Premium
The association between varicocoeles and vascular disease: an analysis of U.S. claims data
Author(s) -
Wang N. N.,
Dallas K.,
Li S.,
Baker L.,
Eisenberg M. L.
Publication year - 2018
Publication title -
andrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.947
H-Index - 43
eISSN - 2047-2927
pISSN - 2047-2919
DOI - 10.1111/andr.12437
Subject(s) - varicocele , medicine , vasectomy , asymptomatic , diabetes mellitus , male infertility , hyperlipidemia , infertility , incidence (geometry) , disease , gynecology , endocrinology , population , pregnancy , genetics , physics , environmental health , family planning , optics , research methodology , biology
Summary Studies have suggested an association between varicocele, hypogonadism, and elevated oxidative stress markers, but no other health risks have been associated with varicoceles. We sought to determine the association between varicocele and incident medical comorbidities. Using the Truven Health MarketScan ® claims database from 2001 to 2009, we identified 4459 men with varicoceles, and 100,066 controls based on ICD‐9 and CPT codes, with an average follow‐up of 3.1 person years. Men with varicoceles were classified as symptomatic or asymptomatic based on co‐existing diagnoses. Men with medical comorbidities present before or within 1 year of index diagnosis were excluded. Metabolic and cardiovascular outcome variables were identified via ICD‐9 codes. A Cox regression analysis was used to assess incident risk of metabolic and cardiovascular disease amongst the different groups. Men with varicoceles had a higher incidence of heart disease compared to men who underwent infertility testing (HR 1.22, 95% CI: 1.03–1.45), and men who underwent vasectomy (HR 1.32, 95% CI 1.13–1.54). The varicoceles group also had a higher risk of diabetes (HR 1.73, 95% CI: 1.37–2.18) and hyperlipidemia (HR 1.15, 95% CI: 1.03–1.28) compared to the vasectomy group. Furthermore, men with symptomatic varicoceles ( n = 3442) had a higher risk of heart disease, diabetes, and hyperlipidemia following diagnosis, while men with asymptomatic varicoceles ( n = 1017) did not. Given the prevalence of varicoceles, further research is needed to understand the implications of a varicocele to a man's overall health.