睾酮替代疗法对迟发性性腺功能减退患者骨密度影响的Meta分析  

Effects of testosterone replacement therapy on bone mineral density in patients with LOH:a Meta-analysis

作　　者：张奥 郭强[2] 景三鹏 薛耀 郝川[2] ZHANG Ao;GUO Qiang;JING Sanpeng;XUE Yao;HAO Chuan(Master Degree Candidate of Surgery Enrolled in 2018,the Second School of Clinical Medicine,Shanxi Medical University,Taiyuan 030000,Shanxi,China;Department of Urology,the Second Hospital of Shanxi Medical University,Taiyuan 030000,Shanxi,China)

机构地区：[1]山西医科大学第二临床医学院,太原030000 [2]山西医科大学第二医院泌尿外科,太原030000

出　　处：《中国性科学》2022年第4期28-32,共5页Chinese Journal of Human Sexuality

摘　　要：目的系统评价睾酮替代疗法对迟发性性腺功能减退患者骨密度及骨折风险的影响。方法检索PubMed、Embase、Medline、Cochrane library、CNKI、万方、维普等数据库,搜索建库至2020年12月发表的睾酮替代疗法对迟发性性腺功能减退患者骨密度影响的随机对照试验。由2名评价者按照纳入与排除标准选择试验、提取资料和评价质量后,采用RevMan 5.3软件进行Meta分析。结果共纳入10篇研究,1230例患者。Meta分析结果显示,无论是短期治疗还是长期治疗,睾酮替代组与安慰剂组的总骨密度、髋关节骨密度、腰椎骨密度、股骨颈骨密度、转子骨密度、Ⅰ型前胶原氨基端前肽、骨特异性碱性磷酸酶、骨钙素、Ⅰ型胶原交联氨基端肽及握力比较,差异无统计学意义(P>0.05);两组下肢肌力比较,差异具有统计学意义(P<0.05)。结论睾酮替代疗法对迟发性性腺功能减退患者的骨密度、骨转化标记物及握力均未产生显著影响,但该疗法加强了迟发性性腺功能减退患者的下肢肌力。Objective To evaluate the effects of testosterone replacement therapy(TRT)on bone mineral density(BMD)and risk of fracture in patients with late-onset hypogonadism(LOH).Methods Controlled clinical trials about efficacy of TRT on BMD in patients with LOH from their establishment to December 2020 were searched in Pubmed,Embase,Medline,Cochrane library,CNKI,Wanfang data and VIP.Two independent reviewers screened the studies according to the inclusion and exclusion criteria,extracted the data,evaluated the quality.RevMan 5.3 software was used for Meta-analysis.Results 10 studies involving 1,230 patients were included.The results of Meta-analysis showed that there were no significant differences in total BMD,hip BMD,lumbar BMD,femoral neck BMD,trochanter BMD,N-terminal propeptide of type Ⅰ procollagen,bone specific alkaline phosphatase,osteocalcin,crosslinked N-telopeptide of type Ⅰ collagen and grip strength,between the two groups(P>0.05).There was a significant difference in the muscle strength of the lower extremity between the two groups(P<0.05).Conclusions TRT did not significantly improve BMD,bone turnover markers and grip strength in patients with LOH.However,TRT increases lower extremity muscle strength in patients with LOH.

关 键 词：迟发性性腺功能减退 睾酮替代疗法 骨密度 骨转化标志物 META分析 

分 类 号：R697[医药卫生—泌尿科学]