Fédération des médecins omnipraticiens du Québec

FORMATION CONTINUE 2010-2011

JEUDI 15 SEPTEMBRE 2011

SÉANCE PLÉNIÈRE DE L'AVANT-MIDI

L'andropause : approche pratique pour l'omnipraticien

11h15

Docteur Gilles Bernard BellavanceUrologue

Clinique médicale Legardeurois

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F O R M AT I O N C O N T I N U E FMOQ — 2011-2012La thérapeutique — 15 et 16 septembre 2011

L’andropauseApproche pratique pour l’omnipraticienDr Gilles Bellavance

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L’andropauseL andropauseApproche pratique pour l’omnipraticienpp p q p p

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F O R M AT I O N C O N T I N U E FMOQ — 2011-2012La thérapeutique — 15 et 16 septembre 2011

L’andropauseApproche pratique pour l’omnipraticien Dr Gilles Bellavance

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Taux de testostérone Mortalité 95% IC

N l 0 201 16 2 24 1%Normal 0,201 16,2 -24,1%

Équivoque 0,246 19,2-30,0%Vous trouverez le tableau à cette adresse :

Bas 0,349 28,5-41,4%http://archinte.ama-assn.org/cgi/reprint/166/15/1660

Fi 1663Figure page 1663

Shores M., et al. Arch Intern Med. 2006;166:1660-1665.

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F O R M AT I O N C O N T I N U E FMOQ — 2011-2012La thérapeutique — 15 et 16 septembre 2011

L’andropauseApproche pratique pour l’omnipraticienDr Gilles Bellavance

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Patients hypogonadiques

(n = 836)*

Patients normaux

(n = 1326)* P

Hypertension 547 (65,4) 678 (51,1) < 0,001

Hyperlipidémie 506 (60,5) 670 (50,5) < 0,001

Diabète 258 (30,9) 237 (17,9) < 0,001

Obésité 270 (32,3) 225 (17,0) < 0,001

Maladie ou troubles 165 (19 7) 226 (17 0) 0 121prostatiques 165 (19,7) 226 (17,0) 0,121

Douleur chronique 155 (18,5) 211 (16,0) 0,113

Insomnie ou troubleInsomnie ou trouble du sommeil 129 (15,4) 185 (14,0) 0,342

Asthme ou BPCO 102 (12,2) 118 (8,9) 0,013

Adapté de l'étude HIM* Valeurs exprimées en n (%)

Medical Conditions Odds Ratio (95% C.I.)

Obesity 2.33 (1.90, 2.85)

Diabetes 2.04 (1.67, 2.50)

Hypertension 1.80 (1.50, 2.14)

Osteoporosis 1.59 (0.77, 3.30)

Rheumatoid Arthritis 1.55 (0.91, 2.62)

Hyperlipidemia 1.49 (1.25, 1.78)

Asthma/COPD 1.42 (1.07, 1.88)( )

Chronic Pain 1.20 (0.95, 1.50)

Prostate Disease 1.19 (0.95, 1.49)( , )

Adapté de l'étude HIM

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F O R M AT I O N C O N T I N U E FMOQ — 2011-2012La thérapeutique — 15 et 16 septembre 2011

L’andropauseApproche pratique pour l’omnipraticien Dr Gilles Bellavance

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This systematic review indicates that endogenous sexThis systematic review indicates that endogenous sex hormones may differentially modulate glycemic status and risk of type 2 diabetes in men and women.

High testosterone levels are associated with higher risk of type 2 diabetes in women but with lower risk in men; the inverse association of SHBG with risk was stronger ininverse association of SHBG with risk was stronger in women than in men.

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F O R M AT I O N C O N T I N U E FMOQ — 2011-2012La thérapeutique — 15 et 16 septembre 2011

L’andropauseApproche pratique pour l’omnipraticienDr Gilles Bellavance

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F O R M AT I O N C O N T I N U E FMOQ — 2011-2012La thérapeutique — 15 et 16 septembre 2011

L’andropauseApproche pratique pour l’omnipraticien Dr Gilles Bellavance

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TESTOSTÉRONETESTOSTÉRONE(DOSAGE ET IMPRÉCISION)

TESTOSTÉRONETESTOSTÉRONE(DOSAGE ET IMPRÉCISION)

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F O R M AT I O N C O N T I N U E FMOQ — 2011-2012La thérapeutique — 15 et 16 septembre 2011

L’andropauseApproche pratique pour l’omnipraticienDr Gilles Bellavance

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•• Il Il doitdoit y y avoiravoir des des symptômessymptômes significatifssignificatifspour le patientpour le patientpour le patient.pour le patient.

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F O R M AT I O N C O N T I N U E FMOQ — 2011-2012La thérapeutique — 15 et 16 septembre 2011

L’andropauseApproche pratique pour l’omnipraticien Dr Gilles Bellavance

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Absolues

Relatives

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F O R M AT I O N C O N T I N U E FMOQ — 2011-2012La thérapeutique — 15 et 16 septembre 2011

L’andropauseApproche pratique pour l’omnipraticienDr Gilles Bellavance

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Dr Gilles Bellavance

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F O R M AT I O N C O N T I N U E FMOQ — 2011-2012La thérapeutique — 15 et 16 septembre 2011

Dr Gilles BellavancerL’andropauseApproche pratique pour l’omnipraticien

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etetetet

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