Catch-up fat in male adults induces low testosterone and consequently promotes metabolic abnormalities and cognitive impairment

Association between the atherogenic index of plasma and testosterone deficiency in American adults: a cross-sectional study from NHANES 2011-2016

Background

A common pathophysiological association between lipid metabolism and sex hormone levels has been revealed in recent research. The atherogenic index of plasma (AIP) is the marker currently used to evaluate metabolism. The purpose of this research was to discover the relationship between the AIP and testosterone deficiency (TD) in a nationwide representative population.

Methods

Data from the National Health and Nutrition Examination Survey (NHANES) database from 2011 to 2016 were utilized in this cross-sectional research. The formula, lg [TG (mmol/L)/HDL-C(mmol/L)], was applied to determine the AIP. Total serum testosterone levels were used to define TD. Our researcher utilized smoothed curve fitting and multivariate logistic or linear regression analysis to inspect the relationship between AIP and TD among adult males. The consistency of these results was examined in various population subgroups.

Results

In total, 1,198 individuals (28.6%) were stratified into the TD group. We observed statistically significant differences (P values < 0.05) in the TD population for all variables. After correcting for potential confounders, our researchers discovered a strong positive relationship between the AIP and the probability of developing TD. With each additional unit of the AIP, the incidence of TD increased by 2.81-fold in adult males. Subgroup analyses showed the correlations for the majority of the subgroups remained stable. However, marital status, CKD, smoking, and alcohol consumption may modify this association.

Conclusions

A higher AIP is correlated with a lower level of testosterone in adult males. This correlation may be altered by factors including marriage, chronic kidney disease, alcohol, and smoking consumption.

Association between cardiometabolic index and testosterone levels in adult men: NHANES 2011-2016

OBJECTIVE

Exploring the relationship between the cardiometabolic index (CMI) and serum testosterone levels as well as testosterone deficiency in American adult males. Additionally, comparing the diagnostic value of the CMI with several common obesity and metabolism indices for identifying testosterone deficiency.

METHODS

This cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2016. Serum testosterone levels and testosterone deficiency were used as dependent variables, with the cardiometabolic index as the independent variable. Multivariable regression was used to assess the relationship between the independent and dependent variables, while subgroup analyses were performed to ensure the stability of the results. Smooth curve fitting was utilized to evaluate the nonlinear relationship between the CMI and testosterone levels. Receiver operating characteristic curves (ROC) were plotted for several obesity and metabolism prediction indices and the area under the curve was calculated to compare the specificity and sensitivity of each diagnostic index in the diagnosis of testosterone deficiency.

RESULTS

Among 3541 adult male participants, CMI is negatively associated with serum testosterone levels and positively associated with testosterone deficiency. In the fully adjusted model, for every unit increase in CMI, serum testosterone decreased by 14.89 ng/dl. Comparing the highest quartile to the lowest quartile of CMI, each unit increase in CMI, serum testosterone decreased by 98.58 ng/dl. Furthermore, each unit increase in CMI was associated with a 16% increase in incidence of testosterone deficiency. By plotting the ROC curves, we found that the AUCs for Lipid Accumulation Product (LAP), Body Mass Index (BMI), Weight Adjusted Waist Index (WWI), CMI, Visceral Adiposity Index (VAI) and Triglyceride glucose index (TyG) were 0.73, 0.72, 0.71, 0.69, 0.66, and 0.66 respectively.

CONCLUSION

Elevated levels of CMI are associated with lower testosterone levels and an increased risk of testosterone deficiency. The predictive value of the LAP was superior to that of CMI, while the predictive value of CMI was higher than VAI and TyG.

Androgens, brain and androgen deprivation therapy in paraphilic disorders: A narrative review

Sexual delinquency is a global problem where those with paraphilic disorders, such as paedophiles, are more likely to commit and reoffend. Androgen deprivation therapy (ADT) has been suggested as a solution. The objective of this narrative review is to present current information on its risks, benefits and limitations as a treatment for paraphilias. The importance of testosterone in sexual function, the effect of its deficiency by age or by pharmacological treatment (anti-androgens, GnRH agonists and GnRH antagonists) and the effect of testosterone replacement therapy will be reviewed. The relationship between androgens, brain, sexual behaviour and pathophysiology of paraphilic disorders will also be explored. ADT reduces sexual urges, but has adverse effects and, because its reversible nature, it does not ensure less recidivism. Likewise, the research quality of ADT drugs is limited and not enough to support their use. Child sex offenders, and not paraphilic subjects who have not committed assaults, show signs of elevated prenatal exposure to androgens and a higher methylation state of the androgen receptor gene. Sexual behaviour is regulated by subcortical (hypothalamus, brainstem and spinal cord) and cortical structures of the brain, in addition to brain circuits (dopaminergic, serotonergic). Those with paraphilic disorders show abnormalities at these levels that could relate to the risk of sexual offences. In conclusion, androgens represent a significant part of the pathophysiology of paraphilias and therefore, ADT seems promising. Nonetheless, more studies are needed to make definite conclusions about the efficacy of long-term ADT in paraphilic patients.