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目的:系统评价睾酮治疗对男性性功能障碍患者代谢综合征相关因素的作用。方法:检索PubMed(1980～2009.8)、EMBASE(1980～2009.8)、Cochrane图书馆临床对照试验资料库、中文期刊全文数据库(CNKI,1995～2009.8),按纳入与排除标准选择试验、评价质量、提取资料,用RevMan5.0对数据进行Meta分析。结果:共纳入6项随机对照试验(RCT),方法学质量评价中5项为B级,1项为C级。分析显示:睾酮治疗可显著改善男性性功能障碍患者的空腹血糖、总胆固醇(TC)水平及胰岛素抵抗(HOMA-IR)程度;可降低低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、甘油三酯(TG)和收缩压(SBP)水平,但并不优于对照治疗组;对腹围(WC)、腰臀比(WHR)和舒张压(DBP)的影响目前证据不足。结论:现有临床证据显示,睾酮治疗可以控制血糖(改善胰岛素抵抗,降低空腹血糖),调节血脂(降低TC、TG、LDL、HDL)。但由于纳入研究存在异质性和发生偏倚的高度可能性,势必影响结果的论证强度,期待针对睾酮治疗后代谢状况的全面的大规模的随机双盲对照试验进一步提供证据。
OBJECTIVE: To systematically evaluate the effect of testosterone on metabolic syndrome-related factors in men with sexual dysfunction. Methods: PubMed (1980 ~ 2009.8), EMBASE (1980 ~ 2009.8), Cochrane Central Register of Controlled Trials, Chinese Journal Full-text Database (CNKI, 1995 ~ 2009.8) were selected according to inclusion and exclusion criteria, Data, using RevMan5.0 Meta-analysis of the data. Results: A total of six randomized controlled trials (RCTs) were enrolled in this study. Five of the methodological quality evaluations were grade B and one grade C. The results showed that testosterone treatment could significantly improve the level of fasting blood glucose, total cholesterol (TC) and insulin resistance (HOMA-IR) in male patients with sexual dysfunction, decrease the levels of low density lipoprotein (LDL), high density lipoprotein Triglyceride (TG), and systolic blood pressure (SBP), but not superior to the control group; there is currently insufficient evidence for the effects of abdominal circumference (WC), waist-to-hip ratio (WHR) and diastolic blood pressure (DBP). CONCLUSION: The available clinical evidence shows that testosterone therapy can control blood glucose (improve insulin resistance, lower fasting blood glucose) and regulate blood lipid (lower TC, TG, LDL, HDL). However, due to the high possibility of inclusion of heterogeneity and bias in the study, it is bound to affect the strength of the results of the argument and look forward to further evidence of a comprehensive, large-scale randomized, double-blind, controlled trial of metabolic status after testosterone therapy.