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      The impact of Klinefelter syndrome on socioeconomic status: a multicenter study

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          Abstract

          Klinefelter syndrome (KS) is associated with an increased risk of neuropsychological morbidity, such as learning disabilities, which may have a significant impact on socioeconomic status (SES). The objective of this study was to investigate the SES in men with KS and to associate this outcome with social participation, age at diagnosis, testosterone therapy and physical and mental health status. Men with KS were recruited in 14 clinical study centers in six European countries which participated in the European dsd-LIFE study. Two hundred five men with KS were eligible for inclusion. Male normative data from the European Social Surveys (ESS) were used for comparison. Data related to education, occupation, satisfaction with income and householding were collected. Compared to the ESS reference population, fewer men with KS achieved a high level of education (13% vs 25%, P < 0.001). There was a significant difference in having a paid job (55% vs 66%, P < 0.001), and the percentage of absence by sickness or disability was higher among men with KS (10% vs 3%, P < 0.001). Furthermore, satisfaction with current household’s income was lower (32% vs 42%, P < 0.01). Lower scores for subjective general health were associated with lower scores for these outcomes. Men with KS achieve on average lower levels of education, occupation and report less satisfaction with income compared to the ESS reference population. The presence of health problems and lower scores of subjective general health was related to lower levels of occupation and lower satisfaction with income in men with KS.

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          Prenatal and postnatal prevalence of Klinefelter syndrome: a national registry study.

          The objective of this study was to describe the prevalence of Klinefelter syndrome (KS) prenatally and postnatally in Denmark and determine the influence of maternal age. All chromosomal examinations in Denmark are registered in the Danish Cytogenetic Central Registry. Individuals with KS diagnosed prenatally or postnatally were extracted from the registry with information about age at the time of diagnosis and mother's age. In the period 1970-2000, 76,526 prenatal examinations on male fetuses resulted in the diagnosis of 163 fetuses with KS karyotype, corresponding to a prevalence of 213 per 100,000 male fetuses. Standardization according to maternal age resulted in a prevalence of 153 per 100,000 males. Postnatally, 696 males of 2,480,858 live born were diagnosed with KS, corresponding to a prevalence among adult men of approximately 40 per 100,000. Less than 10% of the expected number was diagnosed before puberty. Advanced maternal age had a significant impact on the prevalence. KS is severely underdiagnosed in Denmark. Only approximately one fourth of adult males with KS are diagnosed. There is a marked delay in diagnosis of the syndrome. A delay in treatment with testosterone may lead to decreased muscle and bone mass with subsequent risk of osteoporosis.
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            Morbidity in Klinefelter syndrome: a Danish register study based on hospital discharge diagnoses.

            Klinefelter syndrome (KS) is the most prevalent sex chromosome disorder in man; it affects approximately one in 660 men and is a common cause of hypogonadism and infertility. Our current knowledge of morbidity in KS is based on observational studies and case reports and therefore is limited. We used Danish registers to obtain dates of hospital admissions and discharge diagnoses in a cohort of all males diagnosed with KS in Denmark and a randomly selected, age-matched control group. Our cohort consisted of 832 KS subjects and 4033 control subjects, contributing with a total of approximately 100,000 person years. We used stratified Cox regression analysis on main groups of diagnoses. Where significant results were found, subsequent analyses were performed on subgroups of diagnoses. We found a significantly increased risk of being hospitalized among the KS subjects [hazard ratio (HR), 1.69; 95% confidence interval, 1.54-1.86]. The increased admission risk was present in all but one of the main diagnosis groups, with the highest HRs for congenital malformations (HR, 10.7), psychiatric disorders (HR, 3.7), and endocrine and metabolic disorders (HR, 3.2). We compared hospitalization rates before and after the diagnosis of KS and found that the increased rate was present even before the diagnosis of KS. Males suffering from KS experienced an increased hospitalization rate from a variety of disorders. Some are likely to be caused by hypogonadism, and some may be linked to the syndrome per se, whereas others are not readily explained. However, other factors, e.g. socioeconomic, may be involved.
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              Klinefelter Syndrome

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                Author and article information

                Journal
                Endocr Connect
                Endocr Connect
                EC
                Endocrine Connections
                Bioscientifica Ltd (Bristol )
                2049-3614
                13 June 2022
                01 July 2022
                : 11
                : 7
                : e220010
                Affiliations
                [1 ]Department of Obstetrics and Gynaecology , Radboudumc, Nijmegen, The Netherlands
                [2 ]Department of Pediatric Urology , Radboudumc, Nijmegen, The Netherlands
                [3 ]Department of Internal Medicine , Radboudumc, Nijmegen, The Netherlands
                [4 ]Department of Urology , Radboudumc, Nijmegen, The Netherlands
                [5 ]Department of Pediatric Endocrinology , Bicêtre Hospital, Paris Sud University, Paris, France
                [6 ]Department of Andrology and Reproductive Endocrinology , Medical University of Lodz, Lodz, Poland
                [7 ]Department of Endocrinology and Metabolic Disease , Centre Hospitalier Universitaire de Toulouse, Toulouse, France
                [8 ]Departments of Plastic Surgery and Medical Psychology , Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
                [9 ]Department of Pediatrics , Hospital des Enfants, Toulouse, France
                [10 ]Kinderendokrinologie und Diabetologie , Universitätsklinikum Ruhr-Universität Bochum, Kinderklinik, Bochum, Germany
                [11 ]Medizinische Klinik and Poliklinik IV , Department of Endocrinology, University Hospital Munich, Munich, Germany
                [12 ]Klinik fur Kinder- und Jugendmedizin , Universitat zu Lubeck, Lubeck, Germany
                [13 ]Department for Health Evidence , Radboudumc, Nijmegen, The Netherlands
                [14 ]Department of Pediatric Endocrinology , Amalia Childrens Hospital, Radboudumc, Nijmegen, The Netherlands
                Author notes
                Correspondence should be addressed to H L Claahsen-van der Grinten: Hedi.Claahsen@ 123456radboudumc.nl
                Author information
                http://orcid.org/0000-0002-3434-1765
                http://orcid.org/0000-0002-6127-0747
                http://orcid.org/0000-0003-0181-0403
                Article
                EC-22-0010
                10.1530/EC-22-0010
                9254318
                35700267
                e737def0-311d-4448-a716-d9a3dc7d5c3f
                © The authors

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 12 May 2022
                : 13 June 2022
                Categories
                Research

                disorders/differences of sex development,klinefelter syndrome,socioeconomic status,multicentre study

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