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Exercise as a mediator of psychological and nutritional effects of testosterone therapy in HIV+ men

WAGNER, GLENN; RABKIN, JUDITH; RABKIN, RICHARD

Medicine & Science in Sports & Exercise: June 1998 - Volume 30 - Issue 6 - p 811-817
Clinical Sciences: Clinically Relevant

Exercise as a mediator of psychological and nutritional effects of testosterone therapy in HIV+ men. Med. Sci. Sports Exerc., Vol. 30, No. 6, pp. 811-817, 1998.

Purpose: The purpose of this study was to determine whether exercise mediates the psychological and nutritional effects of testosterone therapy in men with symptomatic HIV illness, low serum testosterone, and clinical symptoms of hypogonadism.

Methods: A 12-wk open trial of biweekly intramuscular testosterone injections was conducted, with 54 men completing the trial and exercise assessments. Most (71%) men were diagnosed with AIDS; 41% had a CD4 < 50. One-third of the men were diagnosed with major depression, and nearly half had some evidence of wasting. Twenty-nine men (54%) engaged in exercise (predominantly resistance training) during the trial. Exercisers did not differ from nonexercisers on any measure of psychological well being or nutritional status at baseline.

Results: After 12 wk of testosterone treatment, those who exercised showed significant improvement in mood (Hamilton Rating Scale for Depression; HAM-D) and overall distress (Brief Symptom Inventory; BSI) (P < 0.000 for both), as well as a significant increase in body cell mass (P < 0.01) and lean body mass (mean increase of 2.6 kg; P < 0.000) as measured by bioelectric impedance analysis. In contrast, nonexercisers showed improvement on the HAM-D (P < 0.000), but not the BSI or measures of nutritional status.

Conclusion: These findings indicate that exercise may be an important adjunct to testosterone therapy in the treatment of psychological distress and wasting symptoms in men with symptomatic HIV illness.

Department of Psychiatry, New York State Psychiatric Institute, New York, NY 10032

Submitted for publication July 1996.

Accepted for publication November 1997.

We acknowledge our research assistant, Shira Maguen, M.A., for her valuable assistance in the preparation of the manuscript. Funding for the study was provided in part by NIMH Grant R 01 MH52037 (to J. R.). Testosterone was supplied by the Upjohn Company. The results of the study do not constitute the authors' endorsement of testosterone.

Address for correspondence: Glenn Wagner, Ph.D., New York Psychiatric Institute, 722 West 168th St., U #35, New York, NY 10032.

© Williams & Wilkins 1998. All Rights Reserved.