摘要To evaluate the relationship between testosterone replacement therapy(TRT)and arterial and/or venous thrombosis in patients with pre-treatment total testosterone(TT)＜12 nmol I-1,we performed a meta-analysis following the Population Intervention Comparison Outcome model.Population:men with TT＜12 nmol I-1 or clear mention of hypogonadism in the inclusion criteria of patients;intervention:TRT;comparison:placebo or no therapy;outcomes:arterial thrombotic events(stroke,myocardial infarction[Ml],upper limbs,and lower limbs),VTE(deep vein thrombosis[DVT],portal vein thrombosis,splenic thrombosis,and pulmonary embolism),and mortality.A total of 2423 abstracts were assessed for eligibility.Twenty-four studies,including 14 randomized controlled trials(RCTs),were finally included,with a total of 4027 and 310 288 hypotestosteronemic male patients,from RCTs and from observational studies,respectively.Based on RCT-derived data,TRT did not influence the risk of arterial thrombosis(odds ratio[OR]=1.27,95％confidence interval[Cl]:0.47-3.43,P=0.64),stroke(OR=1.34,95％Cl:0.09-18.97,P=0.83),Ml(OR=0.51,95％Cl:0.11-2.31,P=0.39),VTE(OR=1.42,95％Cl:0.22-9.03,P=0.71),pulmonary embolism(OR=1.38,95％Cl:0.27-7.04,P=0.70),and mortality(OR=0.70,95％Cl:0.20-2.38,P=0.56).Meanwhile,when only observational studies are considered,a significant reduction in the risk of developing arterial thrombotic events,Ml,venous thromboembolism,and mortality was observed.The risk for DVT remains uncertain,due to the paucity of RCT-based data.TRT in men with TT＜12 nmol l-1 is safe from the risk of adverse cardiovascular events.Further studies specifically assessing the risk of DVT in men on TRT are needed.