Intramuscular TRT is more effective than transdermal formulations at increasing LBM and improving muscle strength  in middle-aged and older men , particularly in the lower extremities
BACKGROUND Inconsistent fat-free mass ( FFM ) and muscle strength responses have been reported in r and omized clinical trials ( RCTs ) administering  testosterone replacement therapy ( TRT ) to middle-aged and older men .
Our objective was to conduct a meta- analysis to determine whether TRT improves FFM and muscle strength in middle-aged and older men and whether the muscular responses vary by TRT administration route .
Development of a bedside viable ultrasound protocol to quantify appendicular lean tissue mass
Abstract Background Ultrasound is a non‐invasive and readily available tool that can be prospect ively applied at the bedside to assess muscle mass in clinical setting s. The four‐site protocol , which images two anatomical sites on each quadriceps , may be a viable bedside method , but its ability to predict musculature has not been compared against whole‐body reference methods . Our primary objectives were to ( i ) compare the four‐site protocol 's ability to predict appendicular lean tissue mass from dual‐energy X‐ray absorptiometry ; ( ii ) optimize the predictability of the four‐site protocol with additional anatomical muscle thicknesses and easily obtained covariates ; and ( iii ) assess the ability of the optimized protocol to identify individuals with low lean tissue mass . Methods This observational cross‐sectional study recruited 96 university and community dwelling adults . Participants underwent ultrasound scans for assessment of muscle thickness and whole‐body dual‐energy X‐ray absorptiometry scans for assessment of appendicular lean tissue . Ultrasound protocol s included ( i ) the nine‐site protocol , which images nine anterior and posterior muscle groups in supine and prone positions , and ( ii ) the four‐site protocol , which images two anterior sites on each quadriceps muscle group in a supine position . Results The four‐site protocol was strongly associated ( R 2 = 0.72 ) with appendicular lean tissue mass , but Bl and –Altman analysis displayed wide limits of agreement ( −5.67 , 5.67 kg ) . Incorporating the anterior upper arm muscle thickness , and covariates age and sex , alongside the four‐site protocol , improved the association ( R 2 = 0.91 ) with appendicular lean tissue and displayed narrower limits of agreement ( −3.18 , 3.18 kg ) . The optimized protocol demonstrated a strong ability to identify low lean tissue mass ( area under the curve = 0.89 ) . Conclusions The four‐site protocol can be improved with the addition of the anterior upper arm muscle thickness , sex , and age when predicting appendicular lean tissue mass . This optimized protocol can accurately identify low lean tissue mass , while still being easily applied at the bedside
Intramuscular TRT is more effective than transdermal formulations at increasing LBM and improving muscle strength  in middle-aged and older men , particularly in the lower extremities
BACKGROUND Inconsistent fat-free mass ( FFM ) and muscle strength responses have been reported in r and omized clinical trials ( RCTs ) administering  testosterone replacement therapy ( TRT ) to middle-aged and older men .
Our objective was to conduct a meta- analysis to determine whether TRT improves FFM and muscle strength in middle-aged and older men and whether the muscular responses vary by TRT administration route .