Infertility & Sexual Dysfunction(구연) (E-194) 후발성 성선 기능 저하증에서 대사 증후군 치료를 위한 테스토스테론 대체 요법의 효과 : 체계적 고찰 및 메타 분석 순천향대학교 천안병원 비뇨의학과교실¹ 순천향대학교 서울병원 비뇨의학과교실² 김시현¹, 박재준², 박준영², 김기홍¹, 양희조¹, 김두상¹, 이창호¹, 전윤수¹, 김재헌² CONTEXT: Late onset hypogonadism (LOH) is an age-dependent reduction of testosterone, which is related with alteration of metabolic profile including glucose control, insulin sensitivity, and lipid profile. OBJECTIVE: To investigate the effect of testosterone replacement therapy (TRT) on metabolic syndrome using meta-analysis among the randomized clinical trials (RCTs). Methods and Materials: A systematic review of the literature published until February 2, 2019 was performed using the PubMed/Medline, Embase and Cochrane Database. Among the 1562 articles screened, 19 articles were selected for qualitative analysis and 16 articles (n=1468) included for data synthesis and current analysis based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). Criteria for final inclusion were RCTs Results: Sixteen studies were finally included (TRT group (n=747), placebo group (n=721)). Among the metabolic markers, HbA1C, HOMA IR, serum insulin and leptin showed significant improvement after TRT compared with placebo (MD=-0.172 (95%CI: -0.329,-0.015), MD=-0.514 (95%CI:-0.863,-0.165), MD=-12.622(95%CI:-19.660,-5.585), and MD=-2.381(95%CI: -2.952,-1.810), respectively). Among the lipid profiles, total cholesterol showed significant improvement (MD=-0.4333 (95%CI: -0.761, -0.105)) after TRT, however, HDL showed significant decrease (MD=-0.069 (95%CI:-0.121, -0.018)) after TRT. Among the anthropometric markers, waist circumference showed significant improvement (MD=-0.1640 (95%CI: -2.857, -0.423)). CONCLUSIONS: This study showed overall improvement of metabolic profiles after TRT compared with placebo. Further studies are needed to confirm this result especially about lipid profiles. PATIENT SUMMARY: In this systematic review, we provide an overview of positive effect after TRT compared with placebo in LOH patients. keywords : hypogonadism, hormone replacement therapy, meta-analysis, metabolic syndrome