Association between the Oxidative Balance Score and testosterone levels in males from the National Health and Nutrition Examination Survey 2013-2016

Backgroud: Limited research has explored the combined influence of dietary and lifestyle factors on testosterone levels. The Oxidative Balance Score (OBS) is a method used to evaluate the level of systemic oxidative stress. It indicates that higher scores are associated with greater exposure to antioxidants.This study aims to investigate the probable association between OBS and testosterone levels. Methods A total of 5168 male participants from the 2013 to 2016 National Health and Nutrition Examination Survey (NHANES) were included in this study. The OBS was computed using 20 dietary and lifestyle factors. There were three existence forms of testosterone, including total testosterone (TT), free testosterone (FT), and bioavailable testosterone (BAT). The weighted multivariable linear regression, subgroup analyses and restricted cubic splines (RCS) were employed to examine the relationship between OBS and testosterone levels. Additionally, mediation analyses were performed to investigate the potential involvement of oxidative stress inflammation and oxidative stress. Results After accounting for potential confounding factors, a significant positive correlation was observed between OBS and TT, FT, and BAT, and the beta estimates (95% CI) were 0.005 (0.002, 0.008), 0.004 (0.001, 0.007), and 0.005 (0.002, 0.008), respectively. No statistically significant interaction effects were detected in the subgroup analyses. RCS results suggested TT, FT and BAT exhibited a linear positive relationship with an increase in OBS (all p for nonlinear > 0.05). Moreover, WBC counts and albumin mediated the association between OBS and TT by 9.78%, and 10.79%, respectively in model 3. Conclusion There is a positive association between OBS and testosterone levels in males, and this relationship may be partially mediated by inflammation and oxidative stress. Therefore, dietary and lifestyle-related antioxidant therapy for males with low testosterone concentrations should receive attention.