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脱氢表雄酮 (DHEA) 补充对睾酮水平的剂量反应和荟萃分析:随机临床试验的围产期预测。

A dose-response and meta-analysis of dehydroepiandrosterone (DHEA) supplementation on testosterone levels: perinatal prediction of randomized clinical trials.

机构信息

Perinatal Center, Shijiazhuang Fourth Hospital, Shijiazhuang, Hebei 050000, China.

Obstetrics Department, Shijiazhuang Fourth Hospital, Shijiazhuang, Hebei 050000, China.

出版信息

Exp Gerontol. 2020 Nov;141:111110. doi: 10.1016/j.exger.2020.111110. Epub 2020 Oct 10.

DOI:10.1016/j.exger.2020.111110
PMID:33045358
Abstract

BACKGROUND

Dehydroepiandrosterone (DHEA) has been aggressively sold as a dietary supplement to boost testosterone levels although the impact of DHEA supplementation on testosterone levels has not been fully established. Therefore, we performed a systematic review and meta-analysis of RCTs to investigate the effect of oral DHEA supplementation on testosterone levels.

METHODS

A systematic literature search was performed in Scopus, Embase, Web of Science, and PubMed databases up to February 2020 for RCTs that investigated the effect of DHEA supplementation on testosterone levels. The estimated effect of the data was calculated using the weighted mean difference (WMD). Subgroup analysis was performed to identify the source of heterogeneity among studies.

RESULTS

Overall results from 42 publications (comprising 55 arms) demonstrated that testosterone level was significantly increased after DHEA administration (WMD: 28.02 ng/dl, 95% CI: 21.44-34.60, p = 0.00). Subgroup analyses revealed that DHEA increased testosterone level in all subgroups, but the magnitude of increment was higher in females compared to men (WMD: 30.98 ng/dl vs. 21.36 ng/dl); DHEA dosage of ˃50 mg/d compared to ≤50 mg/d (WMD: 57.96 ng/dl vs. 19.43 ng/dl); intervention duration of ≤12 weeks compared to ˃12 weeks (WMD: 44.64 ng/dl vs. 19 ng/dl); healthy participants compared to postmenopausal women, pregnant women, non-healthy participants and androgen-deficient patients (WMD: 52.17 ng/dl vs. 25.04 ng/dl, 16.44 ng/dl and 16.47 ng/dl); and participants below 60 years old compared to above 60 years old (WMD: 31.42 ng/dl vs. 23.93 ng/dl).

CONCLUSION

DHEA supplementation is effective for increasing testosterone levels, although the magnitude varies among different subgroups. More study needed on pregnant women and miscarriage.

摘要

背景

脱氢表雄酮(DHEA)被作为膳食补充剂大量销售,以提高睾酮水平,尽管 DHEA 补充对睾酮水平的影响尚未完全确定。因此,我们进行了系统评价和随机对照试验的荟萃分析,以调查口服 DHEA 补充对睾酮水平的影响。

方法

在 Scopus、Embase、Web of Science 和 PubMed 数据库中进行了系统的文献检索,以调查 DHEA 补充对睾酮水平影响的 RCT。使用加权均数差(WMD)计算数据的估计效果。进行亚组分析以确定研究之间异质性的来源。

结果

来自 42 篇文献(共 55 个臂)的综合结果表明,DHEA 给药后睾酮水平显著升高(WMD:28.02ng/dl,95%CI:21.44-34.60,p=0.00)。亚组分析显示,DHEA 增加了所有亚组的睾酮水平,但女性的增加幅度高于男性(WMD:30.98ng/dl 比 21.36ng/dl);DHEA 剂量大于 50mg/d 比等于或小于 50mg/d(WMD:57.96ng/dl 比 19.43ng/dl);干预持续时间小于 12 周比大于 12 周(WMD:44.64ng/dl 比 19ng/dl);健康参与者比绝经后妇女、孕妇、非健康参与者和雄激素缺乏患者(WMD:52.17ng/dl 比 25.04ng/dl、16.44ng/dl 和 16.47ng/dl);年龄小于 60 岁的参与者比年龄大于 60 岁的参与者(WMD:31.42ng/dl 比 23.93ng/dl)。

结论

DHEA 补充对提高睾酮水平有效,但不同亚组之间的幅度不同。对孕妇和流产需要更多的研究。

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