title: Associations of androgens with health care utilization and costs in women-Perspectives of a population-based cohort study.
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.
authors.affiliation: Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany; European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany. Electronic address: robin.haring@uni-greifswald.de.
authors.forename: Robin
authors.initials: R
authors.lastname: Haring
authors.affiliation: Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany.
authors.forename: Henri
authors.initials: H
authors.lastname: Wallaschofski
authors.affiliation: Institute for Community Medicine, University Medicine Greifswald, Germany.
authors.forename: Henry
authors.initials: H
authors.lastname: Völzke
authors.affiliation: Faculty of Law and Economics, University Medicine Greifswald, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Flessa
authors.affiliation: Department of Clinical Chemistry, University Hospital South Manchester, UK.
authors.forename: Brian G
authors.initials: BG
authors.lastname: Keevil
authors.affiliation: Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Nauck
authors.affiliation: Institute for Community Medicine, University Medicine Greifswald, Germany; Department of Epidemiology and Preventive Medicine, University of Regensburg, Germany.
authors.forename: Sebastian E
authors.initials: SE
authors.lastname: Baumeister
mesh_terms: D000328:Adult; D000728:Androgens / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011446:Prospective Studies; D012738:Sex Hormone-Binding Globulin / Q000032:analysis*; D013739:Testosterone / Q000097:blood*
chemical_list: D000728:Androgens; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone
keywords: Androgens; Costs; Health care utilization; Sex hormones; Total testosterone; Women