Abstract
Objectives
Obesity is associated with sarcopenia in older adults, and weight loss can lead to
further muscle mass loss. Oxytocin decreases with age, and animal studies suggest
that oxytocin administration has trophic effects on skeletal muscle cells and reduces
adiposity. We conducted a clinical trial to examine the safety and preliminary efficacy
of intranasal oxytocin for older adults with sarcopenic obesity.
Design
A double-blind, placebo-controlled randomized controlled trial of intranasal oxytocin
(24 IU 4 times per day) for 8 weeks.
Setting and Participants
Twenty-one older (67.5 ± 5.4 years), obese (30–43 kg/m2), sedentary (<2 strenuous exercise per week) adults with slow gait speed (<1 m/s,
proxy measure of sarcopenia) were recruited.
Measures
Generalized estimating equations were used to evaluate the effect of oxytocin on safety/tolerability
of oxytocin administration and whole body muscle and fat mass.
Results
At baseline, body mass index (BMI) was 36.8 ± 3.6 kg/m2, fat mass 46.09 ± 6.99 kg, lean mass 50.98 ± 11.77 kg, fasting plasma glucose (FPG)
92.0 ± 8.9 mg/dL, hemoglobin A1c (HbA1c) 5.7% ± 0.4%, low density lipoprotein (LDL)
111.3 ± 41.5 mg/dL, high-density lipoprotein (HDL) 47.85 ± 10.96 mg/dL, and triglycerides
140.55 ± 83.50 mg/dL. Oxytocin administration was well tolerated without any significant
adverse events. Oxytocin led to a significant increase of 2.25 kg in whole body lean
mass compared with placebo (P < .01) with a trend toward decreasing fat mass, and a significantly reduced plasma
LDL cholesterol by −19.3 mg/dL (P = .023) compared against placebo. There were no significant changes in BMI, appetite
scores, glycemia, plasma HDL, triglycerides, or depressive symptoms.
Conclusions and Implications
This proof-of-concept study indicates that oxytocin may be useful for the treatment
of sarcopenic obesity in older adults. Oxytocin administration may also provide additional
cardiovascular benefits.
Keywords
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Article info
Publication history
Published online: May 21, 2021
Footnotes
Sara E. Espinoza and Jessica L. Lee are co-first authors.
Nicolas Musi and Elena Volpi are co-senior authors.
This work was supported by the National Institute on Aging (National Institutes of Health) through the Claude D. Pepper Older Americans Independence Center at University of Texas Health Science Center at San Antonio (Grant P30 AG044271) and at University of Texas Medical Branch (Grant P30 AG024832). It was also supported by the National Institutes of Health through Clinical Translational Science Awards to the University of Texas Health Science Center at San Antonio (Grant UL1 TR002645), the University of Texas Medical Branch (Grant UL1 TR001439), and the University of Texas Health Science Center at Houston (Grant UL1 TR00037). Administrative and infrastructure support was provided by the Geriatrics Research, Education and Clinical Center at the South Texas Veterans Health Care System.
The authors of have no conflicts of interest to declare in relation to this work.
Identification
Copyright
Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine.
