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Klinefelter syndrome and testosterone treatment: a national cohort study on thrombosis risk

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Klinefelter syndrome and testosterone treatment : a national cohort study on thrombosis risk. / Chang, Simon; Christiansen, Christian Fynbo; Bojesen, Anders; Juul, Svend; Münster, Anna-Marie Bloch; Gravholt, Claus H.

I: Endocrine Connections, Bind 9, Nr. 1, 01.2020, s. 34-43.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

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@article{621ecebc4ad54ae489f3e46b9feea8b5,
title = "Klinefelter syndrome and testosterone treatment: a national cohort study on thrombosis risk",
abstract = "OBJECTIVES: Klinefelter syndrome (KS), 47,XXY, can be viewed as a disease model for investigating the risk of thrombosis in male hypogonadism and the subsequent risk related to testosterone treatment. We describe rates of thrombotic risk factors, thrombosis and thrombosis mortality in KS and the association with testosterone treatment.METHODS: National registry-based matched cohort study with follow-up from 1995-2016 set in Denmark. 1155 men with KS were each matched by year and month of birth to 100 men from the background population. First thrombotic events and thrombosis mortality was evaluated by event rates and hazard ratios (HR) and applying testosterone treatment as a time-dependent covariate.RESULTS: The KS cohort had higher incidence of venous thromboembolism relative to the comparison cohort (HR, 3.95; 95 % CI, 2.83-5.52). Total thrombotic deaths were increased in KS (HR, 1.76; 95 % CI, 1.18-2.62), and all-cause mortality was increased in KS following arterial thrombosis (HR 1.73; 95 % CI 1.22-2.47). Only 48.7% of men with KS redeemed prescriptions for testosterone. Untreated men with KS were on average born twelve years before those treated, and the majority of untreated men with KS with available biochemistry were hypogonadal. Testosterone treatment in KS was associated with a non-significant decrease in venous thromboembolism and thrombotic deaths.CONCLUSION: Thrombosis and thrombotic deaths are increased in KS. Only half of men with KS ever received testosterone treatment, despite overt hypogonadism in the non-treated. Testosterone treatment in Klinefelter syndrome was insignificantly associated with lower incidence rates of venous thrombosis and thrombotic deaths.",
keywords = "Cohort study, Hypogonadism, Klinefelter syndrome, Testosterone treatment, Thrombosis",
author = "Simon Chang and Christiansen, {Christian Fynbo} and Anders Bojesen and Svend Juul and M{\"u}nster, {Anna-Marie Bloch} and Gravholt, {Claus H}",
year = "2020",
month = jan,
doi = "10.1530/EC-19-0433",
language = "English",
volume = "9",
pages = "34--43",
journal = "Endocrine Connections",
issn = "2049-3614",
publisher = "BioScientifica Ltd.",
number = "1",

}

RIS

TY - JOUR

T1 - Klinefelter syndrome and testosterone treatment

T2 - a national cohort study on thrombosis risk

AU - Chang, Simon

AU - Christiansen, Christian Fynbo

AU - Bojesen, Anders

AU - Juul, Svend

AU - Münster, Anna-Marie Bloch

AU - Gravholt, Claus H

PY - 2020/1

Y1 - 2020/1

N2 - OBJECTIVES: Klinefelter syndrome (KS), 47,XXY, can be viewed as a disease model for investigating the risk of thrombosis in male hypogonadism and the subsequent risk related to testosterone treatment. We describe rates of thrombotic risk factors, thrombosis and thrombosis mortality in KS and the association with testosterone treatment.METHODS: National registry-based matched cohort study with follow-up from 1995-2016 set in Denmark. 1155 men with KS were each matched by year and month of birth to 100 men from the background population. First thrombotic events and thrombosis mortality was evaluated by event rates and hazard ratios (HR) and applying testosterone treatment as a time-dependent covariate.RESULTS: The KS cohort had higher incidence of venous thromboembolism relative to the comparison cohort (HR, 3.95; 95 % CI, 2.83-5.52). Total thrombotic deaths were increased in KS (HR, 1.76; 95 % CI, 1.18-2.62), and all-cause mortality was increased in KS following arterial thrombosis (HR 1.73; 95 % CI 1.22-2.47). Only 48.7% of men with KS redeemed prescriptions for testosterone. Untreated men with KS were on average born twelve years before those treated, and the majority of untreated men with KS with available biochemistry were hypogonadal. Testosterone treatment in KS was associated with a non-significant decrease in venous thromboembolism and thrombotic deaths.CONCLUSION: Thrombosis and thrombotic deaths are increased in KS. Only half of men with KS ever received testosterone treatment, despite overt hypogonadism in the non-treated. Testosterone treatment in Klinefelter syndrome was insignificantly associated with lower incidence rates of venous thrombosis and thrombotic deaths.

AB - OBJECTIVES: Klinefelter syndrome (KS), 47,XXY, can be viewed as a disease model for investigating the risk of thrombosis in male hypogonadism and the subsequent risk related to testosterone treatment. We describe rates of thrombotic risk factors, thrombosis and thrombosis mortality in KS and the association with testosterone treatment.METHODS: National registry-based matched cohort study with follow-up from 1995-2016 set in Denmark. 1155 men with KS were each matched by year and month of birth to 100 men from the background population. First thrombotic events and thrombosis mortality was evaluated by event rates and hazard ratios (HR) and applying testosterone treatment as a time-dependent covariate.RESULTS: The KS cohort had higher incidence of venous thromboembolism relative to the comparison cohort (HR, 3.95; 95 % CI, 2.83-5.52). Total thrombotic deaths were increased in KS (HR, 1.76; 95 % CI, 1.18-2.62), and all-cause mortality was increased in KS following arterial thrombosis (HR 1.73; 95 % CI 1.22-2.47). Only 48.7% of men with KS redeemed prescriptions for testosterone. Untreated men with KS were on average born twelve years before those treated, and the majority of untreated men with KS with available biochemistry were hypogonadal. Testosterone treatment in KS was associated with a non-significant decrease in venous thromboembolism and thrombotic deaths.CONCLUSION: Thrombosis and thrombotic deaths are increased in KS. Only half of men with KS ever received testosterone treatment, despite overt hypogonadism in the non-treated. Testosterone treatment in Klinefelter syndrome was insignificantly associated with lower incidence rates of venous thrombosis and thrombotic deaths.

KW - Cohort study

KW - Hypogonadism

KW - Klinefelter syndrome

KW - Testosterone treatment

KW - Thrombosis

U2 - 10.1530/EC-19-0433

DO - 10.1530/EC-19-0433

M3 - Journal article

C2 - 31829966

VL - 9

SP - 34

EP - 43

JO - Endocrine Connections

JF - Endocrine Connections

SN - 2049-3614

IS - 1

ER -