Association of lipid accumulation products with testosterone deficiency in adult American men: A cross-sectional study

The association between lipid accumulation products and bone mineral density in U.S. Adults, a nationally representative cross-sectional study

LAP (lipid accumulation products) is a new indicator that estimates lipid overaccumulation and central obesity in our bodies. Nevertheless, the relationship of LAP with bone mineral density (BMD) has not been well established. This study aims to assess the association of LAP with BMD in U.S. adults. Multivariate linear regression was employed to detect the relationship of LAP with lumbar BMD in adult Americans. Subgroup and interaction tests were employed to detect the robustness of our findings. Restricted cubic spline (RCS) and threshold effect analysis were used to assess the nonlinear correlation of LAP with lumbar BMD. A total of 3883 participants consisted of 2117 (54.52%) men and 1766 (45.48%) women. The mean age of participants was 39.33 ± 11.53 years. After adjusting all covariates, we found a negative association of ln-LAP with lumbar BMD (β= -0.011, 95% CI: -0.019, -0.004). Threshold effect analysis identified the inflection points of 2.846. The results showed no correlation to the left of the saturation point but a significant negative correlation to the right. Interaction analyses indicated that all subgroups have no effect on this association (P > 0.05). Our study reported a nonlinear negative association of LAP with lumbar BMD. A large LAP may be associated with reduced BMD in American adults. These findings support the clinical utility of LAP as a predictor of osteoporosis and provide valuable insights into developing early intervention strategies for osteoporosis populations.

Association between lipid accumulation products and relative handgrip strength: a large population-based study

Given the increasing prevalence of chronic diseases in the aging population, it is of great importance to gain an understanding of how changes in body composition affect health outcomes. Handgrip strength (HGS) serves as a valuable proxy for overall muscle strength, while relative HGS (RHGS) adjusts for body size, providing a more accurate assessment of the relationship between muscle strength and metabolic disease. Lipid accumulation products (LAP) are an indicator that can reflect visceral lipid accumulation. Based on previous studies, the relationship between LAP and RHGS has not been explored. This study aims to address this gap in the literature and provide insights for public health recommendations. Data was collected and extracted from the 2011-2014 National Health and Nutrition Examination Survey (NHANES) database. LAP was calculated from the arithmetic product of waist circumference (WC) and fasting plasma triglyceride (TG), the calculation as following formulas: for females, [WC (cm) - 58] × [TG (mmol/l)], and for males, [WC (cm) - 65] × [TG (mmol/l)]; RHGS was derived from the HGS to BMI ratio. The correlation between the variables was initially explored using multivariate linear regression. Secondly, smoothed-fitted curves were used to investigate the non-linear relationship between the variables. The inflection point values were determined based on the results of the threshold effect analysis. Subgroup analyses were also conducted to assess the stability of the relationship between the variables in different populations. The study analyzed 3990 patients. After accounting for different covariates, multivariate linear regression analysis demonstrated a significant negative correlation between increased levels of LAP and increased levels of RHGS (beta coefficient = -0.0020; 95% confidence interval CI: -0.0023 to -0.0017; P < 0.0001). The interaction test did not have a statistically significant effect on this association. Furthermore, curve fit and threshold effect analysis demonstrated a non-linear relationship with a breakpoint at 49.8083 cm·mmol/L. The results of this study demonstrate an inverse relationship between LAP and RHGS in various populations in the United States. These findings provide compelling evidence of the clinical significance of LAP as a predictor of RHGS, offering valuable insights for developing early intervention strategies in high-risk populations.

Association of Dietary Inflammatory Index with Lipid Accumulation Product: A Population-Based Study in the U.S

Numerous studies suggest that the Dietary Inflammatory Index (DII) is inversely associated with the onset of various diseases; however, the relationship between DII and the Lipid Accumulation Product (LAP) remains unclear. This research intends to explore the association between DII and LAP across different people to inform dietary practices and manage body lipid levels effectively. Data were gathered from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2018, examining a cohort of 17,790 participants. Linear regression analysis, along with sensitivity analysis, was used to investigate the association between the Dietary Inflammatory Index (DII) and the Lipid Accumulation Product (LAP). Additionally, subgroup analysis was performed to ascertain if the correlation between DII consumption with LAP varied depending on the population or situations. After accounting for possible confounding variables, a significant positive association between DII with LAP was observed [in model 1 (β= 2.01, 95% CI = 1.40, 2.63, p < 0.001), in model 2 (β = 1.47, 95% CI = 0.83, 2.10, p < 0.001), and model 3 (β = 0.86, 95% CI = 0.25, 1.47, p=0.006)]. Subgroup analyses indicated that this association between DII and LAP persisted across various age groups, among males, and in populations without cancer, cardiovascular diseases, chronic kidney issues, diabetes, hypertension, and non-smokers, among others. The results from the sensitivity analysis imply that the findings made in this research are reliable and consistent. Following an analysis of the data, the results indicated a positive relationship between DII and LAP. This research establishes a basis for additional investigations into the connection between inflammatory diets and circumstances such as diabetes, metabolic syndrome, and nonalcoholic fatty liver disease.

Impact of dual residual risk of cholesterol and inflammation on adult male sex hormones: a cross-sectional study from NHANES

Purpose

Sex hormones are closely linked to inflammation and lipid metabolism. This study explores the correlation of residual cholesterol risk and residual inflammation risk with sex hormones.

Materials and methods

Logistic regression and dose-response curve analyses were conducted to examine the associations of total testosterone (TT), Sex Hormone Binding Protein (SHBG), Estradiol (E2), and Free testosterone (FT) with low density lipoprotein cholesterol (LDL-C) and high sensitive c-reactive protein (hs-CRP). Testosterone deficiency, defined as TT below 300 ng/dL, was analyzed across various subgroups based on LDL-C and hs-CRP levels. Grouped by LDL-C and hs-CRP: normal, LDL-C < 2.6 mmol/L, hs-CRP < 3mg/L, residual cholesterol risk only (RCR): LDL-C ≥ 2.6 mmol/L, hs-CRP < 3mg/L, residual inflammation risk only (RIR): LDL-C < 2.6 mmol/L. hs-CRP ≥ 3mg/L, both risk (BR): LDL-C ≥ 2.6 mmol/L, hs-CRP ≥ 3mg/L.

Results

The results indicated a negative association between hs-CRP and TT (β = -1.98, 95% CI [-3.54, -0.42], p = 0.013), as well as FT (β = -0.04, 95% CI [-0.07, -0.02], p = 0.0002). Similar trends were observed for the relationship between hs-CRP and SHBG (β = -3.61, 95% CI [-5.33, -1.90], p = 0.0003). In the presence of both risk factors (BR), TT decreased most significantly (β = -79.37, 95% CI [-112.74, -46.00], p < 0.0001), as did FT in the same subgroup (β = -1.00, 95% CI [-1.61, -0.40], p = 0.0012). Notably, hs-CRP exhibited a non-linear correlation with TT, SHBG, and FT, with distinct inflection points. Furthermore, in diabetic patients, hs-CRP was positively linked to E2 (β = 0.39, 95% CI [0.03, 0.74], p = 0.0328).

Conclusions

LDL-C was independently correlated with SHBG, hs-CRP with TT and FT, and the BR population had a higher risk of testosterone deficiency. Special populations with diabetes and hypertension need to be concerned about residual cholesterol risk and inflammatory risk.

Association between visceral adipose tissue and total testosterone among the United States male adults: a cross-sectional study

Visceral adipose tissue (VAT) is regarded as an important risk factor for obesity-related diseases. The results of the association between VAT and total testosterone (TT) are controversial and whether this association is nonlinear is still unknown. 3971 male participants who were aged 20-59 years from the National Health and Nutrition Examination Surveys 2011-2016 were included. VAT area was measured by dual-energy x-ray absorptiometry. TT in serum was assessed utilizing the isotope dilution liquid chromatography-tandem mass spectrometry technique. Linear regression models assessed the associations between VAT area and TT. A restricted cubic spline model was employed to investigate nonlinear relationships. A two-piecewise linear regression model was applied to determine the threshold effect. Subgroup analyses were conducted. The weighted methods were utilized in all analyses. VAT area was inversely associated with TT in the crude and adjusted models. In the fully adjusted model, VAT area was associated with TT (β = -0.59, 95% confidence interval [CI] = -0.74, -0.43) and compared to the first tertile of VAT area, the second and the third tertile had a lower TT level, the β and 95% CI = -65.49 (-83.72, -47.25) and -97.57 (-121.86, -73.27) respectively. We found these inverse associations were nonlinear. The cutoff point of the VAT area was 126 cm2. When the VAT area was <126 cm2, VAT area was significantly associated with a lower TT level (β = -1.55, 95% CI = -1.93 to -1.17, p < 0.0001). However, when the VAT area was ≥126 cm2, this association was less apparent (β = -0.26, 95% CI = -0.52 to 0.01, p = 0.06). No significant interactions among different ages (<50 or ≥50 years), marital, and physical activity status were found. These findings underscore the potential for VAT area as a modifiable indicator for improving testosterone deficiency.

Lipid accumulation product, poverty income ratio, and bone mineral density in U.S. adults: a mediation analysis based on NHANES (2009-2020)

Objective

This study aims to investigate the relationship between the lipid accumulation product (LAP) index and total femur bone mineral density (BMD), while also examining the mediating role of the poverty-income ratio (PIR).

Methods

Using the most recent data from the National Health and Nutrition Examination Survey (NHANES) spanning 2009 to 2020, multivariate logistic regression models were employed in this study to investigate the relationship between the LAP index and total femur BMD. Saturation effects and potential non-linear associations were examined using a smooth curve-fitting approach to determine saturation levels. Interaction tests and subgroup analyses were also performed. Additionally, a mediation analysis was conducted to explore the mediating role of PIR.

Results

Three thousand two hundred and twenty three participants aged 20 years or older were recruited for this study. Multivariate regression analysis demonstrated a greater total femur BMD in individuals with a high LAP index. Additionally, analysis of the saturation effect and smooth curve fitting identified a clear saturation effect between the LAP index and total femur BMD. A saturation value of 16.05 was determined when investigating the relationship between the LAP index and total femur BMD. Subgroup analysis revealed no significant interaction effects after adjusting for covariates. Moreover, mediation analysis indicated that the LAP index had a substantial direct effect on total femur BMD (p < 0.0001), with PIR partially mediating this relationship (1.115%, p = 0.0280).

Conclusion

The results of this investigation demonstrated a saturation effect between the LAP index and total femur BMD, which may have been mediated by PIR.

Association between severe headache or migraine and lipid accumulation product and visceral adiposity index in adults: a cross-sectional study from NHANES

BACKGROUND

Existing literature on the impact of lipid accumulation product (LAP) and visceral adiposity index (VAI) on severe headache or migraine is limited. This study aims to elucidate the association between LAP and VAI and the prevalence of migraine.

METHODS

Data for this study were sourced from the 1999-2004 National Health and Nutrition Examination Survey (NHANES). A database-self-administered questionnaire was used to assess severe headache or migraine. A weighted logistic regression model was employed to assess the relationship between LAP and VAI with migraine prevalence. Complementary analytical approaches included subgroup analysis, restricted cubic spline (RCS), and threshold effect analysis to validate the findings.

RESULTS

In the end, 4572 people were recruited for the research, including 880 with migraine and 3692 without migraine. Following adjustment for the relevant covariables, weighted logistic regression analysis (OR = 1.409, 95% CI: 1.054, 1.883, P = 0.022; OR = 1.288, 95% CI: 1.010, 1.642, P = 0.042) revealed significantly elevated odds of migraine prevalence in participants within the highest tertile (T3) of LAP and VAI than those in the lowest tertile (T1). The nonlinear association between migraine prevalence and both VAI and LAP was further elucidated through a restricted cubic spline. The threshold analysis pinpointed 2.142 (log-likelihood ratio = 0.016) as the critical inflection point for VAI. Subgroup analysis and interaction testing revealed the significant association was independent in different subgroup factors.

CONCLUSIONS

The data indicate a robust association between higher levels of LAP and VAI and an increased prevalence of migraine.

Association between weight-adjusted waist index and testosterone deficiency in adult American men: findings from the national health and nutrition examination survey 2013-2016

BACKGROUND

Testosterone deficiency (TD) and obesity are globally recognized health concerns, with a bidirectional causal relationship between them. And a newly discovered obesity indicator, the Weight-Adjusted-Waist Index (WWI), has been proposed, demonstrating superior adiposity identification capability compared to traditional body mass index (BMI) and waist circumference (WC) indicators. Therefore, we present the inaugural investigation into the associations of WWI with total testosterone levels and the risk of TD.

METHODS

Data restricted to the National Health and Nutrition Examination Survey (NHANES) between 2013 and 2016 were analyzed. Only males aged > 20 years who completed body measures and underwent serum sex hormone testing were potentially eligible for analysis. Weighted multivariable linear regression and logistic regression analyses were employed to investigate the relationships between WWI and total testosterone levels, and the risk of TD, respectively. Smooth curve fittings and weighted generalized additive model (GAM) regression were conducted to examine the linear relationship among them. Additionally, subgroup analyses with interaction tests were performed to assess the stability of the results.

RESULTS

Finally, a total of 4099 participants with complete data on testosterone and WWI were included in the formal analysis. The mean age of study participants was 46.74 ± 0.35 years with a TD prevalence of 25.54%. After adjusting all potential confounders, the continuous WWI displayed a negative linear relationship with total testosterone levels (β=-61.41, 95%CI: -72.53, -50.29, P < 0.0001) and a positive linear relationship with risk of TD (OR = 1.88, 95%CI: 1.47, 2.39, P < 0.0001). When WWI was transformed into quartiles as a categorical variable, participants in Q4 exhibited lower total testosterone levels (β=-115.4, 95%CI: -142.34, -88.45, P < 0.0001) and a higher risk of TD (OR = 3.38, 95% CI: 2.10, 5.44, P < 0.001). These associations remained stable in subgroup analyses without significant interaction (all P for interaction > 0.05).

CONCLUSIONS

This investigation firstly unveiled a negative linear association between WWI and total testosterone levels, coupled with a positive linear relationship with the prevalence of TD in U.S. male adults aged 20 years and older. Further studies are needed to validate the potential utility of WWI for the early identification and timely intervention of TD.

Predictive power of lipid-related indicators for testosterone deficiency: a comparative analysis, NHANES 2011-2016

BACKGROUND

Studies have shown that lipid-related indicators are associated with testosterone deficiency. However, it is difficult to determine which indicator is the most accurate predictor of testosterone deficiency. We aimed to identify the lipid-related indicators most predictive of testosterone deficiency in adults in the United States.

METHODS

This observational research was conducted on a population aged ≥ 20 years. By plotting the receiver operating characteristic curve (ROC) and obtaining the corresponding area under the curve (AUC) value, we assessed the predictive capacity of TyG, WTI, LAP, and VAI for testosterone deficiency. We compared the area under the curve (AUC) values of these measures to determine if there were any statistically significant differences. The relationship between lipid-related indices and testosterone hormones was investigated using regression modeling, eXtreme Gradient Boosting (XGBoost) modeling, and sensitivity analysis.

RESULTS

A total of 3,272 eligible participants were included in the study. Testosterone deficiency was found to exist in 20.63% of the participants. Subjects with higher lipid-related markers were more likely to have lower testosterone levels. LAP was the best predictor of testosterone deficiency in ROC analysis over other indicators (AUC = 0.7176, (95% CI: 0.6964-0.7389)).

CONCLUSION

LAP is the most straightforward and convenient indicator for identifying testosterone deficiency in clinical practice.

Association between obstructive sleep apnea and visceral adiposity index and lipid accumulation product: NHANES 2015-2018

BACKGROUND

Obesity refers to a significant contributor to the development of obstructive sleep apnea (OSA). Early prediction of OSA usually leads to better treatment outcomes, and this study aims to employ novel metabolic markers, visceral adiposity index (VAI), and lipid accumulation product (LAP) to evaluate the relationship to OSA.

METHODS

The data used in the current cross-sectional investigation are from the National Health and Nutrition Examination Survey (NHANES), which was carried out between 2015 and 2018. To examine the correlation between LAP and VAI levels and OSA, multivariate logistic regression analysis was adopted. In addition, various analytical methods were applied, including subgroup analysis, smooth curve fitting, and threshold effect analysis.

RESULTS

Among totally 3932 participants, 1934 were included in the OSA group. The median (Q1-Q3) values of LAP and VAI for the participants were 40.25 (21.51-68.26) and 1.27 (0.75-2.21), respectively. Logistic regression studies indicated a positive correlation between LAP, VAI, and OSA risk after adjusting for potential confounding variables. Subgroup analysis revealed a stronger correlation between LAP, VAI levels, and OSA among individuals aged < 60 years. Through smooth curve fitting, specific saturation effects of LAP, VAI, and BMD were identified, with inflection points at 65.684 and 0.428, respectively.

CONCLUSION

This study demonstrates that elevated levels of LAP and VAI increase the risk of OSA, suggesting their potential as predictive markers for OSA and advocating for dietary and exercise interventions to mitigate OSA risk in individuals with high LAP and VAI levels.

Analysis of the association between testosterone and cardiovascular disease potential risk factor apolipoprotein B in adult males without cancer: national health and nutrition examination survey 2011-2016

Background

Over the years, there has been extensive exploration of the association between testosterone and lipid profiles, yet the precise mechanisms underlying their interaction remain incompletely elucidated. Similarly, there is a dearth of research on the correlation between serum apolipoprotein B (apoB) and serum total testosterone (TT), particularly within specific populations.

Methods

We conducted a cross-sectional study to assess the relationship between serum TT concentration and serum apoB concentration. Using the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2016, we employed weighted generalized linear models, weighted univariate, weighted multivariate analysis, and smooth curve fitting to assist in exploring the relationship between serum TT and apoB. Serum apoB concentration served as the independent variable, and serum TT concentration as the dependent variable. ApoB was divided into four quartiles-Q1 (<0.7g/L, N=691), Q2 (≥0.7g/L to <0.9g/L, N=710), Q3 (≥0.9g/L to <1.1g/L, N=696), and Q4 (≥1.1g/L, N=708)-thereby further solidifying the stable association between the two. Additionally, the application of smooth curve fitting will contribute to a more detailed elucidation of the specific relationship between serum TT concentration and serum apoB concentration under different factors (Drinking, Smoke, Diabetes, Hypertension, and High cholesterol level.).

Results

The results indicate a negative correlation between serum TT concentration and apoB concentration (β=-113.4; 95% CI: -146.6, -80.2; P<0.001). After adjusting for confounding variables, the negative correlation between apoB concentration and TT concentration remains significant (β=-61.0; 95% CI: -116.7, -5.2; P=0.040). When apoB concentration was converted from a continuous variable to a categorical variable (quartiles: Q1<0.7g/L; Q2:≥0.7g/L to<0.9g/L; Q3:≥0.9g/L to <1.1g/L; Q4: ≥1.1g/L), TT level of participants in the highest quartile (≥1.1g/L) was -47.2 pg/mL (95% CI: -91.2, -3.3; P=0.045) lower than that in the lowest quartile (<0.7g/L). The smooth curve fitting diagram revealed differences in the relationship between TT concentration and apoB among individuals with different cardiovascular disease (CVD) risk factors.

Conclusions

This study elucidates a robust inverse correlation between serum TT concentration and apoB concentration, maintaining statistical significance even upon adjustment for confounding factors. These findings present a promising avenue for addressing the prevention and treatment of low testosterone and CVD.