–6 weeks afterwards a significant over-compensation in mean plasma testosterone levels was observed . No significant changes in plasma gonadotropins were seen immediately after treatment with either of these steroids bu The aim of the present prospect i ve longitudinal study was to investigate the hormonal response in overtrained athletes at rest and during exercise consisting of a short-term exhaustive endurance test on a cycle ergometer at an intensity 10 % above the individual anaerobic threshold . Over a period of 19+/-1 months , 17 male endurance athletes ( cyclists and triathletes ; age 23.4+/-1.6 yr ; VO2max . 61.2+/-1.8 mL x min(-1 ) x kg(-1 ) ; means+/-SEM ) were examined five times on two separate days under st and ardized conditions . Short-term overtraining states ( OT , N=15 ) were primarily induced by an increase of frequency of high-intensive bouts of exercise or competitions without increase of the total amount of training . OT was compared with normal training states intraindividually ( NS , N=62 ) . During OT , the time to exhaustion of the exercise test was significantly decreased by 27 % on average . At rest and during exercise , the concentrations in plasma and the nocturnal excretion in urine of free epinephrine and norepinephrine were not significantly changed during OT . At physical rest , the concentrations of ( free ) testosterone , cortisol , luteinizing hormone , follicle-stimulating hormone , adrenocorticotropic hormone , growth hormone , and insulin during OT were comparable with those during NS . A significantly ( P < 0.025 ) lower maximal exercise-induced increase of the adrenocorticotropic hormone and growth hormone , as well as a trend for a decrease of cortisol ( P=0.060 ) and insulin ( P=0.036 ) , was measured . The response of free catecholamines as well as the ergometric performance of an all-out 30-s test was unchanged . Serum urea , uric acid , ferritin , and activity of creatine kinase showed no differences between conditions . In conclusion , the results confirm the hypothesis of a hypothalamo-pituitary dysregulation during OT expressed by an impaired response of pituitary hormones to exhaustive short-endurance exercise The few studies that have examined body composition after a carbohydrate-restricted diet have reported enhanced fat loss and preservation of lean body mass in obese individuals . The role of hormones in mediating this response is unclear . We examined the effects of a 6-week carbohydrate-restricted diet on total and regional body composition and the relationships with fasting hormone concentrations . Twelve healthy normal-weight men switched from their habitual diet ( 48 % carbohydrate ) to a carbohydrate-restricted diet ( 8 % carbohydrate ) for 6 weeks and 8 men served as controls , consuming their normal diet . Subjects were encouraged to consume adequate dietary energy to maintain body mass during the intervention . Total and regional body composition and fasting blood sample s were assessed at weeks 0 , 3 , and 6 of the experimental period . Fat mass was significantly ( P < or=.05 ) decreased ( -3.4 kg ) and lean body mass significantly increased ( + 1.1 kg ) at week 6 . There was a significant decrease in serum insulin ( -34 % ) , and an increase in total thyroxine ( T(4 ) ) ( + 11 % ) and the free T(4 ) index ( + 13 % ) . Approximately 70 % of the variability in fat loss on the carbohydrate-restricted diet was accounted for by the decrease in serum insulin concentrations . There were no significant changes in glucagon , total or free testosterone , sex hormone binding globulin ( SHBG ) , insulin-like growth factor-I ( IGF-I ) , cortisol , or triiodothyronine ( T(3 ) ) uptake , nor were there significant changes in body composition or hormones in the control group . Thus , we conclude that a carbohydrate-restricted diet result ed in a significant reduction in fat mass and a concomitant increase in lean body mass in normal-weight men , which may be partially mediated by the reduction in circulating insulin concentrations
RESULTS Body cell mass was correlated with all measures of performance at baseline .
Growth hormone significantly reduced fat mass , increased lean body mass through an increase in extracellular water , and increased body cell mass in men when coadministered with testosterone .
Growth hormone supplementation influenced body composition and increased sprint capacity when administered alone and in combination with testosterone .
BACKGROUND Growth hormone is widely abused by athletes , frequently with and rogenic steroids .
Its effects on performance are unclear .
OBJECTIVE To determine the effect of growth hormone alone or with testosterone on body composition and measures of performance .