雄激素替代疗法对男性身体构成成分影响的meta分析

发布时间：2018-05-31 23:23

本文选题：雄激素替代疗法 + 身体构成　；参考：《浙江大学》2017年硕士论文

【摘要】：目的:肥胖是影响现代社会人群健康的主要疾病,随着现代社会的快速发展,肥胖的发生率日益增多。虽然有大量研究致力于寻找肥胖的危险因素,但是肥胖(尤其是腹型肥胖)的病因并未完全阐明,而有研究发现雄性激素水平的变化可能影响男性肥胖的发生。因此,本文采用Meta分析的方法探讨雄激素替代治疗对身体构成成分的影响,尤其是对肥胖相关指标的影响,为男性肥胖的病因学研究提供依据。方法:检索Pubmed、EMBASE和Cochrane library数据库,时间从建刊起至2014年3月,查找雄激素替代治疗与身体构成成分影响的相关研究。采用Stata 12.0软件进行meta分析。利用I2进行异质性检验,根据异质性检验结果选择固定效应模型或随机效应模型,比较治疗前后身体构成成分指标变化差值的加权均数差(WMD)和95%置信区间(CI)。采用亚组分析和meta回归分析探讨异质性的根源。最后通过Egger's检验和Begg's检验进行发表偏倚分析。结果:本研究通过制定严格的纳入和排除标准,最终纳入53项随机对照试验(RCT),共3023例成年男性,其中雄激素替代疗法组1543例,对照组1481例。雄激素替代疗法组男性人体脂肪量(FM)减少了 1.26kg(95%CI:-1.58～-0.93);体脂率(BF)下降了 1.26%(95%CI.-1.90～-0.62);去脂体重(LBM)增加了 1.72kg(95%CI:1.37～2.07);腰围(WC)减少了 2.93cm(95%CI:-4.76～-1.09);而总体重(BM)及身体质量指数(BMI)无明显改变。患者的基础睾酮含量、雄激素替代疗法持续时间对脂肪量、体脂率和去脂体重无明显影响,但患者的年龄会影响脂肪量及体脂率,药物类型会影响体脂率及去脂体重,给药方式及给药剂量会影响体脂率。结论:本研究发现雄激素替代疗法可以显著地降低男性脂肪量、体脂率及腰围,并增加去脂体重,因此雄性激素缺乏可能是男性肥胖,尤其是男性腹型肥胖的重要病因。
[Abstract]:Objective: obesity is a major disease affecting the health of modern society. With the rapid development of modern society, the incidence of obesity is increasing. Although a great deal of research has been devoted to looking for the risk factors of obesity, the etiology of obesity, especially abdominal obesity, has not been fully clarified, and it has been found that changes in testosterone levels may affect the occurrence of obesity in men. Therefore, Meta analysis was used to study the effect of androgen replacement therapy on the body composition, especially on the obesity related indexes, which provided the basis for the etiological study of male obesity. Methods: the database of Pubmedus EMBASE and Cochrane library was searched from the beginning of publication to March 2014 to find out the effects of androgen replacement therapy on body composition. Meta analysis was carried out with Stata 12.0 software. I _ 2 was used to test the heterogeneity. According to the results of the heterogeneity test, fixed effect model or random effect model were selected to compare the weighted mean difference (WMD) and 95% confidence interval (95% confidence interval) before and after treatment. Subgroup analysis and meta regression analysis were used to explore the root causes of heterogeneity. Finally, the publication bias was analyzed by Egger's test and Begg's test. Results: a total of 3023 adult males were enrolled in 53 randomized controlled trials, including 1543 in androgen replacement therapy group and 1481 in control group. In the androgen replacement therapy group, the male body fat volume decreased by 1.26 kg / 95 CI: -1.58% -0.93C; the body fat rate decreased by 1.2695% and 1.90% -0.62%; the fat free weight increased by 1.72 kg / 95 CI: 1.372.07%; the waist circumference decreased 2.93 cm / 95% CI-4.76-1.09m; the total body weight and body mass index (BMBMI) did not change significantly. The basal testosterone content and the duration of androgen replacement therapy had no significant effects on the body fat, body fat rate and body weight, but the age of the patient affected the fat volume and body fat rate, and the type of drug affected the body fat rate and body weight. The method of administration and dosage will affect the body fat rate. Conclusion: androgen replacement therapy can significantly reduce male fat, body fat rate and waist circumference, and increase fat-free body weight. Therefore, male hormone deficiency may be an important cause of male obesity, especially male abdominal obesity.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R589.2

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