The Therapeutic Intervention of Sex Steroid Hormones for Sarcopenia

Abstract

Sarcopenia, characterized by the excessive loss of skeletal muscle mass, strength, and function, is associated with the overall poor muscle performance status of the elderly, and occurs more frequently in those with chronic diseases. The causes of sarcopenia are multifactorial due to the inherent relationship between muscles and molecular mechanisms, such as mitochondrial function, inflammatory pathways, and circulating hormones. Age-related changes in sex steroid hormone concentrations, including testosterone, estrogen, progesterone, and their precursors and derivatives, are an important aspect of the pathogenesis of sarcopenia. In this review, we provide an understanding of the treatment of sarcopenia through the regulation of sex steroid hormones. The potential benefits and future research emphasis of each sex steroid hormone therapeutic intervention (testosterone, SARMs, estrogen, SERMs, DHEA, and progesterone) for sarcopenia are discussed. Enhanced understanding of the role of sex steroid hormones in the treatment for sarcopenia could lead to the development of hormone therapeutic approaches in combination with specific exercise and nutrition regimens.

Linolenic acid ameliorates sarcopenia in C. elegans by promoting mitophagy and fighting oxidative stress

“…Many studies have proved that sarcopenia was related to mitochondrial function, and improving mitochondrial dysfunction was an important target for the treatment of sarcopenia. 19,37,38 Whether the improvement of C. elegans sarcopenia by linolenic acid is related to mitochondrial function was determined. Two transgenic C. elegans strains CB5600 and SJ4103 were used to investigate the effects of linolenic acid administration on myotome morphology.…”

Combination of selective androgen and estrogen receptor modulators in orchiectomized rats

“…However, both replacement therapies have been shown to be associated with severe side effects [ 5 , 7 ]. Consequently, due to higher tissue selectivity, selective androgen and estrogen receptor modulators (SARM and SERM, respectively) offer new treatment options for the musculoskeletal system [ 2 ]. SARMs resist aromatization of 5-α-reduction compared to testosterone and are considered to have a better bioavailability and pharmacokinetic profile than testosterone [ 8 ].…”

“…Nevertheless, there has been no indication for their use so far [ 9 ]. SERMs present an established therapy for postmenopausal symptoms that have fewer side effects compared to estrogen [ 2 ]. In regard to musculature, studies reported improved muscle function and structure after SERM administration in male mice with muscular dystrophy [ 10 , 11 ].…”

Effect of Ishige okamurae extract on musculoskeletal biomarkers in adults with relative sarcopenia: Study protocol for a randomized double-blind placebo-controlled trial

“…Therefore, sarcopenia has been recognized as a disease since its registration in the International Classification of Disease, Tenth Revision, Clinical Modification on October 1, 2016 ( 8 , 9 ). In recent years, several pharmacological treatments, including synthetic drugs and hormones, have been tested for the improvement of sarcopenia in clinical trials ( 10 – 12 ). However, it has been reported that testosterone may increase the risk for cardiovascular adverse events.…”

“…However, it has been reported that testosterone may increase the risk for cardiovascular adverse events. Selective androgen receptor modulators have been used to avoid the side effects of anabolic steroids, but constipation, dyspepsia, or nausea have also been observed in studies ( 10 ). Growth hormone increased lean body mass and decreased fat mass; however, adverse events such as soft tissue edema, arthralgias, and carpal tunnel syndrome were significantly increased in the clinical trial ( 11 ).…”