Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston.
Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston; Sealy Center on Aging, University of Texas Medical Branch, Galveston.
Ann Epidemiol. 2020 Oct;50:15-19.e8. doi: 10.1016/j.annepidem.2020.05.015. Epub 2020 Jun 8.
Testosterone replacement therapy (TRT) is posited to reduce the risk of depression and anxiety. To our knowledge, this is the first study to assess incident TRT prescribing patterns in a nationally representative sample of men with depression and anxiety in the United States.
This study included 5,565,649 men aged 40-65 years, who were enrolled in Clinformatics Data Mart between January 1, 2002 and December 31, 2016. For each calendar year, we reported incident TRT prescribing and testosterone laboratory testing rates in men diagnosed with depression and/or anxiety.
For each calendar year, incident TRT prescribing rates were higher for men with depression and anxiety, than for men without these disorders. For both groups, TRT prescribing increased by 200% from 2002 to 2013 and decreased by more than 50% from 2013 to 2016. More than 20% of men in either group did not have a laboratory test for testosterone levels before TRT initiation.
In men with depression and anxiety, TRT prescribing increased significantly from 2002 to 2013 and decreased from 2013 to 2016. A significant proportion of men were prescribed TRT without a prior laboratory test for testosterone levels. Further research is needed to better understand the extent to which these conditions influence physician prescribing practices and patient expectations.
睾酮替代疗法（TRT）被认为可以降低抑郁和焦虑的风险。据我们所知，这是第一项在美国有抑郁和焦虑的男性中评估全国代表性样本中 TRT 处方模式的研究。
本研究纳入了 5565649 名 40-65 岁的男性，他们于 2002 年 1 月 1 日至 2016 年 12 月 31 日期间参加了 Clinformatics Data Mart。对于每一个日历年度，我们报告了在被诊断为抑郁和/或焦虑的男性中 TRT 处方和睾酮实验室检测的发生率。
对于每一个日历年度，患有抑郁和焦虑的男性的 TRT 处方率均高于没有这些疾病的男性。对于这两组男性，从 2002 年到 2013 年，TRT 处方率增加了 200%，而从 2013 年到 2016 年，处方率下降了 50%以上。在这两组男性中，超过 20%的男性在开始 TRT 之前没有进行过睾酮水平的实验室检测。
在患有抑郁和焦虑的男性中，TRT 的处方从 2002 年到 2013 年显著增加，并从 2013 年到 2016 年减少。很大一部分男性在没有进行睾酮水平实验室检测的情况下就被开具了 TRT。需要进一步研究以更好地了解这些疾病在多大程度上影响医生的处方行为和患者的期望。
