# Prediction of testosterone deficiency using different screening indexes in adult American men: An NHANES cross-sectional study

## TL;DR

This study finds that a specific obesity-related index called TyG-WHtR is a strong predictor of testosterone deficiency in adult American men.

## Contribution

The study identifies TyG-WHtR as the most effective screening index for testosterone deficiency among several metabolic indicators.

## Key findings

- The TyG-WHtR index showed the highest predictive accuracy (AUC: 0.776) for testosterone deficiency.
- Men in the highest TyG-WHtR tertile had significantly lower testosterone levels and a six-fold higher risk of testosterone deficiency.
- The associations remained consistent even after adjusting for diabetes and hypertension in subgroup analyses.

## Abstract

Testosterone levels are closely associated with visceral obesity, insulin resistance, and lipid metabolism. The objective of this study was to investigate the associations among eight indicators related to visceral obesity, insulin resistance, lipid metabolism, and testosterone levels.

The data were obtained from a cross-sectional survey based on National Health and Nutrition Examination Survey (NHANES) 2013–2016. Logistic and linear regression were employed to assess the associations between these inicators and testosterone levels. Simultaneously, the receiver operating characteristic (ROC) curve was utilized to evaluate their predictive capacity for testosterone deficiency (TD).

Data from a collective of 1514 individuals selected from NHANES were analyzed. After adjusting all potential confounders, a tight association was identified between these eight indexes and TD. The ROC curve analysis showed that the triglyceride-glucose waist-to-height ratio (TyG-WHtR)is the best predictor of testosterone deficiency (AUC: 0.7760, 95%CI: 0.7460–0.8060), with a cut-off value of 5.375. Further analyses indicated that participants with higher TyG-WHtR index exhibitrd a lower total testosterone level(β: −79.36,95%CI: −105.90, −52.82). Additionally, males in TyG-WHtR index tertile 3 had a higher risk of TD (OR: 6.61, 95%CI: 2.90,15.07), and lower total testosterone levels (β: −121.9, 95%CI: −186.82, −56.98). All the results remained stable in the subgroup analyses stratified by diabetes and hypertension.

We found that these indexses are tightly associated with testosterone levels in U.S. adult men. Moreover, the TyG-WHtR index demonstrates the most effective predictive performance in the population. However, more well-designed studies are still needed to validate their association.