Effects of Partnership Status and Social Determinants of Health on Total Testosterone Levels in a Large Cohort of American Men

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Abstract This study aims to investigate the interplay between biological and non-biological factors and their effects on total testosterone (TT) levels in men. This is a retrospective cross-sectional study based on the National Health and Nutrition Examination Survey (NHANES) program designed to investigate the social and biological factors that affect TT levels in adult men in the United States. Data were obtained from the 2011–2016 NHANES survey study. We examined the effect of partnership status, family income-to-poverty ratio (PIR), education, tobacco use, diabetes mellitus (DM), coronary artery disease (CAD), hypercholesterolemia, hypertension, age, and body mass index (BMI) on TT levels. Our final cohort included 7,168 men aged 18 to 79. In the multiple linear regression analysis, cohabitation and being Non-Hispanic Asian had the largest negative effect sizes (-34 [95%CI: -45 - -23] and − 40 [95%CI: -55 - -27]) on TT compared to those of BMI (p < 0.001) and hypercholesterolemia (p < 0.001), but the effect of PIR was not significant. This study suggests that living with a partner is one of the strongest predictors of lower testosterone in men.

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