Low Serum Testosterone Levels Are Associated with Elevated Urinary Mandelic Acid, and Strontium Levels in Adult Men According to the US 2011-2012 National Health and Nutrition Examination Survey.

Cheng Xu,Aihua Gu,Qunwei Zhang,Hui Liu,Qian Liu,Zhao-Yan Jiang,Paul Héroux,Pal Bela Szecsi

doi:10.1371/journal.pone.0127451

Abstract

BackgroundLittle is known regarding the effects of environmental exposure of chemicals on androgenic system in the general population. We studied 5,107 subjects included in the National Health and Nutrition Examination Survey (2011–2012).MethodsUrinary, serum, and blood levels of 15 subclasses comprising 110 individual chemicals were analyzed for their association with serum testosterone levels. The subjects were divided into high and low testosterone groups according to the median testosterone concentration (374.51 ng/dL). Odds ratios (ORs) of individual chemicals in association with testosterone were estimated using logistic regression after adjusting for age, ethnicity, cotinine, body mass index, creatinine, alcohol, and the poverty income ratio.ResultsAdjusted ORs for the highest versus lowest quartiles of exposure were 2.12 (95% CI: 1.07, 4.21; Ptrend = 0.044), 1.84 (95% CI: 1.02, 3.34; Ptrend = 0.018) for the association between urinary mandelic acid, and strontium quartiles with low testosterone concentrations in adult men, respectively. However, no association was observed for the remaining chemicals with testosterone.ConclusionsThe National Health and Nutrition Examination Survey data suggest that elevations in urinary mandelic acid, and strontium levels are negatively related to low serum testosterone levels in adult men.

Highlights

Testosterone, an androgen steroid, plays a crucial role in the growth of male reproductive tissues and other secondary sexual characteristics
We studied 5,107 subjects included in the National Health and Nutrition Examination Survey (2011–2012)
Adjusted Odds ratios (ORs) for the highest versus lowest quartiles of exposure were 2.12, 1.84 for the association between urinary mandelic acid, and strontium quartiles with low testosterone concentrations in adult

Summary

Introduction

Testosterone, an androgen steroid, plays a crucial role in the growth of male reproductive tissues and other secondary sexual characteristics. Essential functions of testosterone include differentiation of spermatogonia, regulation of the hypothalamic–pituitary–adrenal axis response, maintenance of muscle trophism, cognitive competence, and physical strength. Changes in testosterone levels in men may lead to several pathological states. Low testosterone levels are associated with defects in the cardiovascular system [1] and metabolic syndrome, including a risk of diabetes and osteoporosis [2, 3]. Male infertility (oligospermia or azoospermia) has been linked with low testosterone levels. Testosterone replacement therapy may increase the risk of myocardial infarction and ischemic stroke [4, 5]. Maintaining testosterone levels at physiological levels is of major importance. We studied 5,107 subjects included in the National Health and Nutrition Examination Survey (2011–2012)

Methods

Results

Conclusion