Shanlee M Davis1,2, Natalie J Nokoff1, Anna Furniss3, Laura Pyle1,4, Anna Valentine1, Patricia Fechner5, Chijioke Ikomi6, Brianna Magnusen7, Leena Nahata8,9, Maria G Vogiatzi10, Amanda Dempsey1,3,11. 1. Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO 80045, USA. 2. eXtraOrdinarY Kids Clinic, Children's Hospital Colorado, Aurora, CO 80045, USA. 3. Adult & Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine, Aurora, CO 80045, USA. 4. Department of Biostatistics and Informatics, University of Colorado School of Public Health, Aurora, CO 80045, USA. 5. Department of Endocrinology, Seattle Children's Hospital, Seattle, WA 98105, USA. 6. Division of Endocrinology, Nemours Children's Health, Wilmington, DE 19803, USA. 7. Institute for Informatics, Washington University School of Medicine in St. Louis, St. Louis, MO 63110, USA. 8. Center for Biobehavioral Health, Abigail Wexner Research Institute, Columbus, OH 43215, USA. 9. Division of Endocrinology, Nationwide Children's Hospital, Columbus, OH 43215, USA. 10. Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. 11. Merck and Company, Wales, PA 19454, USA.
Abstract
CONTEXT: Diabetes and cardiovascular diseases are common among men with Klinefelter syndrome (KS) and contribute to high morbidity and mortality. OBJECTIVE: To determine if cardiometabolic-related diagnoses are more prevalent among youth with KS than matched controls in a large population-based cohort. METHODS: Secondary data analysis of electronic health records from 6 pediatric institutions in the United States (PEDSnet). Patients included all youth with KS in the database (n = 1080) and 4497 youth without KS matched for sex, age (mean 13 years at last encounter), year of birth, race, ethnicity, insurance, site, and duration of care (mean 7 years). The main outcome measures were prevalence of 5 cardiometabolic-related outcomes: overweight/obesity, dyslipidemia, dysglycemia, hypertension, and liver dysfunction. RESULTS: The odds of overweight/obesity (OR 1.6; 95% CI 1.4-1.8), dyslipidemia (3.0; 2.2-3.9), and liver dysfunction (2.0; 1.6-2.5) were all higher in KS than in controls. Adjusting for covariates (obesity, testosterone treatment, and antipsychotic use) attenuated the effect of KS on these outcomes; however, boys with KS still had 45% greater odds of overweight/obesity (95% CI 1.2-1.7) and 70% greater odds of liver dysfunction (95% CI 1.3-2.2) than controls, and both dyslipidemia (1.6; 1.1-2.4) and dysglycemia (1.8; 1.1-3.2) were higher in KS but of borderline statistical significance when accounting for multiple comparisons. The odds of hypertension were not different between groups. CONCLUSION: This large, population-based cohort of youth with KS had a higher odds of most cardiometabolic-related diagnoses than matched controls.
CONTEXT: Diabetes and cardiovascular diseases are common among men with Klinefelter syndrome (KS) and contribute to high morbidity and mortality. OBJECTIVE: To determine if cardiometabolic-related diagnoses are more prevalent among youth with KS than matched controls in a large population-based cohort. METHODS: Secondary data analysis of electronic health records from 6 pediatric institutions in the United States (PEDSnet). Patients included all youth with KS in the database (n = 1080) and 4497 youth without KS matched for sex, age (mean 13 years at last encounter), year of birth, race, ethnicity, insurance, site, and duration of care (mean 7 years). The main outcome measures were prevalence of 5 cardiometabolic-related outcomes: overweight/obesity, dyslipidemia, dysglycemia, hypertension, and liver dysfunction. RESULTS: The odds of overweight/obesity (OR 1.6; 95% CI 1.4-1.8), dyslipidemia (3.0; 2.2-3.9), and liver dysfunction (2.0; 1.6-2.5) were all higher in KS than in controls. Adjusting for covariates (obesity, testosterone treatment, and antipsychotic use) attenuated the effect of KS on these outcomes; however, boys with KS still had 45% greater odds of overweight/obesity (95% CI 1.2-1.7) and 70% greater odds of liver dysfunction (95% CI 1.3-2.2) than controls, and both dyslipidemia (1.6; 1.1-2.4) and dysglycemia (1.8; 1.1-3.2) were higher in KS but of borderline statistical significance when accounting for multiple comparisons. The odds of hypertension were not different between groups. CONCLUSION: This large, population-based cohort of youth with KS had a higher odds of most cardiometabolic-related diagnoses than matched controls.
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Authors: R J Kuczmarski; C L Ogden; L M Grummer-Strawn; K M Flegal; S S Guo; R Wei; Z Mei; L R Curtin; A F Roche; C L Johnson Journal: Adv Data Date: 2000-06-08
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Authors: Anna Valentine; Shanlee Davis; Anna Furniss; Nadia Dowshen; Anne E Kazak; Christopher Lewis; Danielle F Loeb; Leena Nahata; Laura Pyle; Lisa M Schilling; Gina M Sequeira; Natalie Nokoff Journal: J Clin Endocrinol Metab Date: 2022-09-28 Impact factor: 6.134