title: Low Serum Testosterone Levels Are Associated with Elevated Urinary Mandelic Acid, and Strontium Levels in Adult Men According to the US 2011-2012 National Health and Nutrition Examination Survey.
abstract: BACKGROUND
  Little is known regarding the effects of environmental exposure of chemicals on androgenic system in the general population. We studied 5,107 subjects included in the National Health and Nutrition Examination Survey (2011-2012).
  
  
  METHODS
  Urinary, serum, and blood levels of 15 subclasses comprising 110 individual chemicals were analyzed for their association with serum testosterone levels. The subjects were divided into high and low testosterone groups according to the median testosterone concentration (374.51 ng/dL). Odds ratios (ORs) of individual chemicals in association with testosterone were estimated using logistic regression after adjusting for age, ethnicity, cotinine, body mass index, creatinine, alcohol, and the poverty income ratio.
  
  
  RESULTS
  Adjusted ORs for the highest versus lowest quartiles of exposure were 2.12 (95% CI: 1.07, 4.21; Ptrend = 0.044), 1.84 (95% CI: 1.02, 3.34; Ptrend = 0.018) for the association between urinary mandelic acid, and strontium quartiles with low testosterone concentrations in adult men, respectively. However, no association was observed for the remaining chemicals with testosterone.
  
  
  CONCLUSIONS
  The National Health and Nutrition Examination Survey data suggest that elevations in urinary mandelic acid, and strontium levels are negatively related to low serum testosterone levels in adult men.
authors.affiliation: State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Xu
authors.affiliation: State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Liu
authors.affiliation: State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Liu
authors.affiliation: InVitroPlus Laboratory, Department of Surgery, Royal Victoria Hospital, Montreal, QC, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Héroux
authors.affiliation: Department of Environmental and Occupational Health Sciences, School of Public Health and Information Health Sciences, University of Louisville, Louisville, KY, 40292, United States of America.
authors.forename: Qunwei
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Surgery, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
authors.forename: Zhao-Yan
authors.initials: ZY
authors.lastname: Jiang
authors.affiliation: State Key Laboratory of Reproductive Medicine, Institute of Toxicology, Nanjing Medical University, Nanjing, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China.
authors.forename: Aihua
authors.initials: A
authors.lastname: Gu
mesh_terms: D000328:Adult; D000368:Aged; D004781:Environmental Exposure; D004785:Environmental Pollutants; D005006:Ethnicity; D049674:History, 21st Century; D006801:Humans; D008297:Male; D008333:Mandelic Acids / Q000652:urine*; D008875:Middle Aged; D009749:Nutrition Surveys; D016017:Odds Ratio; D062486:Public Health Surveillance; D012307:Risk Factors; D013324:Strontium / Q000652:urine*; D013739:Testosterone / Q000097:blood*; D014481:United States / Q000453:epidemiology
chemical_list: D004785:Environmental Pollutants; D008333:Mandelic Acids; D013739:Testosterone; C037938:mandelic acid; D013324:Strontium