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Estimated CGMs for totalT in adults in NHANES 2011-2012 age ≥20 years and children 6 -10 years by race/ethnicity; estimated GM by age. a
Source publication
Background:
Limited information is available about testosterone concentrations representative of the general US population, especially children, women, and non-Hispanic Asians.
Methods:
We obtained nationally representative data for total testosterone (totalT), measured with standardized LC-MS/MS, for the US population age 6 years and older from...
Contexts in source publication
Context 1
... age 80 years, concentrations were 30% lower than at age 20 (Fig. 3A). TotalT concentra- tions in MA men were 13% higher than in NHA men (P 0.0038) and 10% higher than in NHW men (P 0.0051) (see online Supplemental Table 3). The concen- trations for men without diabetes were higher than for participants with prediabetes or diabetes (15%, P 0.0034) (see online Supplemental Table 3). ...
Context 2
... concentra- tions in MA men were 13% higher than in NHA men (P 0.0038) and 10% higher than in NHW men (P 0.0051) (see online Supplemental Table 3). The concen- trations for men without diabetes were higher than for participants with prediabetes or diabetes (15%, P 0.0034) (see online Supplemental Table 3). Smokers also had higher concentrations than nonsmokers, but the re- sults were only statistically significant for nonfasting par- ticipants (15% when fasting 8 h, P 0.0001; 3.6% when fasting 8 h, P 0.1769). ...
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Citations
... The LOD for urinary creatinine was 0.1 mg/dL. Since diurnal variations in sex hormones were observed, the time of sample collection was also adjusted (classification: morning, afternoon and evening) [36]. Moreover, the sample collection season was recorded as a six-month time period, and participants were randomly divided into two categories to measure sex hormones from November 1st through April 30th or May 1st through October 31st. ...
Background
Bisphenol A (BPA) exposure and its structural analogs (BPS and BPF) might cause endocrine alterations and adverse physiological effects. Few studies to date have directly explored the association between its structural analogs (BPS, BPF) and sex hormones in adult male participants. Therefore, we aimed to assess the associations between BPA, BPS, BPF, and sex hormones in American adult men.
Methods
We used data from the U.S. National Health and Nutrition Examination Survey 2011–2016. We excluded participants without data available on sex hormones and urinary bisphenols. Furthermore, participants consuming sex hormone medications were excluded. Multivariable regression models were performed to assess the association between bisphenols and sex hormones.
Results
In this study, 2367 participants were included. Of 2367, in 1575 participants, the data on BPS and BPF were available. We found that a per unit increase in BPF was associated with 0.575 ng/dL higher total testosterone (TT) (Model 2: 95% CI: 0.047, 1.103, P = 0.033). However, there was no significant association between BPA or BPS and TT. Furthermore, increased BPA and BPS levels were associated with higher levels of sex hormone-binding globulin (SHBG) (Model 2: β = 0.364, 95% CI: 0.158, 0.571; β = 0.25, 95% CI: 0.071, 0.429, respectively). Additionally, participants in the highest BPA exposure quartile (quartile 4) had 4.072 nmol/L higher levels of SHBG than those in quartile 1 (Model 2: 95% CI: 0.746, 7.397, P = 0.017; P for trend =0.005). Both BPA and BPS were negatively associated with free testosterone (FT, nmol/L) after full adjustment (Model 2, β = − 0.01%, P = 0.0211, P = 0.0211; Model 2, β = − 0.01%, P = 0.0258, respectively). However, BPF was positively associated with FT (Model 2, β = 0.0029%, P = 0.0028).
Conclusion
Our study indicated that exposure to both BPA and its substitutions could alter sex hormone levels. This finding supports the possibility that human exposure to bisphenols at environmental levels might affect the endogenous hormone balance.
... 11 Details on the laboratory and quality control procedures are also described elsewhere. 12 ...
Neonicotinoids are the most used pesticides in the world and, despite being harmful to honeybees, they are considered safe for mammals. However, they have been associated with decreasing testosterone levels in several experimental animal models. In the present study, we aimed to determine the association of urinary neonicotinoids with serum testosterone in humans. We analyzed data on 2014 male and female participants to the National Health and Nutrition Examination Survey conducted between 2015 and 2016 aged 6 or older. In linear regression adjusted for age and potential confounders, serum total testosterone was 37.78% lower with 10‐fold increase in urinary total neonicotinoids (95% CI: −58.82, −6.00), 20.81% lower with 10‐fold increase in urinary 5‐hydroxy‐imidacloprid (95% CI: −34.94, −3.62) and 25.01% lower with 10‐fold increase in urinary n‐desmethyl‐acetamiprid (95% CI: −39.80, −6.58) among males. Serum free androgen index (FAI) was also decreased with higher urinary n‐desmethyl‐acetamiprid. In females, serum total testosterone was 32.91% lower with 10‐fold increase in urinary total neonicotinoids (95% CI: −54.93, −0.13), 21.32% lower with 10‐fold increase in urinary 5‐hydroxy‐imidacloprid (95% CI: −29.31, −12.42) and 15.42% lower with urinary detection of 5‐hydroxy‐imidacloprid (95% CI: −22.80, −7.34). FAI was likewise reduced with higher urinary levels of 5‐hydroxy‐imidacloprid and N‐desmethyl‐acetamiprid. In conclusion, this study using a sample representative of the US population is the first to report that exposure to neonicotinoids is associated with decreased serum testosterone levels in humans. However, future prospective studies are warranted to confirm these findings.
... Total testosterone levels were measured using the radioimmunoassay method (Diagnostic Products Corporation, Los Angeles, CA, USA), from blood samples that were collected in the morning after an overnight fast. The established reference range of total testosterone level in young Korean men is 300-600 ng/dL [14,15] Follicle-stimulating hormone (FSH) levels (DIAsource Immunoassays S.A., Ottignies-Louvain-la-Neuve, Belgium), luteinizing hormone (LH) levels (DIAsource Immunoassays, Belgium), and lipid profiles, including cholesterol and triglyceride levels, were also measured with the intent of establishing their associations with testosterone levels and diabetes. Hemoglobin A1c (HbA1c) levels were measured at baseline and every 6 months. ...
The association between serum testosterone levels and type 1 diabetes (T1D), especially in adolescents and young adults, has not been fully investigated. We aimed to compare testosterone levels between adolescents/young men with T1D and controls and to determine the factors affecting testosterone levels. We enrolled 47 men with T1D and 32 controls aged 15–29 years. We evaluated anthropometric measurements, lipid profiles, diabetic complications, and levels of serum luteinizing hormone, follicle-stimulating hormone, hemoglobin A1c, 24-h urine albumin, insulin autoantibody, and total serum testosterone. We assessed the correlation between serum testosterone levels and clinical characteristics. Total testosterone levels were higher in T1D patients than in controls (694.6 ± 182.2 vs. 554.1 ± 147.3 ng/dL, p = 0.001), and 24-h urine albumin level positively correlated with total testosterone levels (correlation coefficient 0.415, p = 0.004). T1D patients with nephropathy showed higher total testosterone levels than those without nephropathy (778.4 ± 198.9 vs. 655.4 ± 162.5 ng/dL, p = 0.029). However, diabetic nephropathy and testosterone levels were not significantly associated after adjusting for confounders (β ± SE 77.5 ± 55.2, p = 0.169). Further longitudinal studies are imperative to confirm a causal relationship between testosterone levels and T1D.
... Men treated with androgen deprivation therapy were excluded ( Supplementary Fig. 1). Serum T was measured in eligible men via either immunoassay (1999-2000 and 2003-2004) or isotope dilution liquid chromatography and tandem mass spectrometry (2011-2012 and 2013-2014), as described elsewhere [1,[8][9][10]. ...
The relationship between testosterone and premature mortality has caused recent controversy. While previous studies have demonstrated mixed results, this is partly because of variable patient populations, different testosterone thresholds, and the use of antiquated techniques to measure serum testosterone. Using the National Health and Nutrition Examination Survey we analyzed a cohort representative of men in the USA to explore the relationship between serum testosterone and premature mortality using contemporary guidelines and testosterone measurements. We found that men with low testosterone (<300 ng/dl) were at higher risk (odds ratio 2.07, 95% confidence interval 1.30–3.32; p < 0.01) of premature death compared to men with normal testosterone. Furthermore, men with low testosterone were also more likely to have treatable comorbid conditions that were independently predictive of premature mortality. Both testosterone and these comorbid conditions are also modulated by lifestyle modifications, rendering this an important therapeutic approach in men with either or both conditions.
Patient summary
We explored the relationship between testosterone levels and premature death in a large US population. We found that low testosterone is associated with both premature death and related disease processes such as obesity, both of which can be initially treated with diet and exercise.
... Total testosterone levels were measured in serum using isotope dilution liquid chromatography tandem mass spectrometry by the National Center for Environmental Health, Centers for Disease Control and Prevention (https://www.icpsr.umich.edu/web/ICPSR/series/39). Total testosterone was measured with LC-MS/MS [21]; NHANES web page htt ps://wwwn.cdc.gov/Nchs/Nhanes/2011-2012/TST_G.htm). ...
Testosterone is one possible biomarker for depression risk among men and women. Both high and low levels of testosterone have been associated with depression, at least among men. Testosterone may be associated only with specific symptoms of depression, which might help to explain inconsistencies in previous results.
We examined the cross-sectional associations between total testosterone and the specific symptoms of depression using pooled data across three cycles of NHANES (2011-2012, 2013-2014, and 2015-2016). The sample included 4253 men and 5102 women. Testosterone was modelled as 1) a dichotomous (low testosterone cut-off <300 ng/dL for men and 15 ng/dL for women) and 2) a continuous variable using cubic splines.
In men, very low testosterone was weakly associated with problems with appetite, whereas very high testosterone was associated with sleep problems and weakly associated with tiredness. There were no consistent symptom-specific associations among women.
These findings provide only suggestive evidence for symptom-specific associations between testosterone and depression, mainly related to somatic complaints. Further data are needed to assess the reliability of these associations.
... To correct urine dilution of the analytes, urinary creatinine was adjusted as an independent variable (Barr et al., 2005). Moreover, the time of sample collection (morning, afternoon and evening) was also adjusted according to previous studies as diurnal variation in testosterone was observed in men (Brambilla et al., 2009;Vesper et al., 2015). ...
Bisphenol F (BPF) and bisphenol S (BPS) are increasingly used as bisphenol A (BPA) substitutes in consumer products. Little is known about the effects of BPA substitutes on reproductive endocrine function in children and adolescents. Thus, we conducted a cross-sectional study to examine the associations of BPA, BPF, and BPS with sex steroid hormones among 6-19-year old participants. Included were 1317 participants with information on BPA, BPF, BPS, and serum sex hormones [total testosterone (TT), estradiol (E2), and sex hormone binding globulin (SHBG)]. Multiple linear regression accounting for complex survey design was used to assess the association between bisphenols and sex hormones by sex-age groups. Exposure-response (ER) relationships were examined via restricted cubic splines. Significant association with BPF or BPS was sporadic, but BPA presented inverse association with the free androgen index (FAI, calculated as the ratio of TT to SHBG) and E2 and positive association with SHBG and TT/E2 in female adolescents. Further exploration of ER relationships showed that BPA (P for non-linearity = 0.03), BPF (P for non-linearity = 0.005), and BPS (P for non-linearity = 0.08) had a U-shaped relationship with FAI among female adolescents. Additionally, an inverse U-shaped curve was observed for BPA (P for non-linearity = 0.03), BPS (P for non-linearity = 0.01), and BPF (P for non-linearity = 0.01) with SHBG. The associations were virtually nonsignificant among males. Our study demonstrated that BPS and BPF may possess similar endocrine interrupting abilities as BPA.
... In combination, these androgen-driven and sex-based differences in muscle, bone and hemoglobin contribute to a~10% higher maximal oxygen consumption capacity ( _ VO 2max ) in men compared with women [7,8]. Androgen levels are not different between the sexes prior to puberty, however, after completion of puberty, circulating testosterone levels are on average~10-20 times greater in men than children or women at any age [9,10]. This sex-based difference in circulating testosterone is the basic premise to explain why men have faster performance times than women in many time-based sports including running, cycling, swimming, rowing, etc. [11][12][13][14][15][16][17]. ...
Background
The timing and magnitude of sex differences in athletic performance during early human development, prior to adulthood, is unknown.
Objective
To compare swimming velocity of boys and girls for all Olympic-length freestyle swimming events to determine the age of divergence in swimming performance.
Methods
We collected the all-time top 100 U.S. freestyle swimming performance times of boys and girls age 5 to 18 years for the 50m to 1500m events.
Results
Swimming performance improved with increasing age for boys and girls (p<0.001) until reaching a plateau, which initiated at a younger age for girls (15 years) than boys (17 years; sex×age; p<0.001). Prior to age 10, the top 5 swimming records for girls were 3% faster than the top boys (p<0.001). For the 10th-50th places, however, there were no sex-related differences in swimming performance prior to age 10 (p = 0.227). For both the top 5 and 10th-50th places, the sex difference in performance increased from age 10 (top 5, 2.5%; 10th-50th places, 1.0%) until age 17 (top 5, 7.6%; 10th-50th places, 8.0%). For all places, the sex difference in performance at age 18 was larger for sprint events (9.6%; 50-200m) than endurance events (7.1%; 400-1500m; p<0.001). Additionally, the sex-related difference in performance increased across age and US ranking from 2.4% for 1st place to 4.3% for 100th place (p<0.001), indicating less depth of performance in girls than boys. However, annual participation was ~20% higher in girls than boys for all ages (p<0.001).
Conclusion
The top 5 girls demonstrated faster swimming velocities and the 10th-50th place girls demonstrated similar swimming velocities than boys (until ~10 years). After age 10, however, boys demonstrated increasingly faster swimming velocities than girls until 17 years. Collectively, these data suggest girls are faster, or at least not slower, than boys prior to the performance-enhancing effects of puberty.
... Total testosterone levels of the National Health and Nutrition Examination Survey (NHANES), were recently reported [25]. The authors reported values for 3327 female and 3419 male participants of all ages and races. ...
Most studies reporting on the association of circulating testosterone levels with type 2 diabetes in men are of cross-sectional design. Reports on the relevance of altered testosterone levels in women are scarce. Here, we evaluate the role of low serum testosterone levels for incident diabetes in men and women in a population setting of 7706 subjects (3896 females). During a mean follow up time of 13.8 years, 7.8% developed type 2 diabetes. Significant correlations of testosterone with high density lipoprotein (HDL)-cholesterol (R = 0.21, p < 0.001), body-mass-index (R = −0.23, p < 0.001), and waist-to-hip-ratio (R = −0.21, p < 0.001) were found in men. No correlation was found with age in men; in women, the correlation was negligible (R = 0.04, p = 0.012). In men, low testosterone levels predicted high risk of type 2 diabetes, while in women this relationship was opposite. Men with low testosterone levels showed increased risk of future diabetes (hazard ratio (HR) 2.66, 95% confidence interval (CI) 1.91–3.72, p < 0.001 in basic model; HR 1.56 95%, CI 1.10–2.21, p = 0.003). In women, low testosterone levels indicated lower risk with (HR 0.53, 95% CI 0.37–0.77, p = 0.003), while the association lost significance in the fully adjusted model (HR 0.72, 95% CI 0.49–1.05, p = 0.09). Low levels of testosterone predicted future diabetes in men. A borderline opposite association was found in women.
... A study of serum total testosterone concentrations in household populations participating in the National Health and Nutrition Examination Survey (NHANES) in 2011-2012 revealed different patterns of testosterone level between age groups, and between race/ethnic groups. Higher testosterone levels were found in non-diabetic males compared to those with diabetes, and in more physically active men than sedentary men [2]. The authors of that study suggested that these differences may be associated with testosterone metabolism, or with different health outcomes. ...
... Subjects who completed a dietary questionnaire/interview, body mass index (BMI) measurement, and a total serum testosterone measurement were eligible for inclusion. Although testosterone levels are known to peak at 55 to 60 years of age in healthy males [2], we specifically selected males 20 to 39 years old because reproductive activity is greatest during this period. Participants with incomplete information (missing dietary questionnaire/interview, BMI, or total testosterone test results) were excluded. ...
... In brief, blood samples were collected once from each participant, and the timing of the blood collection was considered as serum testosterone levels exhibit a circadian rhythm. The NHANES laboratory examination protocol [15] states that serum testosterone was determined quantitatively using an electrochemiluminescence immunoassay on an Elecsys 2010 autoanalyzer (Roche Diagnostics, Indianapolis, IN, USA), as previously described [2]. Following recommendations of the International Society of Andrology (ISA), International Society for the Study of the Aging Male (ISSAM), European Association of Urology (EAU), European Academy of Andrology (EAA), and the American Society of Andrology (ASA) [16], the cut-off points of 231 ng/dL and 346 ng/dL testosterone (8 to 12 nmol/L) were considered as diagnostic of biochemical hypogonadism, as described previously [17]. ...
Background
This population-based study was designed to investigate whether consumption of sugar-sweetened beverages (SSB) is associated with lower serum total testosterone concentration in men 20–39 years old. Methods
All data for this study were retrieved from the National Health and Nutrition Examination Survey (NHANES) 2011–2012. The primary outcome was serum testosterone concentration, and main independent variable was SSB intake. Other variables included age, race/ethnicity, poverty/income ratio, body mass index (BMI), serum cotinine, heavy drinking, and physical activity. ResultsAmong all subjects (N = 545), 486 (90.4%) had normal testosterone levels (defined as ≥231 ng/dL) and 59 (9.6%) had low testosterone levels (defined as < 231 ng/dL). Multivariate logistic regression revealed the odds of low testosterone was significantly greater with increasing SSB consumption (Q4 [≥442 kcal/day] vs. Q1 [≤137 kcal/day]), adjusted odds ratio [aOR] = 2.29, p = 0.041]. After adjusting for possible confounding variables, BMI was an independent risk factor for low testosterone level; subjects with BMI ≥ 25 kg/m2 had a higher risk of having a low testosterone level than those with BMI < 25 kg/m2 (aOR = 3.68, p = 0.044). ConclusionSSB consumption is significantly associated with low serum testosterone in men 20–39 years old in the United States.
... Second, there is a well-known lack of standardization among LC-MS/MS methods; it is possible that the technique we used differed from the one used by Travison et al. Last but not least, as significant geographical and racial differences in sex-steroid levels have been previously demonstrated [46,47], a real difference in T concentration levels in our population is possible. Eisenhofer et al. [48] recently published total T RRs in 252 healthy men calculated with LC-MS/MS; they found an RR of 7.6-37.1 nmol/L (all age and BMI considered), which is comparable with ours (7.495-34.757 ...
Background
The total testosterone (T) cutoffs clinically adopted to define late-onset hypogonadism (LOH) do not consider the differences that exist between different analytical platforms, nor do they consider the body mass index (BMI) or age of the patient. We aimed at providing method, age and BMI-specific normal values for total T in European healthy men.
Methods
A total of 351 eugonadal healthy men were recruited, and total T was measured with four automated immunometric assays (IMAs): ARCHITECT i1000SR (Abbott), UniCel DxI800 (Beckman Coulter), Cobas e601 (Roche), IMMULITE 2000 (Siemens) and liquid chromatography-tandem mass spectrometry (LC-MS/MS). Reference ranges (RRs) were calculated for each method.
Results
Passing and Bablok regression analysis and Bland-Altman plot showed an acceptable agreement between Abbott and LC-MS/MS, but a poor one between LC-MS/MS and the other IMAs. Age-specific T concentrations in non-obese (BMI <29.9 kg/m ² ) men were greater than in all men. The total T normal range, in non-obese men aged 18–39 years, measured with LC-MS/MS was 9.038–41.310 nmol/L. RRs calculated with LC-MS/MS statistically differed from the ones calculated with all individual IMAs, except Abbott and among all IMAs. Statistically significant differences for both upper and lower reference limits between our RRs and the ones provided by the manufacturers were also noticed.
Conclusions
We calculated normal ranges in a non-obese cohort of European men, aged 18–39 years, with four commercially available IMAs and LC-MS/MS and found statistically significant differences according to the analytical method used. Method-specific reference values can increase the accuracy of LOH diagnosis and should be standardly used.
