代谢手术对男性重度肥胖患者性激素水平影响的Meta分析

摘要

目的：探讨代谢手术（BS ）治疗男性重度肥胖患者对性激素水平的影响。方法计算机检索医学文献数据库相关文献，行质量评价并提取数据，采用STATA 12.0对提取信息进行合并。以随机及固定模型转换行敏感性分析，并采用 Q检验及χ2检验。行单个协变量的M eta分析，探索异质性来源。结果共纳入文献14篇，样本数400例。手术后卵泡刺激素（FSH ）（1.15 U／L ，95％ CI：0.66～1.64，P＜0.001）、黄体生成素（LH）水平（0.94 U／L ，95％ CI：0.41～1.47，P＝0.001]、血清总睾酮（TT）（8.19 nmol／L ，95％ CI：6.14～10.24，P＜0.001）、游离睾酮（cFT ）（44.67 pmol／L ，95％ CI：24.45～64.89，P＜0.001）、性激素结合球蛋白（SHBG）（18.39 nmol／L ，95％ CI：10.64～26.14，P＜0.001）较术前增高，而雌二醇（E2）水平降低（30.00 pmol／L ，95％ CI：12.61～47.38，P＝0.001）。结论 BS有助于恢复男性肥胖患者内环境的性激素平衡。%Objective To explore effect of bariatric surgery (BS ) on sex hormone in men with severely obesity. Methods PubMed and EMBASE website were searched for related literatures .AU obtained literatures were evaluated for the quality .Then the data was extracted. AU the harvested data was pooled by STATA 12.0 software. Sensitivity analysis was carried out by conversion between random and fixed effect models. Source of heterogeneity was assessed through Q test ,χ2 test and meta analysis for single covariate. Results A total of 14 articles were selected with a pooled 400 samples. FSH (1.15 U/L , 95% CI:0.66~1.64 ,P<0.001) ,LH (0.94 U/L ,95% CI:0.41~1.47 ,P=0.001) ,TT (8.19 nmol/L , 95% CI:6.14~10.24 ,P< 0.001) ,cFT (44.67 pmol/L ,95% CI:24.45~64.89 ,P< 0.001) and SHBG (18.39 nmol/L ,95% CI:10.64~26.14 ,P< 0.001) after BS were all increased after BS .E2 level was decreased after BS (30.00 pmol/L ,95% CI:12.61~47.38 ,P= 0.001). Conclusion BS may help to rebalance sex hormone levels in men with severely obesity.