Testosterone Improves Fat Distribution for Older Women

As we age, the amount and distribution of fat in our bodies changes.
Photo Credit: Centre for Ageing Better

Scientific Frontline: "At a Glance" Summary: Testosterone Improves Fat Distribution for Older Women

• Main Discovery: The application of a topical testosterone gel, combined with therapeutic exercise, selectively reduces unhealthy visceral fat in older women recovering from hip fractures without causing an overall loss of total body mass or essential muscle.
• Methodology: Researchers conducted a trial involving 66 women over the age of 65 who had recently suffered a hip fracture. All participants underwent baseline DXA scans and completed a therapeutic exercise program, with one experimental group receiving a topical testosterone gel. Follow-up body composition scans were performed six months later to assess anatomical changes.
• Key Data: After six months, there was no difference in total body fat percentage between the control and experimental groups. However, the group receiving testosterone exhibited a targeted reduction in visceral fat, whereas the control group experienced the expected post-injury increase in visceral fat.
• Significance: This intervention offers a targeted metabolic treatment to reduce visceral fat—which is strictly linked to diabetes and cardiovascular disease—without relying on generalized weight loss protocols that frequently cause detrimental muscle degradation in older, injured adults.
• Future Application: Topical testosterone treatments may be systematically integrated into post-operative rehabilitation protocols for older patients suffering from severe physical traumas, mitigating the physiological decline and compounding health risks associated with prolonged recovery periods.
• Branch of Science: Kinesiology, Gerontology, and Endocrinology.
• Additional Detail: Hip fractures are nearly three times more common in women than men and represent the leading cause of loss of independence in older women, underscoring the necessity of demographic-specific recovery therapies.

A novel UConn study looked at the impact of using a topical testosterone gel as part of treatment for older women who have suffered a hip fracture in conjunction with exercise

Most fat is subcutaneous – meaning it is stored just under the skin. Subcutaneous fat generally does not have detrimental health impacts. In fact, we need some amount of fat to be healthy. Visceral fat, however, is stored in the gut and has been linked to negative health impacts including diabetes and cardiovascular disease.

Research has shown that testosterone levels play a key role in changing the distribution of fat from subcutaneous to visceral as we age.

“As men and women age, there’s an unhealthy redistribution of fat from the more innocuous regions into the visceral compartment,” Jacob Earp, assistant professor of kinesiology in the College of Agriculture, Health and Natural Resources (CAHNR) says. “There is a direct link between sex hormones and fat distribution throughout the body.”

Weight loss interventions cannot target just visceral fat. Instead, they reduce total body weight which can have detrimental effects for older adults.

“Doing these blanket weight loss strategies is not always the healthiest approach, especially because muscle weight will be lost along with fat and maintaining muscle is extremely important as we age,” Earp says.

Earp led a novel study that looked at the impact of using a topical testosterone gel as part of treatment for older women who have suffered a hip fracture in conjunction with exercise.

He published the results of this study in Obesity Pillars.

A hip fracture is a serious medical concern for older women. Hip fracture is nearly three times more common in women than men and is the leading cause of loss of independence for older women. The resultant decrease in physical activity also increases the risk of disease and reinjury.

The study included a group of 66 women over the age of 65 recovering from a recent hip fracture. Before the trial, they underwent a DXA scan that measures body composition.

All participants took part in a therapeutic exercise intervention, but only one group received the testosterone gel.

A scan six months after the trial revealed that there was no change in the percentage of total body fat between the two groups. But there was less fat stored in the visceral compartment in the group that received the testosterone treatment. In the other group, visceral fat actually increased, which normally happens after while recovering from a hip fracture.

“If you have injury and just generally as we age, we expect an increase in visceral fat,” Earp says. “This really bucked that trend and caused selective reduction of fat in that visceral compartment.”

This study marks a promising finding for improving outcomes for older women who suffer a hip fracture.

“These are devastating injuries that most women don’t ever recover from,” Earp says. “In this case, any kind of intervention that can have a beneficial effect on health, you could potentially have a huge improvement in quality of life for the individual.”

Published in journal: Obesity Pillars

Title: Testosterone therapy effects adipose distribution in older females post hip-fracture: The STEP-HI study

Authors: Jacob E. Earp, Shangshu Zhao, Furong Xu, Chia-Ling Kuo, Jenna M. Bartley, Richard H. Fortinsky, Jatupol Kositsawat, Carlos O. Rehbein, Ellen F. Binder, Jennifer Stevens-Lapsley, and George A. Kuchel

Source/Credit: University of Connecticut | Anna Zarra Aldrich

Reference Number: bio031926_01

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