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Redefining Unexplained Anemia in Elderly
JAMA Internal Medicine ( IF 39.0 ) Pub Date : 2017-09-01 , DOI: 10.1001/jamainternmed.2017.2958
Michele F Eisenga 1 , Suzanne P Stam 1 , Stephan J L Bakker 1
Affiliation  

sults reported in our study. First, the median (interquartile range [IQR]) serum testosterone level in our treated cohort during follow-up was 318 (237-435) ng/dL compared with the untreated population with a median (IQR) 212 (160-253) ng/dL; testosterone replacement therapy resulted in a significant increase in serum levels with over half of the patients normalizing their serum testosterone levels. Second, although we did not generate a Framingham Risk Score for the patients in our study,1 we did conduct a stratified analysis restricted to men with baseline cardiovascular risk factors and the results from this stratified analysis were consistent with our overall study findings. Third, we have seen the beneficial effects of treating hypertension or hyperlipidemia in our population in recent years,3 suggesting that this could affect our results. Thus, we included calendar year in our adjusted models and found a lower risk of cardiovascular outcomes over time potentially related to changing treatment patterns and/or length of follow-up. We believe the questions posed by Stavropoulos and colleagues probe important nuances about the potential relationship between testosterone replacement therapy and cardiovascular disease outcomes. Undoubtedly, further focused studies based in other cohorts of men, from different settings, could provide important new insights.

中文翻译:

重新定义老年人不明原因贫血

我们的研究中报告了sults。首先,与未治疗人群相比,随访期间接受治疗的队列的血清睾酮水平中位数(四分位距 [IQR])为 318 (237-435) ng/dL,中位数 (IQR) 为 212 (160-253) ng /dl; 睾酮替代疗法导致血清水平显着增加,超过一半的患者血清睾酮水平恢复正常。其次,虽然我们没有为研究中的患者生成 Framingham 风险评分 1,但我们确实对具有基线心血管危险因素的男性进行了分层分析,该分层分析的结果与我们的整体研究结果一致。第三,近年来我们已经看到治疗高血压或高脂血症对我们人群的有益效果,3 表明这可能会影响我们的结果。因此,我们在调整后的模型中包括日历年,并发现随着时间的推移,心血管结果的风险降低,这可能与改变治疗模式和/或随访时间有关。我们相信 Stavropoulos 及其同事提出的问题探讨了有关睾酮替代疗法与心血管疾病结果之间潜在关系的重要细微差别。毫无疑问,基于来自不同环境的其他男性队列的进一步重点研究可以提供重要的新见解。我们相信 Stavropoulos 及其同事提出的问题探讨了有关睾酮替代疗法与心血管疾病结果之间潜在关系的重要细微差别。毫无疑问,基于来自不同环境的其他男性队列的进一步重点研究可以提供重要的新见解。我们相信 Stavropoulos 及其同事提出的问题探讨了有关睾酮替代疗法与心血管疾病结果之间潜在关系的重要细微差别。毫无疑问,基于来自不同环境的其他男性队列的进一步重点研究可以提供重要的新见解。
更新日期:2017-09-01
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