Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China.
The Fourth Clinical Medical College, Institute of Medicine and Nursing Hubei University of Medicine, Shiyan, 442000, China.
World J Urol. 2018 Aug;36(8):1315-1326. doi: 10.1007/s00345-018-2256-0. Epub 2018 Mar 6.
Testosterone supplement treatment (TST) is a classic therapy for hypogonadal men with type 2 diabetes mellitus (T2DM), but the effects of TST in different studies are inconsistent. We conducted this meta-analysis to evaluate the precise role of TST in hypogonadal men with T2DM.
PubMed, Embase, Cochrane Library and Web of Science were searched to identify qualified randomized controlled trials (RCTs). Pooled mean differences (MDs) with 95% confidence intervals (CIs) were calculated to measure the specific effects of TST. Trial sequential analysis was performed to verify the pooled results.
A total of eight RCTs were enrolled in our meta-analysis, including 596 hypogonadal participants with T2DM. Compared with comparators, TST can significantly improve glycemic control by reducing homeostatic model assessment of insulin resistance (MD - 0.79, 95% CI - 1.23 to - 0.34), fasting glucose (MD - 0.98, 95% CI - 1.13 to - 0.54), fasting insulin (MD - 2.47, 95% CI - 3.99 to - 0.95) and HbA1c% (MD - 0.45, 95% CI - 0.73 to - 0.16). In addition, TST can result in a decline in cholesterol (MD - 0.29, 95% CI - 0.38 to - 0.19) and triglyceride (MD - 0.37, 95% CI - 0.59 to - 0.15).
Our results indicated that TST can improve glycemic control and decrease TC and TG in hypogonadal patients with T2DM. We recommend TST during the anti-diabetic therapy in these patients.
睾酮补充治疗（TST）是治疗 2 型糖尿病（T2DM）伴性腺功能减退男性的经典疗法，但不同研究中 TST 的效果并不一致。我们进行了这项荟萃分析，以评估 TST 在 T2DM 伴性腺功能减退男性中的确切作用。
检索 PubMed、Embase、Cochrane 图书馆和 Web of Science，以确定合格的随机对照试验（RCT）。计算汇总均数差值（MDs）及其 95%置信区间（CIs）以衡量 TST 的具体效果。进行试验序贯分析以验证汇总结果。
本荟萃分析共纳入 8 项 RCT，包括 596 例 T2DM 伴性腺功能减退的参与者。与对照组相比，TST 可通过降低稳态模型评估的胰岛素抵抗（MD-0.79，95%CI-1.23 至-0.34）、空腹血糖（MD-0.98，95%CI-1.13 至-0.54）、空腹胰岛素（MD-2.47，95%CI-3.99 至-0.95）和糖化血红蛋白（HbA1c%）（MD-0.45，95%CI-0.73 至-0.16）显著改善血糖控制。此外，TST 还可导致胆固醇（MD-0.29，95%CI-0.38 至-0.19）和甘油三酯（MD-0.37，95%CI-0.59 至-0.15）降低。
我们的结果表明，TST 可改善 T2DM 伴性腺功能减退患者的血糖控制，并降低 TC 和 TG。我们建议在这些患者的抗糖尿病治疗中应用 TST。
