Department of General Surgery, The Affiliated Chuzhou Hospital of Anhui Medical University (The First People's Hospital of Chuzhou), Chuzhou, Anhui, China.
Department of General Surgery, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China.
BMC Public Health. 2024 Jun 24;24(1):1683. doi: 10.1186/s12889-024-19202-5.
Testosterone deficiency (TD) and obesity are globally recognized health concerns, with a bidirectional causal relationship between them. And a newly discovered obesity indicator, the Weight-Adjusted-Waist Index (WWI), has been proposed, demonstrating superior adiposity identification capability compared to traditional body mass index (BMI) and waist circumference (WC) indicators. Therefore, we present the inaugural investigation into the associations of WWI with total testosterone levels and the risk of TD.
Data restricted to the National Health and Nutrition Examination Survey (NHANES) between 2013 and 2016 were analyzed. Only males aged > 20 years who completed body measures and underwent serum sex hormone testing were potentially eligible for analysis. Weighted multivariable linear regression and logistic regression analyses were employed to investigate the relationships between WWI and total testosterone levels, and the risk of TD, respectively. Smooth curve fittings and weighted generalized additive model (GAM) regression were conducted to examine the linear relationship among them. Additionally, subgroup analyses with interaction tests were performed to assess the stability of the results.
Finally, a total of 4099 participants with complete data on testosterone and WWI were included in the formal analysis. The mean age of study participants was 46.74 ± 0.35 years with a TD prevalence of 25.54%. After adjusting all potential confounders, the continuous WWI displayed a negative linear relationship with total testosterone levels (β=-61.41, 95%CI: -72.53, -50.29, P < 0.0001) and a positive linear relationship with risk of TD (OR = 1.88, 95%CI: 1.47, 2.39, P < 0.0001). When WWI was transformed into quartiles as a categorical variable, participants in Q4 exhibited lower total testosterone levels (β=-115.4, 95%CI: -142.34, -88.45, P < 0.0001) and a higher risk of TD (OR = 3.38, 95% CI: 2.10, 5.44, P < 0.001). These associations remained stable in subgroup analyses without significant interaction (all P for interaction > 0.05).
This investigation firstly unveiled a negative linear association between WWI and total testosterone levels, coupled with a positive linear relationship with the prevalence of TD in U.S. male adults aged 20 years and older. Further studies are needed to validate the potential utility of WWI for the early identification and timely intervention of TD.
睾酮缺乏症（TD）和肥胖是全球公认的健康问题，它们之间存在着双向因果关系。最近发现了一种新的肥胖指标，体重调整腰围指数（WWI），与传统的体重指数（BMI）和腰围（WC）指标相比，它具有更好的肥胖识别能力。因此，我们首次研究了 WWI 与总睾酮水平和 TD 风险之间的关系。
对 2013 年至 2016 年期间进行的国家健康和营养检查调查（NHANES）的数据进行了分析。只有年龄大于 20 岁、完成身体测量并接受血清性激素检测的男性才有资格进行分析。采用加权多变量线性回归和逻辑回归分析分别探讨 WWI 与总睾酮水平以及 TD 风险之间的关系。进行平滑曲线拟合和加权广义加性模型（GAM）回归，以检查它们之间的线性关系。此外，还进行了亚组分析和交互检验，以评估结果的稳定性。
最终，共有 4099 名符合条件的男性（年龄大于 20 岁，完成了睾酮和 WWI 检测）被纳入正式分析。研究参与者的平均年龄为 46.74±0.35 岁，TD 的患病率为 25.54%。在调整所有潜在混杂因素后，连续 WWI 与总睾酮水平呈负线性关系（β=-61.41，95%CI：-72.53，-50.29，P<0.0001），与 TD 风险呈正线性关系（OR=1.88，95%CI：1.47，2.39，P<0.0001）。当 WWI 转换为四分类变量时，Q4 组的参与者总睾酮水平较低（β=-115.4，95%CI：-142.34，-88.45，P<0.0001），TD 风险较高（OR=3.38，95%CI：2.10，5.44，P<0.001）。这些关联在没有显著交互作用的亚组分析中仍然稳定（所有 P 值交互作用>0.05）。
本研究首次揭示了 WWI 与总睾酮水平之间的负线性关系，以及与美国 20 岁及以上男性成年人 TD 患病率之间的正线性关系。需要进一步的研究来验证 WWI 对 TD 的早期识别和及时干预的潜在效用。
