Patients with Klinefelter Syndrome (KS) are at increased risk for both diabetes and cardiovascular disease. While the anabolic effects of androgen replacement therapy may be associated with weight gain in such patients, the metabolic effects of this weight gain are unknown. Since untreated KS represents a natural example of androgen deprivation, we hypothesized that KS patients who are receiving androgen replacement would have a healthier metabolic risk factor profile, in addition to an increased Body Mass Index (BMI), relative to patients who are not receiving androgen replacement.
Using de-identified data collected from Health Facts (a
national, consolidated, and relational database of Electronic
Health Records), we identified 2,447 adult patients with an
ICD-9 billing code for KS. Of these, 262 patients were
included in this study based on available anthropometrics,
metabolic profiles, and information about androgen
replacement. Multiple linear regression analysis was
performed using BMI as the dependent variable in a model
that included age, androgen replacement therapy (yes or
no), A1C, blood pressure, and fasting lipids. Post-hoc
comparisons were made using frequency analysis and the
unpaired Student’s t-test.
There were 81 patients with KS who received androgen
replacement and 181 patients who did not. In multiple
regression, only androgen therapy was positively and
significantly associated with BMI while adjusting for other
risk factors (p=0.03). Post-hoc comparison of metabolic risk
factors revealed no other differences between patients who
received androgen replacement and those who did not.
These data suggest that androgen replacement therapy in
Klinefelter Syndrome is associated with increased BMI, but
this increase does not appear to exert a detrimental effect
on other metabolic risk factors in this condition.
Ehrhart MD, Guthrie IR, Qeadan F, Burge MR