Several types of supplements claim to increase your testosterone levels. More than 33% of men over 45 may have lower than normal testosterone levels. Analyzing a nationally representative sample, our study revealed a negative association between WWI and total testosterone level, coupled with a positive association between WWI and risk of TD. Further studies could extend the research population to children to investigate the impact of WWI on testosterone levels in children. Common comorbidities of male obesity include hypogonadism (low testosterone levels and accompanying signs and symptoms) 43, 44. To our knowledge, this is the first large-scale study to investigate the relationship between WWI and total testosterone level as well as risk of TD using nationally representative data. We also employed stratified multivariate regression analyses to conduct a subgroup analysis, aiming to explore the relationships of WWI with total testosterone level and TD in specific subgroups. Total testosterone levels were measured using isotope dilution liquid chromatography tandem mass spectrometry (ID-LC–MS/MS) at a single time point in the morning following an overnight fast, based on the National Institute for Standards and Technology’s (NIST) reference method. WWI has shown a strong positive correlation with total body fat percentage, total abdominal fat area, and visceral fat area, while displaying a negative correlation with appendicular skeletal muscle mass and appendicular lean mass 28–30. Ht was determined by a stadiometer calibrated to the nearest 0.1 cm and weight was measured on scales calibrated to 0.1 kg to calculate BMI (ratio of body weight in kg to height in m2).26 WC was measured, according to WHO guidelines, at the midpoint distance between the costal margin and iliac crest in the mid-axillary line on the dominant side.26 WHt ratio was calculated by dividing waist (cm) by height (cm). Subjects were also excluded if they had a BMI ≥35 kg m−2 because of the documented association of severe obesity with hypogonadotrophic hypogonadism.16, 17, 18 We investigated whether WC was a better predictor of testosterone than BMI in our cohort and, given increasing evidence of the value of indexing WC to height (Ht) as waist-to-height ratio (WHt ratio),19, 20, 21 we also examined the utility of WHt ratio for prediction of the testosterone level. We have examined the relationships of age, adiposity and testosterone levels in ageing men with symptoms consistent with hypoandrogenism but who were otherwise in good health. Additionally, we compared the strength of the associations between WWI, BMI, WC, and weight with total testosterone levels and the risk of TD, thereby enriching the data and expanding its clinical applicability. Firstly, this is the largest study to date and the first to investigate the relationship between WWI and both testosterone levels and the risk of TD. This may be because participants with higher BMI are more likely to engage in physical exercise and dietary control to reduce their weight, which can increase testosterone levels, thereby weakening the observed association. This study provides new ideas for future studies exploring the relationship between obesity and total testosterone level as well as TD. Unlike exogenous GH injection, tesamorelin preserves the body's natural pulsatile GH secretion pattern. Tesamorelin is a synthetic analogue of growth hormone-releasing hormone (GHRH) that stimulates endogenous growth hormone (GH) production from the anterior pituitary. The gap between standard fat loss approaches and VAT-specific interventions is stark. It's metabolically active tissue wrapped around organs, driving insulin resistance, inflammatory markers, and cardiovascular risk in ways that surface-level fat never does. Research published in JAMA found that visceral adipose tissue (VAT) increases by 200–300% in men between ages 30 and 60. As expected, our findings confirmed the contribution of T2DM, waist circumference and inflammation to the deflection of gonadal function. Lastly, a prospective longitudinal study of 15 newly diagnosed patients was performed to evaluate the effects of CPAP therapy on hormonal control after 3-6 months of treatment. Targeted fat loss, especially around the midsection, sounds good in theory, but it may not be the most realistic. Extra weight may sap your energy and put extra strain on your joints and heart. Decreasing beer intake, along with other diet and lifestyle changes, can help you lose excess weight. Your doctor can prescribe testosterone therapy as part of gender-affirming treatment. However, healthy habits that boost testosterone, like getting good sleep and exercising, certainly won't hurt. Beyond puberty, a woman's body mainly converts it to estrogen. Most cross-sectional and the several available longitudinal studies have demonstrated a gradual linear age-related decrease in levels of FT, and to a lesser extent in TT, after the fourth decade.12, 13, 27, 51, 52, 53, 54 Consistent with these previous findings, an inverse relationship between age and cFT levels was seen in our cohort and this also remained significant after adjusting for BMI, WC or WHt ratio. A causal association of ageing and adiposity with lower serum testosterone levels could involve changes at the level of the hypothalamus, pituitary or testes. The regression and standard coefficients for the univariate linear regression relationships of TT with age, BMI, WC, Ht, WHt ratio and SHBG are shown in Table 4. The regression and standard coefficients for the univariate linear regression relationships of cFT with age, BMI, WC, Ht and WHt ratio are shown in Table 3. The regression and standard coefficients for the univariate linear regression relationships of SHBG with age, BMI, WC, Ht and WHt ratio are shown in Table 2. Linear regression analysis was performed to assess the relationship of TT, cFT, SHBG and LH with age, BMI, WC, Ht and WHt ratio. The WWI has demonstrated the ability to accurately discriminate abdominal fat and muscle mass, and smaller racial differences in distribution28. Subgroup analyses of different baseline characteristics were conducted to further investigate the relationship between the WWI and testosterone deficiency, as demonstrated in Fig. 3Full size imageAssociations between the WWI and testosterone deficiency based on subgroups of different baseline characteristics. Covariates of age, race, BMI, the eGFR, the PIR, duration of sedentary activities, diabetes status, hypertension status, smoking status, alcohol consumption status, education level, and marital status were adjusted. A restricted cubic spline curve was made via Model 3 to investigate any nonlinear relationship between the WWI and testosterone deficiency. Categorical variables are presented as percentages (%) while the weighted number of participants is not displayed. The WWI is a central obesity indicator, with a higher ratio indicating a greater degree of central obesity.
