内分泌疾病治疗学：睾酮补充与身体成分：一项荟萃分析研究的结果。

THERAPY OF ENDOCRINE DISEASE: Testosterone supplementation and body composition: results from a meta-analysis study.

机构信息

Endocrinology UnitMedical Department, Azienda Usl Bologna Maggiore-Bellaria Hospital, Bologna, ItalyUnit of Metabolic Diseases and EndocrinologyConversano, ItalyAndrology and Sexual Medicine UnitDepartment of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Pieraccini 6, 50139 Florence, ItalyDepartment of Experimental MedicineSapienza University of Rome, Rome, ItalyCentre for Reproductive Medicine and AndrologyMuenster, GermanyBayer PharmaGlobal Medical Affairs Andrology, Berlin, GermanySchool of MedicineGulf Medical University, Ajman, United Arab EmiratesDiabetes AgencyCareggi Hospital, Florence, Italy Endocrinology UnitMedical Department, Azienda Usl Bologna Maggiore-Bellaria Hospital, Bologna, ItalyUnit of Metabolic Diseases and EndocrinologyConversano, ItalyAndrology and Sexual Medicine UnitDepartment of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Pieraccini 6, 50139 Florence, ItalyDepartment of Experimental MedicineSapienza University of Rome, Rome, ItalyCentre for Reproductive Medicine and AndrologyMuenster, GermanyBayer PharmaGlobal Medical Affairs Andrology, Berlin, GermanySchool of MedicineGulf Medical University, Ajman, United Arab EmiratesDiabetes AgencyCareggi Hospital, Florence, Italy.

出版信息

Eur J Endocrinol. 2016 Mar;174(3):R99-116. doi: 10.1530/EJE-15-0262. Epub 2015 Nov 4.

DOI:10.1530/EJE-15-0262

PMID:26537862

Abstract

OBJECTIVE

The role of testosterone (T) in regulating body composition is conflicting. Thus, our goal is to meta-analyse the effects of T supplementation (TS) on body composition and metabolic outcomes.

METHODS

All randomized controlled trials (RCTs) comparing the effect of TS on different endpoints were considered.

RESULTS

Overall, 59 trials were included in the study enrolling 3029 and 2049 patients in TS and control groups respectively. TS was associated with any significant modification in body weight, waist circumference and BMI. Conversely, TS was associated with a significant reduction in fat and with an increase in lean mass as well as with a reduction of fasting glycaemia and insulin resistance. The effect on fasting glycaemia was even higher in younger individuals and in those with metabolic diseases. When only RCTs enrolling hypogonadal (total T <12 mol/l) subjects were considered, a reduction of total cholesterol as well as triglyceride (TGs) levels were also detected. Conversely, an improvement in HDL cholesterol levels as well as in both systolic and diastolic blood pressure was not observed.

CONCLUSION

Our data suggest that TS is able to improve body composition and glycometabolic profile particularly in younger subjects and in those with metabolic disturbances. Specifically designed studies are urgently needed to confirm this point.

摘要

目的

睾酮（T）在调节身体成分方面的作用存在争议。因此，我们的目标是对 T 补充（TS）对身体成分和代谢结果的影响进行荟萃分析。

方法

所有比较 TS 对不同终点影响的随机对照试验（RCT）都被考虑在内。

结果

总体而言，共有 59 项试验纳入研究，TS 组和对照组分别纳入 3029 名和 2049 名患者。TS 与体重、腰围和 BMI 的任何显著变化相关。相反，TS 与脂肪减少和瘦体重增加有关，还与空腹血糖和胰岛素抵抗降低有关。在年轻患者和患有代谢疾病的患者中，TS 对空腹血糖的影响更高。当仅考虑纳入低睾酮（总 T <12 mol/l）受试者的 RCT 时，还检测到总胆固醇和甘油三酯（TGs）水平降低。相反，HDL 胆固醇水平以及收缩压和舒张压的改善并未观察到。