- Déficit Androgénique Lié à l'Âge
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Déficit androgénique: effet de la substitution sur la composition corporelle
Androgen deficiency: effect of hormone replacement therapy on body composition
Andrologie volume 12, pages 17–23 (2002)
Résumé
L'inflation de la masse grasse contrastant avec une réduction de la masse maigre, représente un des stigmates de l'hypogonadisme masculin. Des modifications similaires sont observées au cours du vieillissement, phase de l'existence également marquée par le déclin de la fonction testiculaire. L'androgénothérapie substitutive de l'adulte atteint d'un hypogonadisme avéré permet d'inverser cette tendance en stimulant la synthèse protéique, notamment musculaire, effet qui se traduit par un gain de masse et de forces du muscle squelettique. A l'inverse, cette thérapeutique, inhibe l'utilisation tissulaire des lipides, en particulier par le tissue adipeux viscéral, avec ses conséquences de réduction de la masse grasse. Compte tenu de l'analogie existant entre conséquences du vieillissement d'une part et de l'hypogonadisme masculin de l'adulte d'autre part il était tentant d'évaluer l'intérêt d'un traitement par androgènes à doses substitutives chez l'homme âgé atteint d'un déficit androgénique lié à l'age. La dizaine d'études qui ont inclus peu ou prou des hommes de plus de 65 ans confortent le concept de bénéfice d'une telle thérapeutique en termes de composition corporelle, bénéfice qu'ils peuvent tirer d'une restauration de leur taux de testostérone plasmatique dans la fourchette normale de l'adulte jeune.
Abstract
Male hypogonadism is responsible for an increase in fat body mass and a decrease in lean body mass. Similar changes are observed in aging men. Aging is also frequently associated with a decrease in testicular function. Androgen replacement therapy in adult men with hypogonadism has been shown to reverse these changes in body composition. Androgens stimulate protein synthesis, especially in muscles, leading to a gain of muscle mass and muscle strength. In contrast, androgen therapy inhibits tissue utilization of lipids, predominantly in visceral fat and consecutively induces a decrease in fat body mass. As the same changes in body composition are observed in aging and in hypogonadal adult men, the value of androgen replacement therapy was evaluated in aging men with an age-related decrease in androgen production. About ten studies have included human males over the age of 65. The results obtained indicate the benefit of such therapy in terms of improvement in body composition in aging men due to a rise in plasma testosterone levels up to the normal range of young adult men.
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Kuhn, J.M. Déficit androgénique: effet de la substitution sur la composition corporelle. Androl. 12, 17–23 (2002). https://doi.org/10.1007/BF03034944
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DOI: https://doi.org/10.1007/BF03034944