Hypogonadism may greatly increase mortality odds for hospitalized adults with asthma

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Key takeaways:

  • Adults with asthma and hypogonadism have more than 16-times higher odds for mortality during hospitalization than those without hypogonadism.
  • Randomized controlled trials are needed to confirm the findings.

NEW ORLEANS — Adults with asthma and hypogonadism have greatly increased risk for mortality during hospitalization compared with adults with asthma and normal testosterone levels, according to data presented at the AACE annual meeting.

“The key message of our study is the importance of further investigation of the implications of asthma combined with hypogonadism on patient mortality,” Shellsea Portillo-Canales, MD, a fellow in the division of endocrinology, diabetes and metabolism in the department of medicine at SSM Health Saint Louis University Hospital; Garry FrancisMorel, MD, internal medicine physician at SSM Health Saint Louis University Hospital; and Sandeep Dhindsa, MD, professor of medicine and chief of the division of endocrinology and metabolism at Saint Louis University, told Healio. “Previous studies suggest that testosterone therapy may mitigate the adverse effects of long-term glucocorticoid treatment in men with asthma. However, these interactions have not been studied extensively. Incorporating patients with asthma into testosterone replacement therapy trials may provide valuable insights.”

Asthma Blocks

Adults who are hospitalized with asthma exacerbations have a higher risk for mortality if they have hypogonadism. Image: Adobe Stock

Researchers conducted a retrospective cohort study using data from the National Inpatient Sample database of 415,230 adults hospitalized with asthma exacerbation from January 2016 to December 2020. All-cause mortality, length of hospitalization and hospital charges were collected. The study group was separated into a group diagnosed with hypogonadal disorder and a group without hypogonadism.

Of the study group, 145 were diagnosed with hypogonadism. The mortality rate for adults with hypogonadism was 3.45% compared with a 0.19% mortality rate for adults without hypogonadism (P = .0001). Adults diagnosed with hypogonadism were more likely to die during hospitalization than those without hypogonadism (adjusted OR = 16.22; P = .007).

There was no difference in length of hospital stay between the two groups. Hospital charges were affected by multiple factors, including race and ethnicity, household income and the Charlson Comorbidity Index.

The researchers said more studies are needed as the number of adults with hypogonadism in the study was small, and there may have been confounding variables that affected the rates of hypogonadism and mortality.

“Conducting a randomized controlled trial is crucial,” the researchers said. “If these results confirm our initial findings, treatment strategies can be greatly enhanced in patients with asthma and hypogonadism.”

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