Highlights
- •This is the first large-scale population-based epidemiological-econometric study to employ sex hormone measurements from liquid chromatography-tandem mass spectrometry.
- •It is the first investigation of potential associations between sex hormones and health care utilization and costs in women.
- •Sex hormone-binding globulin correlated inversely and free testosterone positively with long-term health care costs.
Abstract
Objective
Despite associations between total testosterone (TT) concentrations and increased
cardiometabolic risk, the impact of serum androgens on health care utilization and
costs among women is unknown.
Methods
We used data from 1521 women in the population-based cohort Study of Health in Pomerania
(SHIP) to investigate the associations of serum TT (measured by liquid chromatography-tandem
mass spectrometry), sex hormone-binding globulin (SHBG), and free testosterone (free
T) with health care utilization and costs at baseline and five-year follow-up (N = 1210), implementing multivariable-adjusted econometric models.
Results
Cross-sectional analyses showed no association of TT, SHBG, or free T with hospitalization
or total health costs (outpatient as well as inpatient costs). Prospective analyses
revealed an inverse association of baseline SHBG with follow-up total health care
costs (% change per standard deviation (SD): −26.2%, 95% confidence interval (CI):
−42.2%; −8.9%) and inpatient costs (% change per SD: −26.5%%, 95% CI: −45.5%; −2.5%).
Baseline free T was positively associated with total health care costs at the five-year
follow-up (% change per SD: +37.7%, 95% CI: +4.6%; +81.4%).
Conclusions
In this first cost analysis among women from the general population, we observed no
association of androgen serum concentration with health care utilization and costs.
However, baseline SHBG appeared to be inversely correlated and free T positively correlated
with long-term health care costs.
Keywords
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Article info
Publication history
Published online: April 09, 2016
Accepted:
April 2,
2016
Received in revised form:
March 29,
2016
Received:
December 15,
2015
Identification
Copyright
© 2016 Elsevier Ireland Ltd. All rights reserved.
