Association between Serum Testosterone Levels and Body Composition among Men 20-59 Years of Age

Abstract

Introduction: Sex hormones play an important role in the development and maintenance of bone and muscle mass. However, studies regarding serum testosterone levels, osteoporosis, and sarcopenia in men are relatively sparse and have led to contradictory conclusions. Therefore, this study aimed to investigate the association between serum testosterone levels and body composition, including bone mineral density (BMD), appendicular lean mass index (ALMI), and appendicular fat mass index (AFMI), among men 20-59 years of age through a cross-sectional analysis of the National Health and Nutrition Examination Survey.

Materials and methods: Our analysis was based on the data for 3,875 men, 20-59 years of age. Weighted multiple regression analyses were used to estimate the independent association between serum testosterone levels and body composition. Weighted generalized additive models and smooth curve fittings were used to characterize the nonlinear associations between them.

Results: The association between the serum testosterone level and lumbar BMD was positive in each multivariable linear regression model. In the model adjusted for age and race, the serum testosterone level was negatively associated with ALMI. However, in the models adjusted for body mass index, this association became positive. In addition, the association between the serum testosterone level and AFMI was negative in each multivariable linear regression model.

Conclusion: Our study demonstrated a positive association of serum testosterone level with lumbar BMD and ALMI, and a negative association with AFMI, among men 20-59 years of age, suggesting that increasing testosterone levels may be beneficial to skeletal health in young and middle-aged men with low testosterone levels.

Figure 1

The association between serum testosterone levels and lumbar bone mineral density. (a) Each black point represents a sample. (b) Solid red line represents the smooth curve fit between variables. Blue bands represent the 95% confidence interval from the fit. Age, race, body mass index, education level, income-to-poverty ratio, smoking status, drinking behavior, moderate activities, calcium supplement use, blood urea nitrogen, serum uric acid, total protein, serum estradiol level, serum phosphorus, and serum calcium were adjusted.

Figure 2

The association between serum testosterone levels and appendicular lean mass index. (a) Each black point represents a sample. (b) Solid red line represents the smooth curve fit between variables. Blue bands represent the 95% confidence interval from the fit. Age, race, body mass index, education level, income-to-poverty ratio, smoking status, drinking behavior, moderate activities, calcium supplement use, blood urea nitrogen, serum uric acid, total protein, serum estradiol level, serum phosphorus, and serum calcium were adjusted.

Figure 3

The association between serum testosterone levels and appendicular fat mass index. (a) Each black point represents a sample. (b) Solid red line represents the smooth curve fit between variables. Blue bands represent the 95% confidence interval from the fit. Age, race, body mass index, education level, income-to-poverty ratio, smoking status, drinking behavior, moderate activities, calcium supplement use, blood urea nitrogen, serum uric acid, total protein, serum estradiol level, serum phosphorus, and serum calcium were adjusted.