Higher Serum Testosterone Level Was Associated with a Lower Risk of Prediabetes in US Adults: Findings from Nationally Representative Data

Abstract

Low testosterone may be a novel risk factor for prediabetes. We assessed the associations between prediabetes and total serum testosterone (TT), and whether the associations were modified by population characteristics. The data from 5330 adults aged ≥ 20 years, who participated in the 2011–2016 National Health and Nutrition Examination Survey in the United States, were used. Prediabetes was based on fasting plasma glucose, HbA1c, or OGTT. Sociodemographic, obesity, co-morbidities, and lifestyle factors were included in logistic regression models. A dose-response relationship was found between prediabetes and the testosterone quartiles. The odds ratio (OR and 95% CI) for prediabetes across the quartiles of TT were: 1.00, 0.68 (0.50–0.92), 0.51 (0.36–0.72), and 0.48 (0.34–0.70) in men; and 1.00, 1.06 (0.81–1.40), 0.81 (0.61–1.06), and 0.68 (0.49–0.93) in women. The results changed marginally if the models were adjusted for additional variables such as BMI. The subgroup analyses showed differences in the association, which was stronger in some groups (for men: age < 50, white and black, overweight/obese, adequate physical activity, never-smoking; and for women: age ≥ 50, black). A higher testosterone level was associated with a lower risk of prediabetes among US adults. The strength of the association varied by population characteristics, weight status, gender, and lifestyle factors.

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“…Conversely, testosterone is positively associated with SUA levels. Among US men, higher testosterone levels were associated with a lower risk of prediabetes 29 . Similarly, a prospective cohort study among Iranian men showed that a low testosterone level was associated with progression to prediabetes 30 .…”

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“…It also affects muscle mass, fat mass, bone mass, insulin sensitivity, lipid profile, and many others [24,25]. Wang et al showed that high testosterone levels are inversely related to prediabetes, especially among younger men up to 50 years of age [26]. On the other hand, excess testosterone can cause side effects, e.g., in young prepubescent boys, it can lead to virilization.…”

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“…Prior work has both established change in fasting plasma glucose as a surrogate for diabetes and identified a complex yet not completely explained relationship between glucose, diabetes, and sex hormones. [33][34][35][36] SHBG is a protein made in the liver which binds to three sex hormones (estrogen, dihydrotestosterone, and testosterone) found in both men and women, and carries these hormones throughout the blood. Lower levels of SHBG has been shown to be associated with impaired glucose tolerance and higher risk of developing metabolic syndrome and diabetes in both men and women.…”