Hospital de Clínicas de Porto Alegre, 2350 Ramiro Barcelos Street, Porto Alegre, Rio Grande do Sul, Brazil; Graduate Program in Food, Nutrition and Health, Medical School, Federal University of Rio Grande do Sul, 2400 Ramiro Barcelos Street - 2nd floor, Porto Alegre, Rio Grande do Sul, Brazil.
Hospital de Clínicas de Porto Alegre, 2350 Ramiro Barcelos Street, Porto Alegre, Rio Grande do Sul, Brazil; Graduate Program in Food, Nutrition and Health, Medical School, Federal University of Rio Grande do Sul, 2400 Ramiro Barcelos Street - 2nd floor, Porto Alegre, Rio Grande do Sul, Brazil.
Exp Gerontol. 2020 Dec;142:111106. doi: 10.1016/j.exger.2020.111106. Epub 2020 Oct 10.
The aim of this study was to conduct a systematic review of the literature of randomized controlled trials on the effect of testosterone (T) supplementation compared to the placebo group or lower dose on sarcopenic components (muscle mass, strength and physical performance) in middle-aged and elderly men. Major electronic databases were searched for articles published on or before December 2019. Studies including individuals with age ≥ 40 years and which described the effect of T supplementation on sarcopenic components were found eligible (11 studies). Outcomes were calculated as the difference in means between the experimental and control/placebo groups, and data were presented as effect size with 95% confidence limits (95%CI). The meta-analysis was performed using a random effects model. Regarding lean body mass (LBM), eight studies evaluated the effect of T supplementation on this outcome, of these, seven reported gains after the intervention period. Our meta-analysis showed a beneficial effect on LBM of 2.54 kg (95% CI, 1.27 to 3.80) (p < 0.001). In muscle strength (MS), seven included studies evaluated the handgrip strength (HGS) and just one reported gain after the intervention period, but the meta-analysis showed an increase for HGS of 1.58 kgf (95%CI, 0.17 to 3.0) (p = 0.03). The second outcome for MS was leg strength (LS), where nine studies were included and five demonstrated gains in this parameter after the intervention period. In the meta-analysis, two out of three tests showed an effect on LS: T supplementation increase the leg press strength in 91.23 N (95%CI, 0.23 to 182.22) (p = 0.05) and leg extension in 144.10 N (95%CI, 44.21 to 244.00) (p < 0.01). In physical performance, four studies evaluated this outcome, with three of them showing positive effects in this parameter. In the meta-analysis, only two studies that reported the same assessment test (Physical Performance Test) were included, but no effect of T supplementation on this parameter was found. It can be concluded that T supplementation influences sarcopenic components in middle-aged and older men, because is associated with increased in muscle mass and strength in addition to physical performance.
本研究的目的是对已发表的随机对照试验文献进行系统综述，以评估与安慰剂组或低剂量组相比，睾丸素（T）补充对中年和老年男性的肌肉减少症成分（肌肉量、力量和身体机能）的影响。主要电子数据库检索了截至 2019 年 12 月发表的文章。纳入符合以下条件的研究：研究对象年龄≥40 岁，描述了 T 补充对肌肉减少症成分的影响（11 项研究）。结局指标为试验组和对照组/安慰剂组之间的均数差值，数据以效应量和 95%置信区间（95%CI）表示。采用随机效应模型进行荟萃分析。关于瘦体重（LBM），有 8 项研究评估了 T 补充对该结局的影响，其中 7 项研究报告了干预后有增加。我们的荟萃分析显示，T 补充对 LBM 的有益影响为 2.54kg（95%CI，1.27 至 3.80）（p<0.001）。在肌肉力量（MS）方面，有 7 项纳入研究评估了握力（HGS），其中只有 1 项研究报告了干预后有增加，但荟萃分析显示 HGS 增加了 1.58kgf（95%CI，0.17 至 3.0）（p=0.03）。MS 的第二个结局是腿部力量（LS），纳入了 9 项研究，其中 5 项研究报告了干预后该参数的增加。荟萃分析中，三项测试中有两项显示出对 LS 的影响：T 补充增加了 91.23N（95%CI，0.23 至 182.22）（p=0.05）和 144.10N（95%CI，44.21 至 244.00）（p<0.01）的腿蹬力量和腿部伸展力量。在身体机能方面，有 4 项研究评估了这一结局，其中 3 项研究显示出对这一参数的积极影响。荟萃分析中，仅纳入了两项报告了相同评估测试（身体机能测试）的研究，但未发现 T 补充对该参数有影响。综上所述，T 补充对中年和老年男性的肌肉减少症成分有影响，因为它与肌肉量和力量的增加以及身体机能的提高有关。
