The FASEB Journal article fj.13-245480. Published online January 17, 2014. The FASEB Journal • Research Communication Resistance training restores muscle sex steroid hormone steroidogenesis in older men Koji Sato, Motoyuki Iemitsu, Kenji Matsutani, Toshiyuki Kurihara, Takafumi Hamaoka, and Satoshi Fujita
Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga, Japan
ABSTRACT Skeletal muscle can synthesize testoster-
cular system, brain, and skeletal muscle (1). As
one and 5␣-dihydrotestosterone (DHT) from dehydro-
precursors of sex steroid hormones, dehydroepi-
epiandrosterone (DHEA) via steroidogenic enzymes in vitro, but hormone levels and steroidogenic enzyme
(DHEA-S) play critical physiological roles in main-
expression decline with aging. Resistance exercise has
taining steroidogenesis in peripheral tissues (1). been shown to increase in plasma sex steroid hormone
DHEA is converted to testosterone by 3-hydroxys-
levels. However, it remains unclear whether resistance
teroid dehydrogenase (HSD) and 17-HSD and tes-
training can restore impaired steroidogenic enzyme
tosterone then converted to 5␣-dihydrotestosterone
expressions in older individuals. Six young and 13
(DHT) by 5␣-reductase (1). Aging leads to reduced
older men were recruited, and muscle biopsies were
serum levels of DHEA (2), which are significantly
taken from the vastus lateralis at basal state. The same
correlated with increased risks of metabolic syn-
group of older subjects underwent resistance training
drome (3). Thus, it seems critical to prevent the
involving knee extension and flexion exercises for 12
aging-induced attenuation of steroidogenesis for
wk, and post-training biopsies were performed 4 –5 d after the last exercise session. Muscular sex steroid
In our previous studies, we demonstrated that
hormone levels and sex steroidgenesis-related enzyme
skeletal muscle can synthesize testosterone, estradiol,
expressions were significantly lower in older subjects
and DHT from DHEA locally in cultured skeletal
than younger ones at baseline, but 12 wk of resistance
muscle and rat muscle tissue models (4, 5). In a
training significantly restored hormone levels (DHEA:
recent study by Vingren et al. (6), it was found that
432؎26 at baseline, 682؎31 pg/g protein, DHT:
acute resistance exercise for young human subjects
6.2؎0.9 at baseline, 9.8؎1.4 pg/g protein). Further-
did not change muscular steroidogenesis-related en-
more, the steroidogenesis-related enzymes such as 3-
zymes. Moreover, another study reported that gene
hydroxysteroid dehydrogenase (HSD), 17-HSD, and
expression of steroidogenic enzymes were detected
5␣-reductase expressions were significantly restored by
in female subjects, and they declined with aging,
resistance training. We conclude progressive resis-
specifically 3-HSD and P450 aromatase (2). In ad-
tance training restores age-related declines in sex
dition, a significant correlation was found between
steroidogenic enzyme and muscle sex steroid hor-
serum DHEA level and muscle force per cross-sec-
mone levels in older men.—Sato, K., Iemitsu, M.,
tional area (CSA; ref. 2). However, the effect of aging
Matsutani, K., Kurihara, T., Hamaoka, T., Fujita, S.
on steroidogenic enzymes and muscular sex steroid
Resistance training restores muscle sex steroid hor-
hormone levels in men has not been investigated. If
mone steroidogenesis in older men. FASEB J. 28,
it is possible to improve the aging-induced decrease
000 – 000 (2014). www.fasebj.org
in muscular steroidogenesis, this improvement maycontribute to augmentation of muscle mass. Exercise,
Key Words: skeletal muscle ⅐ exercise ⅐ aging ⅐ muscle strength
especially resistance exercise, is characterized bycontracting skeletal muscles and has been shown toincrease plasma DHT levels in the older adults (7).
Steroid sex hormones, which are secreted mainly
The program of chronic resistance exercise com-
by the ovary, testis, and adrenal cortex, regulate
bined with endurance trainings elevated serum levels
diverse physiological processes in target tissues, in-
of testosterone and estradiol, whereas resistance
cluding reproductive organs, bone, liver, cardiovas-
training itself only increased serum DHT level ac-cording to the previous study (8). Thus, resistanceexercise may reverse aging-induced impairment of
Abbreviations: CSA, cross-sectional area; DHEA, dehydro-
epiandrosterone; DHT, 5␣-dihydrotestosterone; HRP, horse-
radish peroxidase; HSD, hydroxysteroid dehydrogenase;
Correspondence: Ritsumeikan University, 1-1-1 Nojihigashi,
IGF-1: insulin-like growth factor 1; MRI, magnetic resonance
Kusatsu, Shiga, Japan. 525-8577. E-mail: safujita@fc.ritsumei.
imaging; mTOR, mammalian target of rapamycin; 1-RM,
1-repetition maximum; RPE, rating of perceived exertion
steroidogenesis in skeletal muscle with concomitant
of 1-RM was repeated every 4 wk to adjust the training weights
increase in muscle mass and function in older indi-
viduals. However, it remains unclear whether chronicresistance exercise induces changes in muscle sex
Magnetic resonance imaging (MRI)
Therefore the aim of this study was to investigate
MRI was used to determine the muscle CSA of the quadri-ceps. A 1.5-T magnetic resonance system (Signa HDxt; GE
whether 12 wk of progressive resistance training can
Medical Systems) was used to obtain a series of axial slices
enhance muscle steroidogenesis and muscle sex steroid
from the superior border of the patella to the anterior
hormones in older men. To achieve this, we measured
superior iliac spine, encompassing the entire quadriceps
seroidogenic enzymes such as 3-HSD, 17-HSD, and
femoris muscle group. The images were obtained from 10-
5␣-reductase protein expressions, as well as muscular
mm-thick slices. Multislice T1-weighed spin-echo images were
sex steroid hormone levels especially, DHEA, free-
acquired to guide the positioning of the volume of interest
testosterone, and DHT levels, which were measured
and used for measuring muscle CSA at the level of themidthigh (9). Subjects were instructed not to drink or eat
before and after resistance training in older subjects.
after midnight on the night before the scans, which were
We hypothesized that 12 wk resistance training en-
hanced impaired muscular steroidogenesis in oldermen. Muscle biopsies
Muscle biopsies were obtained from the lateral portion of the
MATERIALS AND METHODS
vastus lateralis using a Core biopsy instrument (Bard Max-Core; Bard Peripheral Vascular, Tempe, AZ, USA) understerile conditions with local anesthesia (1% lidocaine). The
Subjects
subjects were fed the same standard dinner (1800 kcal) at1800 h and were allowed only water ad libitum after 2200 h. All
Thirteen older men (mean age: 67.2Ϯ1.8 yr) and 6 young
subjects participated in an overnight fast under basal condi-
men (mean age, 24.3Ϯ1.3 yr) volunteered to participate in
tions and refrained from exercise for 24 h before study
this study. All volunteers provided written informed consent
participation. The biopsy for older subjects after 12 wk of
before participating in the study, which was approved by the
resistance training was performed 4 –5 d after the last exercise
Ethics Committee of Ritsumeikan University and was con-
session to minimize its acute effects. The muscle sample was
ducted in accordance with the Declaration of Helsinki. The
quickly rinsed with ice-cold saline, blotted, and then frozen
older subjects were examined by a physician to confirm that
immediately in liquid nitrogen and stored at Ϫ80°C until
none had medical problems that might preclude participa-
tion or affect the results. None of the subjects regularlyperformed resistance exercise, but they were moderately
Immunoblot analysis
active. Their physical activities included walking and jogging. Subjects were instructed to continue their normal activities of
Muscle specimens were homogenized with 20 mM Tris-HCl,
daily living and usual diets throughout the experimental
pH 7.8; 300 mM NaCl; 2 mM ethylenediaminetetraacetic acid;
2 mM dithiothreitol; 2% nonidet P-40 (Nonidet P-40); 0.2%
One-repetition maximum (1-RM) strength tests were per-
sodium lauryl sulfate; 0.2% sodium deoxycholate; 0.5 mM
formed every 4 wk to adjust training intensity. Isokinetic peak
phenylmethylsulfonyl fluoride; 60 g/ml aprotinin; and 1
torque was assessed in the knee extensors before and after
g/ml leupeptin. The homogenate was gently mixed for 30
training using a dynamometer (Biodex System 4; Biodex
min at 4°C and then centrifuged at 12,000 g for 15 min at 4°C.
Medical Systems, Shirley, NY, USA). To avoid a possible
The protein concentration of the resulting supernatant was
learning effect, a 1-RM test was performed twice at least 3 d
determined. Samples (40 g protein) were denatured at 96°C
after the first 1-RM measurement. The same investigator
for 7 min in Laemmli buffer. Western blot analysis was
measured 1-RM strength before and after training using the
performed essentially as described previously (11). Briefly,
same levels of vocal encouragement. In addition, body com-
muscle samples were separated using 10% SDS-polyacryl-
position and lean mass were measured by dual-energy X-ray
amide gels and transferred to polyvinylidene difluoride
absorptiometry (Lunar Prodigy, GE Medical Systems, Little
(PVDF) membranes (Millipore, Billerica, MA, USA). The
membranes were then treated for 24 h at 4°C with blockingbuffer (5% skim milk in phosphate-buffered saline with 0.1%
Resistance training
Tween 20). Next, the membranes were probed with antibod-ies against 17-HSD, 3-HSD, and the androgen receptor
Resistance exercise sessions for older subjects were carried
(Cell Signaling Technology, Beverly, MA, USA), all diluted
out 3ϫ/wk on alternate days for 12 wk. Experienced trainers
1:1000 with blocking buffer. Anti-5␣-reductase (Abnova, Tai-
supervised all training sessions to ensure that proper tech-
pei, Taiwan) was used at 1:500 dilution. The membranes were
nique and progression were being used in each exercise
washed 3 times with PBS-T and then incubated for 1 h at
session. Each exercise included 2 exercises; bilateral knee
room temperature with a horseradish peroxidase (HRP)-
extension involving the leg extensors, and bilateral knee
conjugated secondary antibody and anti-rabbit immunoglob-
flexion exercising the leg flexors. The starting weight used
ulin (Cell Signaling Technology), diluted 1:3000 in blocking
during the resistance exercise portion of this study was 70% of
buffer. Next, the membranes were washed 3 times with PBS-T.
each subject’s predetermined 1-RM for 3 sets of 10 repetitions
Finally, 17-HSD, 3-HSD, 5␣-reductase, and androgen re-
using weight-stack machines (Life Fitness, Tokyo, Japan). The
ceptor proteins were detected using an enhanced chemilumi-
rest period between sets was 3 min. The weight was increased
nescence plus system (GE Healthcare Biosciences, Piscataway,
for each subject when his rating of perceived exertion (RPE)
NJ, USA) and visualized using an LAS4000 imager (GE
was Ͻ16 for the 10th repetition of the 3rd set. Determination
of resistance exercise induced significant increases inmaximal isokinetic extension strength and quadriceps
Serum hormone levels
Serum sex steroid hormone and IGF-1 levels were
significantly lower in older compared with young
subjects at baseline. Resistance exercise was associ-
ated with increased serum DHEA and DHT levels
(PϽ0.01). Although there was no statistically signifi-
cant change in either serum free testosterone
(Pϭ0.052) or IGF-1 (Pϭ0.055) concentrations, there
was a tendency toward increased serum levels with resistance exercise (Table 2).
Young pre, young subjects at baseline; old pre, older subjects at
baseline; old post, older subjects after training. Values are means ϮSE. *P Ͻ 0.01 vs. old pre. Muscle sex steroid hormone levels
DHEA and DHT levels in skeletal muscle were signifi-
Sandwich enzyme immunoassay (EIA)
cantly lower in older as compared with young subjectsat baseline. However, DHEA levels increased signifi-
Muscle sample was homogenized in same method withimmunoblot analysis. For the determination of DHEA, free
cantly in the older subjects after the training period
testosterone, DHT, and insulin-like growth factor 1 (IGF-1)
(PϽ0.01). Baseline muscle free testosterone levels were
levels, muscle samples were diluted by 200 times with each
also significantly lower in the older subjects than the
assay buffer (11). All techniques and materials used in
young subjects, but free testosterone levels increased
these analyses were in accordance with the manufacturer’s
significantly after training. Moreover, muscle DHT lev-
protocol. The levels of DHEA (Assay Designs, Ann Arbor,
els were lower in older compared with young subjects.
MI, USA), free testosterone (Cayman Chemical, Ann Ar-bor, MI, USA), DHT (Assay Designs), and IGF-1 (R&D
In contrast, 12 wk of training were associated with
Systems, Minneapolis, MN, USA) in plasma and skeletal
significant increases in muscle DHT levels in older
muscle extracts were determined using a sandwich-enzyme
subjects. Resistance training restored muscular sex ste-
immunoassay kit. The immobilized polyclonal antibodies
roid hormones in older subjects to levels seen in the
were raised against DHEA, free testosterone, DHT, and
young subjects (Fig. 1).
IGF-1, whereas the secondary HRP-coupled antibodieswere monoclonal. Optical density at 450 nm was qualifiedusing a microplate reader (BioLumin 960; Molecular Dy-
Sex steroidogenic enzyme expression in muscle
namics, Tokyo, Japan). All samples were assayed in dupli-cate. The average coefficient of variation between dupli-
Expression of steroidogenic enzymes such as 3-HSD
and 17-HSD were significantly lower in older sub-jects before training. However, resistance training
Statistical analysis
was associated with significant increases in the ex- pression of steroidogenic enzymes (PϽ0.01; Fig. 2).
All values are means Ϯ se, unless indicated otherwise. Statis-
5␣-Reductase and androgen receptor expression was
tical analysis was performed using 1-way ANOVA. A post hoc
also higher after 12 wk of resistance training in older
Bonferroni test was used to correct for multiple comparisons
when analyses revealed significant differences. For ANOVA,
PϽ0.01; Fig. 3). In addition, significant P Ͻ 0.05 was considered to be significant; P Ͻ 0.01 was
correlation was seen between percentage change of
considered to be significant for post hoc tests. Relationships
muscular DHEA and DHT levels (rϭ0.721, PϽ0.001).
between the differences in serum or muscle sex steroid
Furthermore, 5␣-reductase protein expression was
hormone concentrations and muscle power and quadricepsCSA, respectively, were determined using Pearson correlationcoefficients.
TABLE 2. Serum hormone concentrations
At baseline, older and young subjects had similar body
weight, although older subjects had a significantly
higher percentage of body fat. Maximal isokinetic
extension strength was significantly lower in older
subjects. Furthermore, older subjects had lower quad-
Young pre, young subjects at baseline; old pre, older subjects at
riceps CSA than young subjects at baseline and after
baseline; old post, older subjects after training. Values are means Ϯ
resistance exercise training (Table 1). However, 12 wk
SE. *P Ͻ 0.01 vs. old pre.
EXERCISE TRAINING AND STEROIDOGENESIS IN HUMAN MUSCLE
Figure 1. Effect of 12 wk of resistance exercise on DHEA, free testosterone, and DHT levels in muscle. Muscle concentrations of DHEA (A), free testosterone (B), and DHT (C) in both young and older subjects were normalized based on total protein levels. Young pre, young subjects at baseline; old pre, older subjects at baseline; old post, older subjects after training. Data represent means Ϯ se. *P Ͻ 0.01 vs. old pre.
significantly correlated with muscular DHT level
protein expression was significantly correlated with
both isokinetic strength (PϽ0.001) and CSA (PϽ0.001). Relationship between sex steroid hormone concentrations and muscle strength and mass DISCUSSION
No significant correlations were found between per-centage changes in serum hormone concentrations
Here we report for the first time that 12 wk progres-
and isokinetic strength or between percentage
sive resistance training appeared to increase or par-
changes in serum hormone concentrations and mus-
tially reverse the age-associated reduction in muscle
cle CSA (PϾ0.1). However, the percentage change of
sex steroid hormone levels and muscular steroido-
intramuscular DHEA and free testosterone levels was
genic enzyme protein expression in men. Although
significantly correlated with isokinetic strength.
protein expression of steroidogenic enzymes such as
Moreover, muscular DHT levels were significantly
3-HSD, 17-HSD, 5␣-reductase, and androgen re-
correlated with both muscle power (PϽ0.001) and
ceptor protein expressions in muscle were signifi-
CSA (Pϭ0.018; Table 3). In addition, 5␣-reductase
cantly lower in older men compared with younger
Figure 2. Effect of exercise on HSD and 17-HSD protein expression. Representative immunoblotting results and histograms of 3-HSD (A) and 17-HSD (B) protein expression are shown. Young pre, young subjects at baseline; old pre, older subjects at baseline; old post, older subjects after training; AU, arbitrary unit. Data represent means Ϯ se. *P Ͻ 0.01 vs. old pre. Figure 3. Effect of exercise on 5␣-reductase type 1 and androgen receptor protein expression. A) Representative immunoblot- ting results and histogram of 5␣-reductase type 1 protein expression in the muscle. B) Representative immunoblotting results and histograms of androgen receptor protein expression. Young pre, young subjects at baseline; old pre, older subjects at baseline; old post, older subjects after training. Data represent means Ϯ se. *P Ͻ 0.01 vs. old pre.
counterparts at baseline, 12 wk of resistance training
15) and accelerated sarcopenia (15, 16). Using in
significantly increased levels of these enzymes and
vitro and in vivo animal models, we have previously
restored both serum and muscle levels of DHEA, free
demonstrated that testosterone and DHT can be
testosterone, and DHT to levels seen in young sub-
synthesized from DHEA in muscle (4, 5) and acute
jects. Interestingly muscular steroid hormone levels
and chronic aerobic exercise increases sex steroid
significantly correlated with muscle strength and
hormones in muscle with concomitant elevations of
CSA. Thus, progressive resistance training seems to
serum steroid hormones in rats (11, 17). Further-
restore muscle sex steroid hormone levels via en-
more, exercise, especially resistance exercise, is char-
hancement of steroidogenesis-related enzyme ex-
acterized by contracting skeletal muscles and in-
pressions in the skeletal muscle and may partly
creased sex steroid hormone levels in the older
contribute to the increase in muscle strength and
adults (7). In the present human study, the serum
and muscle levels of sex steroid hormones were
Aging is associated with decreases in serum DHEA
significantly lower in older as compared with younger
levels (12). Consequently, reductions in sex steroid
men However, resistance training restored both
hormone concentrations in blood would result in an
plasma and muscular sex steroid hormone levels in
increased risk of the metabolic syndrome (3, 13, 14,
older subjects. Importantly, restoring DHT has amore potent effect on target tissue than DHEA and
TABLE 3. Association of systemic and local hormone levels with
testosterone because of its greater affinity to the
muscle power and CSA in percentage changes
androgen receptor (1). Therefore, resistance train-ing-induced increases in muscular DHT and andro-
gen receptor expressions may have contributed to
the training effect in older subjects.
A previous study reported gene expression of steroido-
genic enzymes declines with aging, especially 3-HSD and
P450 aromatase in women (2). In the present study,
steroidogenic enzyme expressions such as 3-HSD, 17-
HSD, and 5␣-reductase significantly were lower in older
men compared with young at baseline. However, 12 wk
resistance training significantly increased muscular ste-
roidogenic enzyme expressions; therefore, the training-
induced restoration of impaired muscular steroidogenic
enzymes in older men may have increased the synthesis
Italics denote significance at P Ͻ 0.05.
and intramuscular levels of sex steroid hormones.
EXERCISE TRAINING AND STEROIDOGENESIS IN HUMAN MUSCLE
In the previous study, chronic resistance training
lower in older men as compared with young men.
induced to elevate serum testosterone and DHEA levels
However, progressive resistance training significantly
(8). A recent study reported that gene expression of
restored age-related decline of steroidogenic enzyme
steroidogenesis-related enzymes in human muscle re-
expressions and sex steroid hormone levels, and
duced with aging (2). In addition, serum DHEA-S level
these enzymes and hormone levels significantly cor-
was significantly correlated with muscle force per CSA
related with muscle size and strength. Therefore,
in female subjects (2). In the present study, significant
resistance training-induced increase muscular sex
correlations were seen between training effects of mus-
steroid hormone may positively affect age-related
cle sex steroid hormone levels, muscle CSA and maxi-
concerns such as accidental falls, diabetes, sarcope-
mum isokinetic strength. In addition, steroidogenic
nia, and osteoporosis and may improve the quality of
enzyme especially 5␣-reductase protein expression sig-
nificantly correlated with muscle CSA and isokineticstrength. However, no significant correlation was seen
The authors specially thank Dr. Noboru Mesaki for sup-
between serum DHEA level and muscle force per CSA
porting this study. This work was supported by grants-in-aidfor scientific research from the Ministry of Education, Cul-
in men (rϭ0.318, Pϭ0.082). The mechanism underly-
ture, Sports, Science, and Technology of Japan (23700849,
ing the relationship between androgen levels in muscle
24300235, and 22680050). This work was also funded by the
and muscle mass and strength remains to be eluci-
Yamaha Motor Foundation for Sports (to K.S., S.F., and M.I.).
dated. In several previous studies, androgen replace-
The authors declare no conflicts of interest.
ment enhanced skeletal muscle mass and strength inolder adults (18, 19, 20, 21). Testosterone supplemen-tation induces increases in satellite cell replication and
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Accepted for publication December 2, 2013.
EXERCISE TRAINING AND STEROIDOGENESIS IN HUMAN MUSCLE
Restless Legs Syndrome and Periodic Limb Movement Disorder Restless Legs Syndrome is a movement disorder where a child reports uncomfortable sensations in the legs when sitting still or lying in bed. To relieve these sensations the child will move and stretch their legs, hence the term ‘restless legs’. Many young people with restless legs syndrome also suffer with periodic limb movement
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