Association between testosterone and bone mineral density in females aged 40-60 years from NHANES 2011- 2016

Abstract Introduction: Growing evidence indicates that testosterone is a conspicuous marker for assessing male bone mineral density (BMD). However, research regarding testosterone levels and BMD is sparse and controversial for females. Hence, we aimed to investigate the association between testosterone levels and BMD among adult females aged 40–60 years in America. Methods In this cross-sectional study, all individuals were part of the National Health and Nutrition Examination Survey (2011–2016). A weighted general linear model was used to estimate the association between testosterone and lumbar BMD. Age, race, income level, education level, body mass index (BMI), blood urea nitrogen (BUN) level, serum uric acid (UA) level, serum calcium (Ca) level, serum phosphorus (P) level, oral contraceptive use, female hormones use(estrogen and progesterone), smoking status, drinking status were adjusted using a weighted multiple regression model. Results We included 2198 female individuals in the study, testosterone levels were positively associated with lumbar BMD after adjusting for all the covariates (β = 0.0008, 95% confidence interval = 0.0001, 0.0015, P < 0.05). Subgroup analysis showed that the results remained stable. Conclusions In US adults female aged 40–60 years, the testosterone level was an independent positive correlation with the lumbar BMD after adjusting for covariates. Based on our findings, testosterone may be a marker for predicting osteoporosis in females.