Department of Gynecology, Jinan People's Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 271199, China.
Department of Gynecology, Jinan People's Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 271199, China.
Exp Gerontol. 2021 Nov;155:111586. doi: 10.1016/j.exger.2021.111586. Epub 2021 Oct 8.
The menopause is associated in females with the presence of dysglycemia, insulin resistance and with the development of endothelial dysfunction. Tibolone (TIB) is a synthetic steroid compound with selective oestrogenic and, to a lesser extent, progestogenic and androgenic properties prescribed to postmenopausal women to alleviate the symptoms of the climaterium and to prevent the development of osteoporosis. However, the impact of TIB on fasting blood sugar (FBS), insulin, Homeostatic Model Assessment-Insulin Resistance (HOMA-IR) index and flow-mediated dilation (FMD) in women has not been evaluated so far. Thus, to investigate this research question, we conducted the present systematic review and meta-analysis.
Two independent reviewers searched the Scopus, Web of Science, PubMed/Medline and Embase databases up to 20 December 2020. The weighted mean differences (WMDs) and the 95% confidence intervals (CI) were calculated using the DerSimonian and Laird random effects models between the TIB and control groups and included in the forest plot.
The overall findings were generated from 12 eligible randomized controlled trials. As compared to controls, TIB administration resulted in a significant reduction of FBS (WMD: -3.06 mg/dL, 95% CI: -5.30 to -0.82, P = 0.007), and of the HOMA-IR index (WMD: -0.61, 95% CI: -1.11 to -0.11, P = 0.01). However, treatment with TIB did not lead to significant changes of the FMD (WMD: 0.78%, 95% CI: -0.20 to 1.77, P = 0.12) or of insulin levels (WMD: -0.10 mIU/L, 95% CI: -2.04 to 1.83, P = 0.91).
TIB administration can decrease FBS and the HOMA-IR index in postmenopausal women. However, the use of TIB does not influence insulin levels or FMD.
女性更年期与血糖异常、胰岛素抵抗以及内皮功能障碍的发生有关。替勃龙（TIB）是一种合成甾体化合物，具有选择性雌激素和一定程度的孕激素及雄激素作用，用于治疗绝经后妇女以缓解更年期症状并预防骨质疏松症的发生。然而，TIB 对女性空腹血糖（FBS）、胰岛素、稳态模型评估-胰岛素抵抗（HOMA-IR）指数和血流介导的扩张（FMD）的影响尚未得到评估。因此，为了研究这一问题，我们进行了本次系统评价和荟萃分析。
两名独立的审查员搜索了 Scopus、Web of Science、PubMed/Medline 和 Embase 数据库，检索时间截至 2020 年 12 月 20 日。采用 DerSimonian 和 Laird 随机效应模型计算 TIB 组与对照组之间的加权均数差值（WMDs）和 95%置信区间（CI），并将其纳入森林图。
总体研究结果来自 12 项符合条件的随机对照试验。与对照组相比，TIB 治疗可显著降低 FBS（WMD：-3.06mg/dL，95%CI：-5.30 至 -0.82，P=0.007）和 HOMA-IR 指数（WMD：-0.61，95%CI：-1.11 至 -0.11，P=0.01）。然而，TIB 治疗并未导致 FMD（WMD：0.78%，95%CI：-0.20 至 1.77，P=0.12）或胰岛素水平（WMD：-0.10mIU/L，95%CI：-2.04 至 1.83，P=0.91）的显著变化。
TIB 治疗可降低绝经后妇女的 FBS 和 HOMA-IR 指数。然而，TIB 的使用并不影响胰岛素水平或 FMD。
