Association between weight-adjusted waist index and serum total testosterone in males aged 6–19 years in the United States: Data from NHANES 2013–2016

Abstract

ObjectiveThis study aimed to estimate the association between weight-adjusted waist index and serum total testosterone (sTT) in males aged 6–19 years in the United States. MethodsA cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey (NHANES) 2013–2016. sTT was considered as the response variable, and weight-adjusted waist circumference index (WWI) as the independent variable. Multiple linear regression was performed to estimate the association between the two variables, and subgroup analysis was performed to identify sensitive cohorts. Smoothing curve fitting and threshold effects analysis was carried out to assess possible nonlinear relationships between WWI and sTT. ResultsThe study included 4207 participants. The mean value of sTT (117.93 ng/dl) was used as the grouping basis, with 1066 participants having serum total testosterone levels above the mean. A negative association was observed between WWI and sTT [beta coefficient (β) = −72.50, 95% confidence interval (CI): -79.45, −65.55], which decreased as WWI increased (P for trend<0.05). Subgroup analysis indicated a stronger negative correlation in late adolescent (16–19 years) males (β = −128.94, 95% CI: −146.75, −111.13). The smoothing curve fit analysis revealed a U-shaped curve relationship for the negative correlation between WWI and sTT. Threshold effect analysis suggested a significant change when WWI exceeded 10.09 (β = −15.82, 95% CI: −24.11, −7.54), and stepwise threshold effect analysis indicated that this negative correlation became less stable when WWI exceeded 11.45 (β = −0.80, 95% CI: −9.15, 7.56). ConclusionsParticipants with higher WWI exhibited lower total testosterone levels, and a negative association was found between WWI and total testosterone, particularly in late adolescent males aged 16–19 years. Among males aged 6–19 years, caution should be exercised regarding the risk of lower testosterone levels associated with elevated WWI, particularly when WWI is below 10.09.