http://www.medscape.com/viewarticle/524461_4
Effects of Nandrolone Decanoate Compared With Placebo or Testosterone on HIV-Associated Wasting
J Gold; MJ Batterham; H Rekers; MK Harms; TBP Geurts; PME Helmyr; et al
["This study is the first large multicentre randomized placebo-controlled study to demonstrate the effectiveness of nandrolone decanoate over placebo in increasing fat free mass, weight and body mass index in HIV-positive males with wasting."]
["In view of the escalating nature of health care costs, it is critical that an effective anabolic agent that will improve fat free mass and perception of treatment benefit is of low cost and has minimal side effects so that it may be of use in resource-poor settings."]
["It has been reported that the lower than normal testosterone level in HIV-positive male patients is associated with decreased sexual functioning, depression and loss of fat free mass.[SUP][23,24][/SUP] The aetiology of this physiological observation is unclear.
HIV may have an impact on the hypothalamic pituitary axis or a direct impact on the testis, or both.
In addition to involuntary weight loss, lowered testosterone levels are associated with a poor prognosis.[SUP][25][/SUP] Because of these documented associations, the relationship between baseline androgen levels and treatment with androgenic anabolic agents warrants investigation. Bhasin
et al[SUP][26][/SUP] did not find a correlation between change in fat free mass and baseline testosterone levels in their study investigating the effects of testosterone replacement in hypogonadal HIV-positive men with weight loss."]
["This study is the first large multicentre randomized placebo-controlled study to demonstrate the effectiveness of nandrolone decanoate over placebo in increasing fat free mass, weight and body mass index in HIV-positive males with wasting. In addition, fortnightly treatment with 150 mg nandrolone decanoate was superior to fortnightly treatment with 250 mg testosterone for increasing weight, increasing body mass index and (insignificantly) increasing fat-free mass.
Subjectively, nandrolone was superior to both placebo and testosterone for improving perception of treatment benefit and recovery from symptoms. Testosterone and nandrolone were chosen as the two agents to compare in this study as they were the treatments most commonly prescribed at the participating research centres for treatment of weight loss...
In view of the escalating nature of health care costs, it is critical that an effective anabolic agent that will improve fat free mass and perception of treatment benefit is of low cost and has minimal side effects so that it may be of use in resource-poor settings...
... This study also addresses the concern that anabolic/androgenic agents may increase serum lipids and liver function test results, and have a negative effect on glycaemic control.[SUP][27,28][/SUP] Current evidence does not support these concerns...
... (in those without) HIV infection have been associated with reduced visceral adipose tissue, lower glucose levels and improved insulin sensitivity.[SUP][29][/SUP] Epidemiological studies have shown inverse relationships between total and free serum testosterone and visceral fat, cardiovascular disease and type 2 diabetes.[SUP][29][/SUP] Sattler
et al[SUP][30][/SUP] demonstrated no detrimental effects of nandrolone on triglycerides, or total or LDL cholesterol. HDL cholesterol did decrease transiently during nandrolone treatment, but returned to near-baseline levels when assessed 12 weeks after the treatment was finished. Previously we have also investigated changes in serum lipids, fasting insulin and glucose over an 8-week period in 10 HIV-positive male patients with body composition changes consistent with lipodystrophy and found no significant changes in these parameters.[SUP][31][/SUP] No significant differences were detected between the placebo and nandrolone groups for changes in serum cholesterol (total, LDL or HDL), triglycerides, glucose and insulin in the present study, although a significant difference did exist between the nandrolone and testosterone groups for LDL and total cholesterol. "]
