Liu Nuozhou, Luo Xinyao, Li Peiyao, Xiong Wei
West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China.
Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.
Andrology. 2023 Feb;11(2):215-224. doi: 10.1111/andr.13207. Epub 2022 Jun 24.
Testosterone decline and deficiency in males have aroused increased attention in male health management, which might have a close relationship with insulin resistance (IR).
We utilized a novel and practical IR indicator, the triglyceride-glucose (TyG) index, to investigate the association between the TyG index and serum testosterone in US adult males.
This was a cross-sectional study based on data from the National Health and Nutrition Examination Survey (NHANES) 2013-2014 and 2015-2016. The TyG index was calculated from fasting plasma glucose and serum triglyceride, and serum testosterone was measured by isotope dilution liquid chromatography tandem mass spectrometry in NHANES.
A total of 2186 male participants aged more than 20 years old were included, and the mean TyG index was 8.72 ± 0.71. Participants with a higher TyG index showed a lower level of total testosterone (β = -45.83, 95% CI: -58.50, -33.15, p < 0.0001) and a higher risk of testosterone deficiency (OR = 1.80, 95% CI: 1.46, 2.21, p < 0.0001) after we adjusted for all potential cofounders. Males in TyG index tertile 3 had a 113% (95% CI: 1.50, 3.02, p < 0.0001) higher risk of testosterone deficiency than those in tertile 1. Subgroup analysis stratified by diabetes condition indicated that the TyG index might be a good predictor of testosterone decline or deficiency in either people with or without diabetes. However, ROC cure analysis indicated that a larger area under the curve was found in the homeostasis model assessment of insulin resistance (HOMA-IR) (0.71, 95% CI: 0.68,0.74) than in the TyG index (0.67, 95% CI: 0.64, 0.70).
Males with a higher TyG index tended to have a higher risk of testosterone decline or even testosterone deficiency. However, the predictability of the TyG index for testosterone deficiency was not better than that of HOMA-IR. More well-designed studies are still needed to validate this relationship.
男性睾酮水平下降和缺乏在男性健康管理中引起了越来越多的关注，这可能与胰岛素抵抗（IR）密切相关。
我们使用一种新颖且实用的IR指标，即甘油三酯-葡萄糖（TyG）指数，来研究美国成年男性中TyG指数与血清睾酮之间的关联。
这是一项基于2013 - 2014年和2015 - 2016年美国国家健康与营养检查调查（NHANES）数据的横断面研究。TyG指数由空腹血糖和血清甘油三酯计算得出，血清睾酮在NHANES中通过同位素稀释液相色谱串联质谱法进行测量。
共纳入2186名年龄超过20岁的男性参与者，平均TyG指数为8.72±0.71。在对所有潜在混杂因素进行校正后，TyG指数较高的参与者总睾酮水平较低（β = -45.83，95%CI：-58.50，-33.15，p < 0.0001），且睾酮缺乏风险较高（OR = 1.80，95%CI：1.46，2.21，p < 0.0001）。TyG指数处于第三三分位数的男性睾酮缺乏风险比处于第一三分位数的男性高113%（95%CI：1.50，3.02，p < 0.0001）。按糖尿病状况分层的亚组分析表明，TyG指数可能是糖尿病患者和非糖尿病患者睾酮水平下降或缺乏的良好预测指标。然而，ROC曲线分析表明，胰岛素抵抗稳态模型评估（HOMA-IR）的曲线下面积（0.71，95%CI：0.68，0.74）大于TyG指数（0.67，95%CI：0.64，0.70）。
TyG指数较高的男性睾酮水平下降甚至缺乏的风险往往更高。然而，TyG指数对睾酮缺乏的预测能力并不优于HOMA-IR。仍需要更多设计良好的研究来验证这种关系。
