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临床试验/NCT03054168
NCT03054168Unknown3 期

The Regulation of Skeletal Muscle Protein Synthesis by Systemic Hormones and Its Influence on Ageing and Anabolic Resistance

University of Nottingham1 个研究点 分布在 1 个国家目标入组 34 人开始时间: 2016年12月15日最近更新:
适应症
干预措施
相关药物

试验速览

阶段
3 期
入组人数
34
试验地点
1
主要终点
Muscle Protein Synthesis

研究概览

简要总结

This study evaluates the effect of increase in testosterone levels in older males and the effects of decrease in testosterone levels in young males on muscle protein synthesis.

详细描述

Skeletal muscle represents the largest organ in the body, comprising >50% of total body mass. The function of skeletal muscle is best understood for its role in locomotion and providing mechanical support to the skeleton to facilitate movement. However, skeletal muscles are also important for maintaining whole-body metabolic health. For example, muscles also act as a site for glucose disposal thereby acting to maintain whole-body glycaemic control. In addition, skeletal muscles represent a vast protein store, the amino acids from which can be used in times of fasting, infection and disease to provide energy to maintain other critical organs. Exercise (resistance type exercise (RE-T) in particular) still remains the most effective means by which to maintain and increase muscle mass through stimulation of muscle protein synthesis (MPS), despite this, how exercise regulates these changes in muscle mass is still unknown. A number of pathways have been inferred as key, however it is clear from a number of studies that systemic hormone levels, testosterone in particular, may provide a significant contribution. It is well known that chronic androgenic hormone deficiency can lead to a loss of lean body mass and strength, which can in turn contribute to impaired physical function. Furthermore, when testosterone levels are pharmacologically reduced (using a gonadotropin releasing hormone analogue) in healthy young males, resistance exercise training induced increases in muscle mass and strength are absent. Whilst systemic hormone levels are carefully maintained in youth (unless illness or deficiency is present), levels of these hormones decrease with age, particularly in those that are not regularly physically active, indeed approximately 25-30% of older men have levels of testosterone which are below the threshold used to define hypogonadism. Therefore, there is significant need to understand the underlying mechanisms behind hormonally induced muscle mass regulation. Furthermore, in older age there is a resistance to traditional anabolic stimuli such as nutrition or resistance exercise, with older adults showing a blunted-anabolic hormonal profile in response to resistance training compared to young. These impairments to hormonal regulation with ageing may in part be responsible for the slow decline in muscle mass with age known as sarcopenia. Whilst all muscle-wasting conditions are of considerable concern, it is the loss of muscle in older age that poses the greatest socio-economic burden. Therefore there is a significant clinical need to identify contributing factors to this muscle loss so that they can be specifically targeted for intervention (i.e., pharmacological hormonal therapies).

The aims of this project are two fold: 1) Firstly we aim to investigate the impact of systemic hormone levels on control of muscle mass in healthy young adults undertaking a resistance exercise training program, we hypothesize that reduction of hormone levels in systemically normal young adults will impair MPS and muscle mass gains in response to resistance exercise training. 2) Secondly we aim to investigate the impact of enhancing testosterone levels in older adults on responsiveness to resistance exercise training and the contribution of systemic testosterone levels to muscle mass regulation in ageing, we hypothesize that increasing testosterone levels in older males will improve responsiveness to anabolic stimuli (RE-T).

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Parallel
主要目的
Basic Science
盲法
Triple (Participant, Investigator, Outcomes Assessor)

入排标准

年龄范围
18 Years 至 75 Years(Adult, Older Adult)
性别
Male
接受健康志愿者

入选标准

  • Young (18-30y) and old (60-75y) males who are generally healthy

排除标准

  • Participation in a formal exercise regime
  • BMI < 18 or > 30 kg·m2
  • Active cardiovascular disease:
  • uncontrolled hypertension (BP > 160/100),
  • heart failure (class III/IV),
  • arrhythmia,
  • right to left cardiac shunt,
  • recent cardiac event
  • Taking beta-adrenergic blocking agents, statins, non-steroidal anti-inflammatory drugs or HRT
  • Cerebrovascular disease:
  • previous stroke,
  • aneurysm (large vessel or intracranial)
  • Respiratory disease including:
  • pulmonary hypertension,
  • Metabolic disease:
  • hyper and hypo parathyroidism,
  • Hypo and hyper gonadism
  • untreated hyper and hypothyroidism,
  • Cushing's disease,
  • type 1 or 2 diabetes
  • Active inflammatory bowel or renal disease
  • Malignancy
  • Altered hormonal profile
  • Recent steroid treatment (within 6 months) or hormone replacement therapy
  • Clotting dysfunction
  • Musculoskeletal or neurological disorders
  • Family history of early (<55y) death from cardiovascular disease

研究组 & 干预措施

Old Testosterone trained

Experimental

8 old participants (65-75 years old) who will receive resistance exercise training and Testosterone (Sustanon 250: 250 mg every 2wks)

Drug name: Sustanon 250 Generic Name: Testosterone Proprietary Name: N/A Formulation: 250mg of Testosterone in 1ml volume Dose: 250mg of testosterone Frequency: every 2 weeks Route: intramuscular injection

干预措施: Sustanon 250 (Drug)

Old Placebo trained

Placebo Comparator

8 old participants (65-75 years old) who will receive resistance exercise training and Placebo every two weeks.

干预措施: Placebo (Other)

Young Zoladex trained

Experimental

8 young participants (18-30 years old) who will receive resistance exercise training and Testosterone inhibitor (3.6mg Zoladex subcutaneous injection, one time over the study)

Drug name: Zoladex Generic Name: Gonadotropin-releasing hormone analogue; Goserelin Proprietary Name: N/A Formulation: Solution for injection Dose: 3.6mg Frequency: Single injection one time over the study. Route: Subcutaneous injection (abdomen) performed by clinician.

干预措施: Zoladex (Drug)

Young placebo trained

Placebo Comparator

8 young participants (18-30 years old) who will receive resistance exercise training and placebo, one time over the study.

干预措施: Placebo (Other)

结局指标

主要结局

Muscle Protein Synthesis

时间窗: 0-6 Weeks

Comparison of muscle protein synthesis between young and older individuals when their testosterone levels decrease and increase, respectively; in response to 6 weeks whole body resistance exercise training

次要结局

未报告次要终点

研究者

申办方类型
Other
责任方
Principal Investigator
主要研究者

Philip Atherton

Philip Atherton

University of Nottingham

研究点 (1)

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