Increased risk of incident chronic medical conditions in infertile men: analysis of United States claims data
Increased risk of incident chronic medical conditions in infertile men: analysis of United States claims data
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DOI：
10.1016/j.fertnstert.2015.11.011
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发表时间：
2016-03-01
影响因子：
6.7
通讯作者：
Baker, Laurence C.
中科院分区：
文献类型：
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作者：
Eisenberg, Michael L.;Li, Shufeng;Baker, Laurence C.
目的：确定男性不育患者慢性疾病的发病率。设计：回顾性队列研究。设置：不适用。患者：2001年至2009年Truven Health MarketScan索赔数据库中包含的受试者。干预：不适用。主要结果测量：慢性疾病的发展，包括高血压、糖尿病、高脂血症、肾病、肺病、肝病、抑郁症，外周血管疾病、脑血管疾病、心脏病、损伤、酒精滥用、药物滥用、焦虑症和双相情感障碍。结果：总共有13，027名男性被诊断为男性因素不育，另外23，860名仅接受生育测试。被诊断患有不孕症的男性的平均年龄为33.1岁，仅接受检测的男性为32.8岁。在调整混杂因素后，诊断为男性因素不育的男性患糖尿病的风险更高（风险比[HR] 1.30，95%置信区间[CI] 1.10-1.53），缺血性心脏病（HR 1.48，95% CI 1.19-1.84）、酗酒（HR 1.48，95% CI 1.07-2.05）和药物滥用（1.67，95% CI 1.06-2.63）。在比较男性因素不育与输精管切除男性时，发现了类似的模式。男性因素不孕症和以后的健康结果之间的关联是最强的男性与较长的follow-up. Conclusions（S）：在这个队列的患者在国家保险数据库，男性诊断为男性因素不孕症有显着较高的风险，不良的健康结果在几年后的不孕症评估。这些研究结果表明男性生殖健康的整体重要性，并保证额外的调查，以了解相关性，并确定干预措施，以改善这些患者的结果。(C)2016年，美国生殖医学会（American Society for Reproductive Medicine）
Objective: To determine the incidence of chronic medical conditions of men with infertility.Design: Retrospective cohort study.Setting: Not applicable.Patient(s): Subjects contained within the Truven Health MarketScan claims database from 2001 to 2009.Intervention(s): Not applicable.Main Outcome Measure(s): The development of chronic medical conditions including hypertension, diabetes, hyperlipidemia, renal disease, pulmonary disease, liver disease, depression, peripheral vascular disease, cerebrovascular disease, heart disease, injury, alcohol abuse, drug abuse, anxiety disorders, and bipolar disorder.Result(s): In all, 13,027 men diagnosed with male factor infertility were identified with an additional 23,860 receiving only fertility testing. The average age was 33.1 years for men diagnosed with infertility and 32.8 years for men receiving testing alone. After adjusting for confounding factors, men diagnosed with male factor infertility had a higher risk of developing diabetes (hazard ratio [HR] 1.30, 95% confidence interval [CI] 1.10-1.53), ischemic heart disease (HR 1.48, 95% CI 1.19-1.84), alcohol abuse (HR 1.48, 95% CI 1.07-2.05), and drug abuse (1.67, 95% CI 1.06-2.63) compared with men who only received infertility testing. Similar patterns were identified when comparing those with male factor infertility to vasectomized men. The association between male factor infertility and later health outcomes were strongest for men with longer follow-up.Conclusion(s): In this cohort of patients in a national insurance database, men diagnosed with male factor infertility had a significantly higher risk of adverse health outcomes in the years after an infertility evaluation. These findings suggest the overall importance of men's reproductive health and warrant additional investigation to understand the association and identify interventions to improve outcomes for these patients. (C) 2016 by American Society for Reproductive Medicine.