Systematic review on the relationship between menopausal hormone replacement therapy, sarcopenia, and sarcopenia-related parameters

IF 3.9 2区医学 Q2 GERIATRICS & GERONTOLOGY

Maturitas Pub Date : 2025-06-17 DOI:10.1016/j.maturitas.2025.108609

Marc F. Österdahl , Mary Ni Lochlainn , Carly Welch , Janice Rymer , Mark Ashworth , Julie Whitney , Emma L. Duncan , Claire J. Steves

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引用次数: 0

Abstract

Objective

Whilst the beneficial effect of menopausal hormone replacement therapy (HRT) on osteoporosis is well established, its effect on sarcopenia is less clear. We conducted a systematic review of evidence exploring the relationship between HRT and sarcopenia.

Methods

We searched OVID Medline, Embase, CINAHL and Web of Science to 8 August 2024, identifying both in randomised controlled trials (RCTs) and observational studies of community-dwelling women. We excluded articles focussed on androgen therapy, or hormone therapy for indications other than menopause.

Our primary outcome was the effect of HRT upon sarcopenia defined by a consensus set of criteria (e.g. the definition proposed by the European Working Group on Sarcopenia in Older People 2). Grip strength, measures of physical performance, and radiological measures of muscle quantity were included as secondary outcomes. Reporting follows PRISMA guidelines.

Results

Searches identified 6090 articles, of which 43 were included in our final analysis. No studies used a consensus definition of sarcopenia. Most used data over 20 years old, with older formulations of HRT, though formulations were inconsistently reported.

Of the 15 RCTs included, two of six suggested a beneficial effect on grip strength, one of six on physical performance, and seven of 12 on radiologically assessed muscle quantity.

Of the 28 observational studies included, three of 11 suggested a beneficial effect on grip strength, two of seven on physical performance and three of 18 on radiologically assessed muscle quantity.

No studies reported detrimental effects on muscle. Risk of bias was high/severe. Observational models seldom adjusted for confounders.

Conclusions

No studies used modern consensus definitions of sarcopenia. For secondary outcomes, there was no consistent evidence of benefit, with methodological flaws, and outmoded HRT formulations.

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绝经期激素替代疗法、肌肉减少症和肌肉减少相关参数之间关系的系统综述

目的虽然绝经期激素替代疗法（HRT）对骨质疏松症的有益作用已得到证实，但其对肌肉减少症的作用尚不清楚。我们对HRT与肌肉减少症之间的关系进行了系统的证据回顾。方法检索OVID Medline、Embase、CINAHL和Web of Science至2024年8月8日，纳入随机对照试验（RCTs）和观察性研究。我们排除了关于雄激素治疗或激素治疗除更年期以外适应症的文章。我们的主要结果是HRT对一组共识标准（例如欧洲老年人肌肉减少症工作组提出的定义2）定义的肌肉减少症的影响。握力、体能测量和肌肉量的放射测量作为次要结果。报告遵循PRISMA准则。结果检索到6090篇文章，其中43篇纳入我们的最终分析。没有研究使用一致的肌少症定义。大多数使用超过20年的数据，使用较旧的激素替代疗法配方，尽管配方报告不一致。在纳入的15项随机对照试验中，6项中有2项对握力有有益影响，6项中有1项对身体表现有有益影响，12项中有7项对放射学评估的肌肉量有有益影响。在纳入的28项观察性研究中，11项研究中有3项表明对握力有有益影响，7项研究中有2项对身体表现有有益影响，18项研究中有3项对放射学评估的肌肉量有有益影响。没有研究报告对肌肉有有害影响。偏倚风险高/严重。观测模型很少根据混杂因素进行调整。结论：没有研究采用现代一致的肌少症定义。对于次要结果，由于方法上的缺陷和过时的HRT配方，没有一致的益处证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Maturitas 医学-妇产科学

CiteScore

9.10

自引率

2.00%

发文量

142

审稿时长

40 days

期刊介绍： Maturitas is an international multidisciplinary peer reviewed scientific journal of midlife health and beyond publishing original research, reviews, consensus statements and guidelines, and mini-reviews. The journal provides a forum for all aspects of postreproductive health in both genders ranging from basic science to health and social care. Topic areas include:• Aging• Alternative and Complementary medicines• Arthritis and Bone Health• Cancer• Cardiovascular Health• Cognitive and Physical Functioning• Epidemiology, health and social care• Gynecology/ Reproductive Endocrinology• Nutrition/ Obesity Diabetes/ Metabolic Syndrome• Menopause, Ovarian Aging• Mental Health• Pharmacology• Sexuality• Quality of Life