Guang'anmen Hospital, China Academy of Traditional Chinese Medicine, Beijing, China.
Xiyuan Hospital, China Academy of Traditional Chinese Medicine, Beijing, China.
PLoS One. 2024 Aug 28;19(8):e0306401. doi: 10.1371/journal.pone.0306401. eCollection 2024.
Exploring the relationship between the cardiometabolic index (CMI) and serum testosterone levels as well as testosterone deficiency in American adult males. Additionally, comparing the diagnostic value of the CMI with several common obesity and metabolism indices for identifying testosterone deficiency.
This cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2016. Serum testosterone levels and testosterone deficiency were used as dependent variables, with the cardiometabolic index as the independent variable. Multivariable regression was used to assess the relationship between the independent and dependent variables, while subgroup analyses were performed to ensure the stability of the results. Smooth curve fitting was utilized to evaluate the nonlinear relationship between the CMI and testosterone levels. Receiver operating characteristic curves (ROC) were plotted for several obesity and metabolism prediction indices and the area under the curve was calculated to compare the specificity and sensitivity of each diagnostic index in the diagnosis of testosterone deficiency.
Among 3541 adult male participants, CMI is negatively associated with serum testosterone levels and positively associated with testosterone deficiency. In the fully adjusted model, for every unit increase in CMI, serum testosterone decreased by 14.89 ng/dl. Comparing the highest quartile to the lowest quartile of CMI, each unit increase in CMI, serum testosterone decreased by 98.58 ng/dl. Furthermore, each unit increase in CMI was associated with a 16% increase in incidence of testosterone deficiency. By plotting the ROC curves, we found that the AUCs for Lipid Accumulation Product (LAP), Body Mass Index (BMI), Weight Adjusted Waist Index (WWI), CMI, Visceral Adiposity Index (VAI) and Triglyceride glucose index (TyG) were 0.73, 0.72, 0.71, 0.69, 0.66, and 0.66 respectively.
Elevated levels of CMI are associated with lower testosterone levels and an increased risk of testosterone deficiency. The predictive value of the LAP was superior to that of CMI, while the predictive value of CMI was higher than VAI and TyG.
探讨美国成年男性中心血管代谢指数（CMI）与血清睾酮水平及睾酮缺乏的关系，并比较 CMI 与几种常见肥胖和代谢指标对识别睾酮缺乏的诊断价值。
本横断面研究使用了 2011 年至 2016 年国家健康和营养调查（NHANES）的数据。以血清睾酮水平和睾酮缺乏为因变量，以心血管代谢指数为自变量。采用多变量回归评估自变量与因变量之间的关系，同时进行亚组分析以确保结果的稳定性。采用平滑曲线拟合评估 CMI 与睾酮水平之间的非线性关系。绘制几种肥胖和代谢预测指标的受试者工作特征曲线（ROC），并计算曲线下面积，以比较各诊断指标在诊断睾酮缺乏症时的特异性和敏感性。
在 3541 名成年男性参与者中，CMI 与血清睾酮水平呈负相关，与睾酮缺乏呈正相关。在完全调整模型中，CMI 每增加一个单位，血清睾酮水平下降 14.89ng/dl。与 CMI 的最高四分位相比，CMI 每增加一个单位，血清睾酮水平下降 98.58ng/dl。此外，CMI 每增加一个单位，睾酮缺乏的发生率增加 16%。通过绘制 ROC 曲线，我们发现脂质蓄积产物（LAP）、体重指数（BMI）、体重校正腰围指数（WWI）、CMI、内脏脂肪指数（VAI）和甘油三酯葡萄糖指数（TyG）的 AUC 分别为 0.73、0.72、0.71、0.69、0.66 和 0.66。
CMI 水平升高与睾酮水平降低和睾酮缺乏风险增加有关。LAP 的预测价值优于 CMI，而 CMI 的预测价值高于 VAI 和 TyG。
