老年男性的丸激素治疗:最近的里程碑性试验的临床影响
Mathis Grossmann1,2, Bradley D Anawalt3, Bu B Yeap4,5
1Department of Medicine (Austin Health), The University of Melbourne, Heidelberg, Victoria 3084, Australia.
European journal of endocrinology
|June 25, 2024
概括
丸激素疗法对患有阴性腺体缺陷症的男性提供了适度的好处,改善了能量,情绪和性功能. 它还有助于控制2型糖尿病和肌肉力量,而不会显著增加心血管或前列腺癌的风险.
科学领域:
- 内分泌学 在内分泌学.
- 男人的健康 男人的健康
- 老年学是一门学科.
背景情况:
- 没有明显的下丘脑 - 垂体 - 丸 (HPT) 轴病理的男性的性质下降症在丸激素治疗方面存在不确定的风险和益处.
- 以前的理解缺乏关于在这个特定患者群体的影响的全面数据.
研究的目的:
- 评估丸激素治疗对中年和老年男性的益处和风险,这些男性患有阴性双胞胎症症状和低丸激素水平,但没有确定的HPT病理.
- 为临床决策提供基于证据的见解,关于在男性水平低于正常水平的男性中使用.
主要方法:
- 进行了具有里程碑意义的安慰剂对照试验,涉及中年和老年男性.
- 评估结果包括自我报告的能量,情绪,性功能,2型糖尿病 (T2D) 发病率,肌肉强度,骨密度,骨折和主要心血管不良事件 (MACE).
- 包括血清丸激素度低或低于正常水平的男性,以及低阴性恋或雄激素缺乏症的症状/迹象,不包括HPT病理.
主要成果:
- 激素治疗对自我报告的能量,情绪和性功能产生了适度的好处.
- 结合生活方式的改变,它减少或逆转发生的2型糖尿病 (T2D).
- 观察到肌肉强度和骨密度的适度改善,但没有减少跌倒或骨质疏松性骨折;意外地增加了与创伤相关的骨折.
- 没有发现心肌梗塞,中风或前列腺癌风险的显著增加.
结论:
- 丸激素疗法在男性患有低腺体和低丸激素的特定症状和疾病方面提供了临床上显著的益处,即使没有确定的HPT病理.
- 该疗法在主要心血管事件和前列腺癌方面表现出良好的安全性,但建议对骨折保持谨慎.
- 这些发现提供了关键的数据,以指导在男性出现雄激素缺乏症症状时适当使用丸激素治疗.
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