Abstract
BackgroundAnabolic steroids are known to improve body composition and muscle strength in healthy people. However, whether anabolic steroids improve the physical condition and function in patients with chronic obstructive pulmonary disease (COPD) remains undetermined. A meta-analysis was conducted to review the current evidence regarding the effects of anabolic steroids on COPD patients.MethodsA comprehensive literature search of PubMed and EMBASE was performed to identify randomised controlled trials that examine the effects of anabolic steroids on COPD patients. Weighted mean differences (WMDs) with 95% confidence intervals were calculated to determine differences between anabolic steroid administration and control conditions.ResultsEight eligible studies involving 273 COPD patients were identified in this meta-analysis. Significant improvements were found in body weight (0.956 kg), fat-free mass (1.606 kg), St. George's Respiratory Questionnaire total score (−6.336) and symptom score (−12.148). The apparent improvements in maximal inspiratory pressure (2.740 cmH2O) and maximal expiratory pressure (12.679 cmH2O) were not significant. The effects on handgrip strength, forced expiratory volume in one second (FEV1), predicted FEV1 percent, PaO2, PaCO2 and six-min walk distance were negative, with WMDs of −0.245 kg, −0.096 L/sec, −1.996% of predicted, −1.648 cmHg, −0.039 cmHg and −16.102 meters, respectively.ConclusionsLimited evidence available from the published literature suggests that the benefit of anabolic steroids on COPD patients cannot be denied. However, further studies are needed to identify the specific benefits and adverse effects of anabolic steroids on COPD patients and to determine the optimal populations and regimes of anabolic steroids in COPD patients.
Highlights
Chronic obstructive pulmonary disease (COPD) is a leading cause of chronic disability and mortality worldwide, and is predicted to be the third leading cause of death by 2030 [1]
Results of pooled analysis The pooled results indicated that an increase trend in body weight, fat-free mass (FFM), maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) was observed after anabolic steroid administration, but decrease in handgrip strength, FEV1, FEV1%, PaO2, PaCO2, 6-MWD, St. George’s Respiratory Questionnaire (SGRQ) total and symptom score
Change in FFM is presented in seven randomised controlled trials (RCTs) [9,14,15,16,17,18,19], six of which showed significant increase after anabolic steroid administration [9,14,15,16,17,18]
Summary
Chronic obstructive pulmonary disease (COPD) is a leading cause of chronic disability and mortality worldwide, and is predicted to be the third leading cause of death by 2030 [1]. Considered formerly a disease of the lungs, COPD has significant systemic manifestations, including weight loss, skeletal muscle dysfunction and nutritional abnormalities, which are important determinants of physical capacity, health-related quality of life and increased disability and mortality [2,3]. Anabolic steroids, which include testosterone and its derivatives, have been reported to increase the weight, fat-free mass (FFM) and muscle mass/strength of healthy people as well as patients with a number of chronic diseases. Administration of anabolic steroids to improve the body weight, FFM and muscle mass/strength in COPD patients may bring about significant benefits. Whether anabolic steroids improve the physical condition and function in patients with chronic obstructive pulmonary disease (COPD) remains undetermined. A meta-analysis was conducted to review the current evidence regarding the effects of anabolic steroids on COPD patients
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