Bian Hege, Zhang Yuzhong, Liu Kun
Supply Chain Department, Hefei BOE Hospital, Hefei, 230013, China.
Department of Surgery, The Third Affiliated Hospital of Anhui Medical University (The First People's Hospital of Hefei), Hefei, 230061, China.
Sex Med. 2025 Sep 15;13(4):qfaf075. doi: 10.1093/sexmed/qfaf075. eCollection 2025 Aug.
Emerging evidence suggests that insulin sensitivity plays a role in testosterone regulation. The estimated glucose disposal rate (eGDR) is a validated metabolic marker reflecting insulin resistance (IR). However, the relationship between eGDR and testosterone levels in adult men remains unclear.
This study aimed to examine the association between eGDR, total testosterone (TT) levels, and testosterone deficiency (TD) risk.
Data from the 2013-2016 National Health and Nutrition Examination Survey (NHANES) were analyzed. Weighted multivariable linear and logistic regression models were used to evaluate the association between eGDR, TT levels, and TD risk (TT <300 ng/dL). A smoothing spline curve fitting approach was applied to assess the shape of the relationship. Subgroup analyses and interaction tests were conducted to explore potential effect modifications. Receiver operating characteristic (ROC) analysis was performed to assess the predictive ability of eGDR for TD.
eGDR was calculated using waist circumference (WC), hypertension (HTN), and glycated hemoglobin (HbA1c).
A total of 4087 male participants were included in the final analysis. After adjusting for all covariates, higher eGDR was significantly associated with increased TT levels ( = 31.83, 95% CI, 22.13-41.54, < .001) and a lower risk of TD (OR = 0.68, 95% CI, 0.58-0.80, = .002). Quartile analysis showed that participants in the highest eGDR quartile (Q4) had significantly higher TT levels than those in Q1 ( = 147.27, 95% CI, 66.99-227.55, = .02) and a markedly reduced TD risk (OR = 0.20, 95% CI, 0.06-0.70, = .03). Smoothing spline curve fitting approach confirmed a linear relationship between eGDR and TT levels, as well as an inverse association with TD risk. A significant interaction was observed for diabetes status ( for interaction = .001), indicating a potential modifying effect. ROC analysis demonstrated that eGDR had moderate predictive ability for TD (AUC = 0.6839, 95% CI, 0.6659-0.7019).
eGDR may serve as a useful metabolic marker for identifying individuals at risk of TD.
GDR may serve as a valuable metabolic marker for identifying individuals at risk of TD; due to its cross-sectional design, we cannot establish causality between eGDR and testosterone levels.
These findings suggest that eGDR is associated with testosterone levels and TD risk in adult men, highlighting the potential metabolic link between insulin sensitivity and testosterone regulation.
新出现的证据表明胰岛素敏感性在睾酮调节中起作用。估计的葡萄糖处置率（eGDR）是反映胰岛素抵抗（IR）的经过验证的代谢标志物。然而，成年男性中eGDR与睾酮水平之间的关系仍不清楚。
本研究旨在探讨eGDR、总睾酮（TT）水平与睾酮缺乏（TD）风险之间的关联。
分析了2013 - 2016年美国国家健康与营养检查调查（NHANES）的数据。使用加权多变量线性和逻辑回归模型来评估eGDR、TT水平与TD风险（TT <300 ng/dL）之间的关联。应用平滑样条曲线拟合方法来评估关系的形状。进行亚组分析和交互作用检验以探索潜在的效应修饰。进行受试者工作特征（ROC）分析以评估eGDR对TD的预测能力。
最终分析纳入了4087名男性参与者。在调整所有协变量后，较高的eGDR与TT水平升高显著相关（β = 31.83，95%CI，22.13 - 41.54，P <.001）以及TD风险降低（OR = 0.68，95%CI，0.58 - 0.80，P =.002）。四分位数分析表明，eGDR最高四分位数（Q4）的参与者的TT水平显著高于Q1的参与者（β = 147.27，95%CI，66.99 - 227.55，P =.02），且TD风险显著降低（OR = 0.20，95%CI，0.06 - 0.70，P =.03）。平滑样条曲线拟合方法证实了eGDR与TT水平之间的线性关系，以及与TD风险的负相关。观察到糖尿病状态存在显著交互作用（交互作用P =.001），表明存在潜在的修饰效应。ROC分析表明，eGDR对TD具有中等预测能力（AUC = 0.6839，95%CI，0.6659 - 0.7019）。
eGDR可能是识别有TD风险个体的有用代谢标志物。
GDR可能是识别有TD风险个体的有价值的代谢标志物；由于其横断面设计，我们无法确定eGDR与睾酮水平之间的因果关系。
这些发现表明eGDR与成年男性的睾酮水平和TD风险相关，突出了胰岛素敏感性与睾酮调节之间潜在的代谢联系。
