Wu Xu, Zhang Yuyang, Zhang Xiansheng
Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui Province, China.
Institute of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui Province, China.
J Sex Med. 2025 Jan 9;22(2):265-273. doi: 10.1093/jsxmed/qdae196.
BACKGROUND: There have been many studies of the association between testosterone and cardiovascular disease (CVD). However, limited research has examined the association between testosterone and Life's Essential 8 (LE8), a recently updated algorithm for assessing cardiovascular health (CVH). OBJECTIVES: This study aims to investigate the association between serum total testosterone (TT) levels and LE8 scores-where higher LE8 scores indicate better CVH-among adult males in the United States. METHOD: Data from 3308 adult males were extracted from the National Health and Nutrition Examination Survey conducted between 2013 and 2016. Weighted univariate and multivariate linear regression models [β and 95% confidence intervals (CIs)] and logistic regression models [odds ratios (ORs) and 95% CIs] were used to explore the association between testosterone and LE8 and high CVH risk. Additionally, a smoothed curve fit (penalized spline method) and generalized additive model regression were applied to further explore these relationships. OUTCOMES: LE8 includes 4 health behaviors (nicotine exposure, diet, physical activity, and sleep duration) and 4 health factors (body mass index, non-high-density lipoprotein cholesterol, blood pressure, and blood glucose). RESULTS: Serum TT levels were strongly associated with LE8 scores after adjusting for all confounders (continuous: β = 2.75, 95% CI: 1.92, 3.57, P < .0001; quartiles: Q4 vs Q1: β = 3.89, 95% CI: 2.78, 5.01, P < .0001). Similarly, high levels of TT were associated with a significantly lower CVH risk (OR = 0.59, 95% CI: 0.49, 0.73, P < .001). Compared to low TT levels, normal TT levels significantly reduced the risk of CVH (OR = 0.51, 95% CI: 0.38, 0.69, P < .001). Smoothed curve fitting showed a positive linear correlation between TT levels and LE8 scores, as well as a consistent linear negative correlation with CVH risk. CLINICAL IMPLICATIONS: These findings highlight the importance of endogenous TT levels in promoting CVH and provide new insights into factors influencing CVH. STRENGTHS AND LIMITATIONS: This study is the first to investigate the association between serum TT level and LE8 scores as well as LE8-assessed CVH among adult males. However, the observational nature of this study precludes any assessment of causality. CONCLUSIONS: This study demonstrates a robust positive association between serum TT levels and LE8 scores in a nationally representative sample of adult men in the United States.
背景：已有许多关于睾酮与心血管疾病（CVD）关联的研究。然而，针对睾酮与生命必需8项（LE8）之间关联的研究较少，LE8是一种最近更新的用于评估心血管健康（CVH）的算法。 目的：本研究旨在调查美国成年男性血清总睾酮（TT）水平与LE8评分之间的关联，LE8评分越高表明心血管健康状况越好。 方法：从2013年至2016年进行的美国国家健康与营养检查调查中提取了3308名成年男性的数据。使用加权单变量和多变量线性回归模型[β和95%置信区间（CI）]以及逻辑回归模型[比值比（OR）和95%CI]来探讨睾酮与LE8以及高心血管健康风险之间的关联。此外，应用平滑曲线拟合（惩罚样条法）和广义相加模型回归来进一步探索这些关系。 结果：LE8包括4种健康行为（尼古丁暴露、饮食、身体活动和睡眠时间）和4种健康因素（体重指数、非高密度脂蛋白胆固醇、血压和血糖）。 结果：在调整所有混杂因素后，血清TT水平与LE8评分密切相关（连续变量：β = 2.75，95%CI：1.92，3.57，P <.0001；四分位数：Q4与Q1相比：β = 3.89，95%CI：2.78，5.01，P <.0001）。同样，高水平的TT与显著较低的心血管健康风险相关（OR = 0.59，95%CI：0.49，0.73，P <.001）。与低TT水平相比，正常TT水平显著降低了心血管健康风险（OR = 0.51，95%CI：0.38，0.69，P <.001）。平滑曲线拟合显示TT水平与LE8评分之间呈正线性相关，与心血管健康风险呈一致的线性负相关。 临床意义：这些发现凸显了内源性TT水平在促进心血管健康方面的重要性，并为影响心血管健康的因素提供了新的见解。 优点和局限性：本研究首次调查了成年男性血清TT水平与LE8评分以及LE8评估的心血管健康之间的关联。然而，本研究的观察性质排除了对因果关系的任何评估。 结论：本研究在美国成年男性具有全国代表性的样本中证明了血清TT水平与LE8评分之间存在强有力的正相关。
JAMA Cardiol. 2025-4-23
BMC Public Health. 2025-2-1
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