Effekten av hormonsubstitution hos äldre män med åldersrelaterad testosteronbrist
en litteraturgranskning
Background: Testosterone is the most important androgenic hormone in the male. Aging is closely associated with reduction of serum testosterone which can lead to reduced muscle mass, muscle strength, bone density, and depression. These symptoms may be counteracted by administration of testosterone. Objective: The purpose of this study was to examine the effects of hormone replacement in men with age-related testosterone deficiency. Method: We performed a systematic review using Randomised Controlled Trials (RCT). We searched for trials in Pubmed and used keywords such as aging male, older men, testosterone and androgen therapy. The quality of each included study was then assessed using a template based on the PEDro scale combined with information of the sample size and intervention time. The level of evidence was then assessed using the guidelines of the Swedish council on technology assessment in health care (SBU). Results: 13 RCT were included. Testosterone was administered as oral, transdermal or intramuscular preparation. Strong evidence shows that androgen therapy, regardless of intervention, affects body composition. The result of androgen therapy on quality of life, strength, physical function and bone mineral density on elderly men is ambiguous. Conclusion: This systematic review shows that there is strong evidence that androgen therapy affects body composition in men with age-related hormone deficiency. Route of administration, duration of treatment and the amount of serum testosterone in the subjects before the treatment seem to be crucial to the outcome. We feel that it is important to indicate that androgen therapy should only been seen as a complement to a healthy lifestyle. Further studies are needed in order to draw definitive conclusions about risks and benefits of androgen therapy.