Incomplete Evidence of Bone Density Normalization Following Long-Term Reproductive Hormone Treatment in Men With Hypogonadotropic Hypogonadism.

Background

We performed a systemic review and meta-analysisof several small, observational studies to investigate the effect of reproductive hormone treatment on BMD in men with HH compared with control groups where available.

我们对几项小型观察性研究进行了系统回顾和荟萃分析，以研究生殖激素治疗对HH男性BMD的影响，与可用的对照组进行比较。

Methods

We searched OVID Medline, Embase, CINAHL, SCOPUS, Web of Science, and Cochrane Library for studies reporting BMD or fractures in men with HH (congenital [CHH] or acquired).

我们通过OVID Medline、Embase、CINAHL、SCOPUS、Web of Science和Cochrane Library检索了报告男性HH（先天性[CHH]或获得性）患者骨密度或骨折的研究。

Study selection and data extraction were performed using COVIDENCE and a prespecified tool.

研究选择和数据提取使用COVIDENCE和预先设定的工具进行。

Results were summarized using descriptive statistics.

结果使用描述性统计进行了总结。

Meta-analysiscompared BMD in men with HH vs healthy controls.

荟萃分析比较了患有高催乳素血症的男性与健康对照组的骨密度。

Meta-regression assessed relationships between treatment duration and BMD Z-scores against normative population data.

元回归分析了治疗持续时间与骨密度Z分数相对于正常人群数据的关系。

Results

Of the 33 eligible studies, 24 included data specific to men with HH (n = 625).

在33项符合条件的研究中，有24项包含了特定于HH男性（n = 625）的数据。

Men with HH had low lumbar spine (LS) and femoral neck BMD, improving with hormonal treatment.

患有HH的男性腰椎(LS)和股骨颈骨密度(BMD)较低，通过激素治疗有所改善。

Meta-analysisof 5 studies found lower LS BMD in men with HH vs healthy controls (SMD -5.98; 95% CI; -11.5 to -0.47).

对5项研究的荟萃分析发现，与健康对照组相比，患有HH的男性的腰椎(LS)骨密度(BMD)较低（SMD -5.98; 95% 置信区间; -11.5 到 -0.47）。

Men with CHH may have persistently low BMD despite prolonged hormonal treatment.

尽管接受了长期激素治疗，患有先天性促性腺激素缺乏症（CHH）的男性可能会持续存在骨密度（BMD）偏低的情况。

Higher BMD in HH was associated with younger age at treatment initiation, partial HH, and higher serum testosterone and estradiol concentrations.

在先天性促性腺激素缺乏症（HH）中，较高的骨密度（BMD）与治疗开始时年龄较小、部分性HH以及较高的血清睾酮和雌二醇浓度有关。

Fracture prevalencewas high in the few studies systematically studying fractures as an outcome; in other studies, fractures were seldom reported.

在少数系统研究骨折作为结果的研究中，骨折的患病率很高；在其他研究中，骨折很少被报告。

Conclusions

Men with HH have low BMD that improves with reproductive hormone treatment.

患有HH的男性骨密度低，通过生殖激素治疗可以得到改善。

However, current evidence suggests that incomplete BMD normalization may be common despite long-term reproductive hormone treatment in men with HH, particularly those with CHH.

然而，当前的证据表明，尽管长期接受生殖激素治疗，但男性HH患者，特别是CHH患者中，骨密度（BMD）不完全正常化可能很常见。