Effect of oral anabolic steroid on muscle strength and muscle growth in hemodialysis patients

Abstract

Background and objectives Sarcopenia is common in hemodialysis patients. This study examined whether the anabolic steroid oxymetholone improves muscle mass and handgrip strength in hemodialysis patients and possible mechanisms that might engender such changes. Design, setting, participants, & measurements Forty-three eligible hemodialysis patientswere randomly assigned to ingest oxymetholone or placebo for 24 weeks. Body composition, handgrip strength, and quality of life were measured during the study.Muscle biopsieswere performed and analyzed formRNAlevels formyostatin, IGF-I, IGF binding proteins, and myosin heavy chains and protein expression. Muscle fiber types and diameter were assessed by reduced nicotinamide-adenine dinucleotide staining. Results There was a significantly greater increase in fat-free mass and handgrip strength and decrease in fat mass in the oxymetholone comparedwith the placebo group.Moreover, comparedwith baseline values, patients given oxymetholone exhibited an increase in fat-free mass, handgrip strength, physical functioning scores, and type I muscle fiber cross-sectional area and a decrease in fat mass, whereas patients receiving placebo did not undergo changes. There was a significantly greater increase in muscle mRNA levels for myosin heavy chain 2×, IGF-I, and IGF-II receptor with oxymetholone treatment than placebo. Liver enzyme rose significantly in the oxymetholone group, but the number of values greater than three times the upper limit of normal were not different between these groups. Conclusions In hemodialysis patients, ingesting oxymetholone was associated with an increase in fat-free mass, handgrip strength, and muscle mRNA levels for several growth factors and a decrease in fat mass, but it also induced liver injury. © 2013 by the American Society of Nephrology.