Background The relationship between testosterone deficiency (TD) and depressive symptoms among obese individuals has not been fully clarified. This study explores the relationship between TD and depressive symptoms in obese males and possible mediating factors. Methods These cross-sectional analyses included 6177 participants from the National Health and Nutrition Examination Survey (NHANES) conducted between 2011 and 2016. Logistic regression models were employed to assess the association of TD with depressive symptoms in different subgroups. Sensitivity analyses were performed using restricted cubic splines (RCS), subgroup analysis, and mediation analysis. Results There was a significant positive correlation between TD and depressive symptoms in obese males (OR = 1.33, 95% CI = 1.04-1.69, P = 0.023). The analysis further demonstrated a significant L-shaped nonlinear relationship between testosterone levels and depressive symptoms in obese males. The analysis of the threshold effects showed that the risk of depressive symptoms increased below testosterone levels of 273 ng/dL. Furthermore, the study also found that inflammatory markers demonstrated a statistically significant partial mediating effect in the observed association between TD and depressive symptoms. Conclusion In obese males, testosterone levels exhibit an L-shaped correlation with depressive symptoms, with inflammation acting as a statistical mediating factor. These findings offer new hypotheses for future clinical interventional studies.
Xie et al. (Fri,) studied this question.