The Association of Low Muscle Mass With Serum Sex Hormones and Sex Hormone-Binding Globulin

IF 9.1 1区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of Cachexia Sarcopenia and Muscle Pub Date : 2025-09-11 DOI:10.1002/jcsm.70056

Hailin Qin, Wenyong Jiao, Gui Liao

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Abstract

Background

The purpose of this study was to explore the associations of low muscle mass with serum sex hormones and sex hormone-binding globulin (SHBG) using data from the National Health and Nutrition Examination Survey (NHANES).

Methods

We analysed 4403 adults aged 20–59 years from the 2013–2016 NHANES. Appendicular skeletal muscle index (ASMI) was calculated as appendicular skeletal muscle (kg) divided by height squared (m²). Low muscle mass was defined as ASMI < 7.0 kg/m² (men) or < 5.5 kg/m² (women). Logistic regression was performed separately for male and female participants to assess the associations of low muscle mass with serum sex hormones and sex hormone-binding globulin (SHBG).

Results

The mean age of the participants was 38.6 years (± 11.35 years), and 46.3% of the participants were female. In men, both total testosterone (TT) (Model 3: OR = 1.003, 95% CI: 1.002–1.004, p < 0.001) and free testosterone (Model 3: OR = 1.007, 95% CI: 1.001–1.013, p = 0.022) levels correlated positively with low muscle mass. The highest TT quartile had 4.529 times the odds compared to the lowest quartile (Model 3: OR = 4.529, 95% CI: 1.927–10.645, p = 0.003). Each unit increase in SHBG was associated with higher odds (Model 3: OR = 1.035, 95% CI: 1.024–1.045, p < 0.001). The highest SHBG quartile (> 45.26 nmol/L) showed 6.442-fold higher odds (Model 3: OR = 6.442, 95% CI: 3.134–13.242, p < 0.001). For women, the highest estradiol quartile (> 116 pg/mL) had 56.4% lower odds of low muscle mass than the lowest quartile (Model 3: OR = 0.436, 95% CI: 0.268–0.709, p = 0.004). Each unit increase in free testosterone (FT) showed an inverse association (Model 3: OR = 0.710, 95% CI: 0.605–0.834, p < 0.001). The highest FT quartile (> 3.70 pg/mL) had 73.7% lower odds (Model 3: OR = 0.263, 95% CI: 0.146–0.473, p < 0.001). Each unit increase in SHBG showed a positive association with low muscle mass (Model 3: OR = 1.009, 95% CI: 1.007–1.012, p < 0.001). The highest SHBG quartile (> 87.21 nmol/L) showed 5.482-fold higher odds (Model 3: OR = 5.482, 95% CI: 2.854–10.527, p < 0.001).

Conclusions

In women, estradiol and free testosterone levels are negatively associated with low muscle mass. In men, elevated total testosterone was unexpectedly associated with an increased risk of LMM. SHBG elevation is a consistent risk factor across sexes.

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低肌肉质量与血清性激素和性激素结合球蛋白的关系

本研究的目的是利用国家健康与营养检查调查（NHANES）的数据，探讨低肌肉量与血清性激素和性激素结合球蛋白（SHBG）的关系。方法分析2013-2016年NHANES中4403名年龄在20-59岁的成年人。阑尾骨骼肌指数（ASMI）计算方法为阑尾骨骼肌（kg）除以身高的平方（m2）。低肌肉质量被定义为ASMI 7.0 kg/m2（男性）或5.5 kg/m2（女性）。分别对男性和女性参与者进行Logistic回归，以评估低肌肉质量与血清性激素和性激素结合球蛋白（SHBG）的关系。结果参与者平均年龄38.6岁（±11.35岁），女性占46.3%。在男性中，总睾酮（TT）（模型3:OR = 1.003, 95% CI: 1.002-1.004, p < 0.001）和游离睾酮（模型3:OR = 1.007, 95% CI: 1.001-1.013, p = 0.022）水平与低肌肉质量呈正相关。最高TT四分位数是最低四分位数的4.529倍（模型3:OR = 4.529, 95% CI: 1.927-10.645, p = 0.003）。SHBG每增加一个单位与更高的几率相关（模型3:OR = 1.035, 95% CI: 1.024-1.045, p < 0.001）。SHBG最高的四分位数（45.26 nmol/L）显示出6.442倍的高概率（模型3:OR = 6.442, 95% CI: 3.134-13.242, p < 0.001）。对于女性来说，雌二醇水平最高的四分位数（> 116 pg/mL）肌肉质量低的几率比最低的四分位数低56.4%（模型3:OR = 0.436, 95% CI: 0.268-0.709, p = 0.004）。游离睾酮（FT）的每单位增加均呈负相关（模型3:OR = 0.710, 95% CI: 0.605-0.834, p < 0.001）。FT最高的四分位数（> 3.70 pg/mL）的赔率降低73.7%（模型3:OR = 0.263, 95% CI: 0.146-0.473, p < 0.001）。SHBG每增加一个单位与低肌肉质量呈正相关（模型3:OR = 1.009, 95% CI: 1.007-1.012, p < 0.001）。SHBG最高的四分位数（> 87.21 nmol/L）显示出5.482倍的高概率（模型3:OR = 5.482, 95% CI: 2.854-10.527, p < 0.001）。结论在女性中，雌二醇和游离睾酮水平与肌肉质量低呈负相关。在男性中，总睾酮水平升高与LMM风险增加出乎意料地相关。SHBG升高是男女一致的危险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cachexia Sarcopenia and Muscle MEDICINE, GENERAL & INTERNAL-

CiteScore

13.30

自引率

12.40%

发文量

234

审稿时长

16 weeks

期刊介绍： The Journal of Cachexia, Sarcopenia and Muscle is a peer-reviewed international journal dedicated to publishing materials related to cachexia and sarcopenia, as well as body composition and its physiological and pathophysiological changes across the lifespan and in response to various illnesses from all fields of life sciences. The journal aims to provide a reliable resource for professionals interested in related research or involved in the clinical care of affected patients, such as those suffering from AIDS, cancer, chronic heart failure, chronic lung disease, liver cirrhosis, chronic kidney failure, rheumatoid arthritis, or sepsis.