Testosterone Lab Testing and Initiation in the United Kingdom and the United States, 2000 to 2011
Testosterone Lab Testing and Initiation in the United Kingdom and the United States, 2000 to 2011
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DOI：
10.1210/jc.2013-3570
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发表时间：
2014-03-01
影响因子：
5.8
通讯作者：
Brookhart, M. Alan
中科院分区：
文献类型：
--
作者：
Layton, J. Bradley;Li, Dongmei;Brookhart, M. Alan
内容：新的配方，增加营销，以及更广泛地认识到老年人睾酮水平下降可能有助于在许多国家更广泛的睾酮测试和补充。目的：我们的目的是描述英国和美国男性的睾酮测试和睾酮治疗。设计：这是一个回顾性事件用户队列。设置：我们评估了2000年至2011年美国的商业和医疗保险索赔以及英国全科医生的医疗保健记录。参与者：我们确定了410019名美国男性和6858名英国男性谁开始了睾酮制剂以及1114329名美国男性和66140名英国男性与一个新的睾酮实验室测量。结果的措施，包括开始任何注射睾酮，植入睾酮丸，或规定的经皮或口服睾酮formulation.Results：睾酮测试和补充增加了在美国的发音。在英国增加测试已经确定了更多的男性低水平，但美国测试中增加了正常水平的男性。在美国的男性往往比在英国更经常在正常水平开始，许多男性在没有最近的测试开始睾酮。凝胶已成为最常见的初始治疗在这两个countries.Conclusions：在过去的十年中，特氟沙星的测试和使用有所增加，特别是在美国，从注射到凝胶的戏剧性转变。大量使用被认为是在男性没有最近的测试和美国男性与正常水平。尽管存在安全性和有效性问题，但由于使用范围扩大，处方者必须在开始使用前考虑睾酮的医疗必要性。
Context: New formulations, increased marketing, and wider recognition of declining testosterone levels in older age may have contributed to wider testosterone testing and supplementation in many countries.Objective: Our objective was to describe testosterone testing and testosterone treatment in men in the United Kingdom and United States.Design: This was a retrospective incident user cohort.Setting: We evaluated commercial and Medicare insurance claims from the United States and general practitioner healthcare records from the United Kingdom for the years 2000 through 2011.Participants: We identified 410 019 US men and 6858 UK men who initiated a testosterone formulation as well as 1 114 329 US men and 66 140 UK men with a new testosterone laboratory measurement.Main Outcome Measures: Outcome measures included initiation of any injected testosterone, implanted testosterone pellets, or prescribed transdermal or oral testosterone formulation.Results: Testosterone testing and supplementation have increased pronouncedly in the United States. Increased testing in the United Kingdom has identified more men with low levels, yet US testing has increased among men with normal levels. Men in the United States tend to initiate at normal levels more often than in the United Kingdom, and many men initiate testosterone without recent testing. Gels have become the most common initial treatment in both countries.Conclusions: Testosterone testing and use has increased over the past decade, particularly in the United States, with dramatic shifts from injections to gels. Substantial use is seen in men without recent testing and in US men with normal levels. Given widening use despite safety and efficacy questions, prescribers must consider the medical necessity of testosterone before initiation.