Meta-analysis: hypogonadism prevalent in male opioid users

  • de Vries F & al.
  • J Clin Endocrinol Metab
  • 12/09/2019

  • Brian Richardson, PhD
  • Clinical Essentials
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Takeaway

  • In a systematic review and meta-analysis of opioid users, prevalence of hypogonadism was 63%, and prevalence of hypocortisolism was 15%.

Why this matters

  • This study supports the link between opioid use and hypogonadism while clarifying prevalence and examining effects on other hormonal systems.

Key results

  • The most frequently used opioids in the included studies were methadone (13 studies) and morphine (12 studies).
  • The weighted mean prevalence of hypogonadism was 63% (95% CI, 55%-70%; 15 studies, 3250 patients, 99.5% males).
  • The weighted mean prevalence of hypocortisolism was 15% (95% CI, 6%-28%; 5 studies, 205 patients, 58% males).
  • Further studies were systematically reviewed, without meta-analysis, for effects of opioids on the hypothalamo-pituitary-gonadal axis, the hypothalamic-pituitary-adrenal axis, the hypothalamic-pituitary-thyroid axis, prolactin secretion, the somatotropic axis, and testosterone replacement.

Study design

  • 52 studies (18,428 subjects) were included in the systematic review, with 15 studies examining the gonadal axis and 5 studies examining the corticotropic axis included in the meta-analysis.
  • Funding: None.

Limitations

  • Heterogeneity between included studies.
  • Only 22 included studies at low risk for bias.