Table 2. Miliary Service, Morbidity, and Participant-Reported Outcome Measures Assessed From VHA Electronic Health Records and Baseline and Lifestyle Million Veteran Program Surveys.
| Measure | 47,XXY Cohort | 47,XYY Cohort | ||||
|---|---|---|---|---|---|---|
| No. (%) | P value | No. (%) | P value | |||
| Cases | Controls | Cases | Controls | |||
| Source: VHA records | ||||||
| No. | 862 | 4310 | NA | 747 | 3735 | NA |
| Period of miliary service | ||||||
| Pre-Vietnam era | 46 (5.3) | 280 (6.5) | .12 | 48 (6.4) | 248 (6.6) | .33 |
| Vietnam era | 463 (53.7) | 2264 (52.8) | 376 (50.3) | 1882 (60.4) | ||
| Post-Vietnam era | 137 (15.9) | 571 (13.3) | 122 (16.3) | 530 (14.2) | ||
| Persian Gulf War era | 163 (18.9) | 918 (21.4) | 148 (19.8) | 839 (22.5) | ||
| Other or missing | 54 (6.1) | 256 (6.0) | 53 (7.1) | 236 (6.3) | ||
| First military service branch | ||||||
| Air Force | 59 (7.0) | 334 (7.7) | .046 | 65 (8.7) | 300 (8.0) | .53 |
| Army | 224 (26.6) | 1189 (27.6) | 194 (26.0) | 996 (26.7) | ||
| Navy | 109 (12.9) | 442 (10.2) | 89 (11.9) | 393 (10.5) | ||
| Othera | 50 (5.9) | 346 (8.0) | 51 (6.8) | 308 (8.2) | ||
| Unknown or missing | 400 (47.5) | 1999 (46.4) | 348 (46.6) | 1738 (46.5) | ||
| Combat service | 125 (14.5) | 571 (13.2) | .71 | 102 (13.7) | 512 (13.7) | .67 |
| Military discharge status | ||||||
| Honorable | 422 (49.0) | 2161 (50.1) | .40 | 361 (48.3) | 1867 (50.0) | .01 |
| General, Honorable Conditions | 34 (3.9) | 134 (3.1) | 38 (5.1) | 108 (2.3) | ||
| Other than Honorableb | 2 (0.2) | 4 (0.1) | 0 (0) | 7 (0.2) | ||
| Unknown or missing | 404 (46.9) | 2011 (46.7) | 348 (46.6) | 1753 (46.9) | ||
| 100% VHA service connection | 121 (14.0) | 668 (15.5) | .23 | 105 (14.1) | 580 (15.5) | .33 |
| Height at enrollment, mean (SD), cm | 182.6 (7.8) | 178.0 (7.1) | <.001 | 187.0 (8.3) | 177.8 (7.3) | <.001 |
| Weight at enrollment, mean (SD), kg | 103.3 (23.0) | 95.3 (20.2) | <.001 | 113.9 (28.3) | 95.1 (20.2) | <.001 |
| BMI at enrollment, mean (SD) | 31.4 (6.6) | 30.5 (6.1) | <.001 | 33.0 (7.7) | 30.5 (6.1) | <.001 |
| Duration of VHA data, median (IQR), y | 18 (13-21) | 17 (12-20) | <.001 | 17 (13-20) | 16 (12-20) | <.001 |
| Charlson Comorbidity Index | ||||||
| Mean (SD) | 4.30 (2.72) | 3.90 (2.47) | <.001 | 4.45 (2.90) | 3.82 (2.50) | <.001 |
| 10-y survival, % (95% CI) | 44 (38-50) | 56 (54-58) | <.001 | 39 (32-46) | 59 (56-61) | <.001 |
| Outpatient encounters, median (IQR), No. per y | 22.6 (11.8-37.8) | 16.8 (9.4-28.0) | <.001 | 21.4 (12.4-33.8) | 17.0 (9.4-28.2) | <.001 |
| Emergency encounters, median (IQR), No. per y | 0.44 (0.19-1.0) | 0.33 (0.14-0.7) | <.001 | 0.50 (0.20-0.95) | 0.33 (0.14-0.68) | <.001 |
| Inpatient encounters, median (IQR), No. per y | 0.24 (0.11-0.49) | 0.19 (0.1-0.42) | .001 | 0.24 (0.11-0.49) | 0.19 (0.10-0.42) | .001 |
| Deceased | 110 (12.8) | 510 (11.5) | .48 | 112 (15.0) | 430 (11.5) | .02 |
| Age of death, mean (SD), y | 71.3 (9.6) | 70.4 (9.5) | .39 | 71.3 (9.9) | 71.4 (10.0) | .95 |
| Source: Baseline Survey | ||||||
| No. | 574 | 2758 | NA | 500 | 2385 | NA |
| Age at survey, mean (SD), yc | 64.0 (10.0) | 64.2 (10.2) | .72 | 63.7 (10.0) | 63.5 (10.7) | .61 |
| Military service branch(es)d | ||||||
| Army | 302 (52.6) | 1366 (49.5) | .10 | 236 (47.2) | 1152 (48.3) | .15 |
| Navy | 138 (24.0) | 586 (21.2) | 130 (26.0) | 527 (22.1) | ||
| Air Force | 88 (15.3) | 496 (18.0) | 91 (18.2) | 413 (17.3) | ||
| Othera | 101 (17.6) | 562 (20.4) | 88 (17.6) | 499 (20.1) | ||
| Deployed outside the USe | 423 (73.7) | 2076 (75.3) | .46 | 363 (72.6) | 1773 (74.3) | .45 |
| Exposure to biochemical warfaree | 74 (12.9) | 264 (9.6) | .04 | 64 (12.8) | 230 (9.6) | .09 |
| Health care from VHA facilities, % | ||||||
| <50 | 156 (27.1) | 813 (29.4) | .42 | 138 (27.6) | 713 (29.9) | .16 |
| 51-75 | 49 (8.5) | 189 (8.5) | 42 (8.4) | 158 (6.6) | ||
| 76-99 | 93 (16.2) | 468 (16.2) | 75 (15.0) | 426 (17.9) | ||
| Hospitalization this yeare | ||||||
| ≥1 At VHA facility | 162 (33.1) | 484 (20.0) | <.001 | 110 (26.1) | 413 (19.8) | .004 |
| ≥1 At non-VA facility | 97 (25.5) | 362 (18.1) | <.001 | 93 (26.4) | 323 (18.6) | <.001 |
| Prescription medications, No. | ||||||
| 0-3 | 180 (33.2) | 1107 (42.9) | <.001 | 170 (36.2) | 966 (43.3) | <.001 |
| 4-9 | 230 (42.4) | 1068 (41.4) | 194 (41.3) | 914 (41.0) | ||
| >10 | 132 (24.4) | 407 (15.8) | 106 (22.6) | 348 (15.6) | ||
| Health-related QOLf | ||||||
| Physical functioning summary | 34.2 (12.0) | 37.8 (12.8) | <.001 | 36.3 (11.6) | 37.9 (12.0) | .004 |
| Mental health summary | 45.3 (14.0) | 47.8 (13.3) | <.001 | 46.3 (13.8) | 47.3 (13.5) | .15 |
| Source: lifestyle survey | ||||||
| No. | 429 | 2113 | NA | 350 | 1753 | NA |
| Age at survey, mean (SD), yc | 65.3 (9.7) | 65.5 (9.4) | .70 | 64.6 (10.2) | 64.8 (10.1) | .73 |
| Reproductive health | ||||||
| Sexual problems (eg, pain) | 57 (13.5) | 184 (8.9) | .005 | 30 (8.6) | 157 (9.0) | .90 |
| Erectile dysfunction | 227 (53.9) | 1218 (59.2) | .05 | 208 (59.4) | 1025 (58.5) | .79 |
| Fertility problems | 215 (51.1) | 139 (6.8) | <.001 | 53 (15.1) | 121 (6.9) | <.001 |
| Fathered a child | 76 (18.1) | 1627 (79.1) | <.001 | 200 (57.1) | 1382 (78.8) | <.001 |
| Neuropsychological health | ||||||
| MOS Cog-Rg | 12.6 (7.4) | 11.6 (7.1) | .01 | 13.1 (8.1) | 11.7 (7.1) | .003 |
| PHQ-4h | ||||||
| Total | 2.93 (3.47) | 2.25 (3.17) | <.001 | 2.80 (3.26) | 2.40 (3.26) | .046 |
| Anxiety subscale | 1.45 (1.13) | 1.13 (1.69) | .001 | 1.38 (1.87) | 1.21 (1.74) | .12 |
| Depression subscale | 1.54 (1.88) | 1.15 (1.67) | <.001 | 1.46 (1.83) | 1.20 (1.71) | .01 |
| PCL totali | 35.8 (17.1) | 31.4 (15.6) | <.001 | 34.8 (15.8) | 32.1 (12.9) | .004 |
Abbreviations: BMI, body mass index (calculated as weight in kilograms divided by height in meters squared); MOS Cog-R, Medical Outcomes Survey Cognitive Functioning Revised Scale; NA, not applicable; PCL, Posttraumatic Stress Disorder Checklist; PHQ-4, Patient Health Questionnaire-4; QOL, quality of life; VHA, Veterans Health Administration.
Other military branches include Coast Guard, Marine Corps, National Guard, and Merchant Marines.
Dishonorable Discharge was combined with Other than Honorable Discharge due to low numbers.
Participants were matched on age at time of study enrollment, which does not necessarily indicate balanced age at time of survey completion.
More than 1 selection was allowed; therefore, percentages add up to more than 100%.
At least 10% of respondents did not answer these questions; however, the proportion of nonresponders was similar among all groups, and results did not change if missing was included as a separate category.
Assessed using the Veterans RAND 12-Item Health Survey (range 0-100; higher values indicate better QOL).
Scores are norm-based, with higher values indicating more problems.
Total range, 0 to 12; subscale ranges, 0-6; higher values indicate more concern.
Range, 0 to 80; higher values indicate more concern.