Published ahead of print on December 10, 2004, doi:10.1164/rccm.200412-1643OC Am. J. Respir. Crit. Care Med., Volume 171, Number 6, March 2005, 598-605 A more recent version of this article appeared on March 15, 2005
Submitted on December 8, 2004 Respiratory and Skeletal Muscles in Hypogonadal Men with Chronic Obstructive Pulmonary DiseaseFranco Laghi1,1 Division of Pulmonary and Critical Care Medicine, Edward Hines Jr. Veterans Administration Hospital and Loyola University of Chicago Stritch School of Medicine, Hines, IL, USA * To whom correspondence should be addressed. E-mail: mtobin2{at}lumc.edu.
Hypogonadism, found in about one-third of patients with chronic obstructive pulmonary disease, has potential for decreasing muscle mass and muscle performance. Compared with eugonadal patients, we hypothesized that hypogonadal patients with chronic obstructive pulmonary disease have decreased respiratory and skeletal muscle performance. Nineteen hypogonadal and 20 eugonadal men with chronic obstructive pulmonary disease (forced expiratory volume in one second 1.14±0.08 and 1.17±0.11 liter (standard error) respectively) were studied. Diaphragmatic contractility, assessed as transdiaphragmatic twitch pressure generated by phrenic nerve stimulation, was similar in hypogonadal and eugonadal patients: 20.6±2.2 and 19.8±2.5 cm H2O. During progressive inspiratory threshold loading, hypogonadal and eugonadal patients had similar respiratory muscle endurance times (302±29 and 313±48 seconds) and airway pressure sustained during the last minute of loading (38.2±3.0 and 40.5±4.7 cm H2O) (similar to predicted values in healthy subjects). Hypogonadal and eugonadal patients had equivalent limb muscle strength and endurance. During cycle exercise to exhaustion, exercise performance, gas exchange, and respiratory muscle recruitment (estimated by esophageal and gastric pressure swings during tidal breathing) were similar in both groups. In conclusion, hypogonadism does not decrease respiratory or limb muscle performance and exercise capacity in men with moderate to severe chronic obstructive pulmonary disease who, for the most part, are not underweight. Key words: respiratory muscles, testosterone, androgens, exercise tolerance, phrenic nerve, muscle fatigue
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