title: Salivary Testosterone Levels and Health Status in Men and Women in the British General Population: Findings from the Third National Survey of Sexual Attitudes and Lifestyles (Natsal-3).
abstract: BACKGROUND
  Salivary T (Sal-T) measurement by liquid chromatography-tandem mass spectroscopy resents the opportunity to examine health correlates of Sal-T in a large-scale population survey.
  
  
  OBJECTIVE
  This study sought to examine associations between Sal-T and health-related factors in men and women age 18-74 years.
  
  
  METHODS
  Morning saliva samples were obtained from participants in a cross-sectional probability-sample survey of the general British population (Natsal-3). Self-reported health and lifestyle questions were administered as part of a wider sexual health interview.
  
  
  METHODS
  Study participants included 1599 men and 2123 women.
  
  
  METHODS
  Sal-T was measured using liquid chromatography-tandem mass spectroscopy. Linear regression was used to examine associations between health factors and mean Sal-T.
  
  
  RESULTS
  In men, mean Sal-T was associated with a range of health factors after age adjustment, and showed a strong independent negative association with body mass index (BMI) in multivariable analysis. Men reporting cardiovascular disease or currently taking medication for depression had lower age-adjusted Sal-T, although there was no association with cardiovascular disease after adjustment for BMI. The decline in Sal-T with increasing age remained after adjustment for health-related factors. In women, Sal-T declined with increasing age; however, there were no age-independent associations with health-related factors or specific heath conditions with the exception of higher Sal-T in smokers.
  
  
  CONCLUSIONS
  Sal-T levels were associated, independently of age, with a range of self-reported health markers, particularly BMI, in men but not women. The findings support the view that there is an age-related decline in Sal-T in men and women, which cannot be explained by an increase in ill health. Our results demonstrate the potential of Sal-T as a convenient measure of tissue androgen exposure for population research.
authors.affiliation: Research Department of Infection and Population Health (S.C., A.J.C., C.T., N.F., P.S., C.H.M., A.M.J.), University College London, London WC1E 6BT, United Kingdom; Department of Social and Environmental Health Research (W.M., K.R.M., K.W.), London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Department of Clinical Biochemistry (B.G.K.), University Hospital S Manchester, Manchester M13 9WL, United Kingdom; Cathie Marsh Institute for Social Research, School of Social Sciences (D.M.L.), The University of Manchester, Manchester M13 9WL, United Kingdom; MRC/CSO Social and Public Health Sciences Unit (K.R.M.), University of Glasgow, Glasgow G12 8QQ, United Kingdom; Kinsey Institute (J.B.), Indiana University, Bloomington, Indiana 47405; Department of Clinical Biochemistry (A.M.W.), Royal Infirmary, Glasgow G4 0SF, United Kingdom; and Andrology Research Unit (F.C.W.W.), Manchester Centre of Endocrinology and Diabetes, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, United Kingdom.
authors.forename: S
authors.initials: S
authors.lastname: Clifton
authors.affiliation: Research Department of Infection and Population Health (S.C., A.J.C., C.T., N.F., P.S., C.H.M., A.M.J.), University College London, London WC1E 6BT, United Kingdom; Department of Social and Environmental Health Research (W.M., K.R.M., K.W.), London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Department of Clinical Biochemistry (B.G.K.), University Hospital S Manchester, Manchester M13 9WL, United Kingdom; Cathie Marsh Institute for Social Research, School of Social Sciences (D.M.L.), The University of Manchester, Manchester M13 9WL, United Kingdom; MRC/CSO Social and Public Health Sciences Unit (K.R.M.), University of Glasgow, Glasgow G12 8QQ, United Kingdom; Kinsey Institute (J.B.), Indiana University, Bloomington, Indiana 47405; Department of Clinical Biochemistry (A.M.W.), Royal Infirmary, Glasgow G4 0SF, United Kingdom; and Andrology Research Unit (F.C.W.W.), Manchester Centre of Endocrinology and Diabetes, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, United Kingdom.
authors.forename: W
authors.initials: W
authors.lastname: Macdowall
authors.affiliation: Research Department of Infection and Population Health (S.C., A.J.C., C.T., N.F., P.S., C.H.M., A.M.J.), University College London, London WC1E 6BT, United Kingdom; Department of Social and Environmental Health Research (W.M., K.R.M., K.W.), London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Department of Clinical Biochemistry (B.G.K.), University Hospital S Manchester, Manchester M13 9WL, United Kingdom; Cathie Marsh Institute for Social Research, School of Social Sciences (D.M.L.), The University of Manchester, Manchester M13 9WL, United Kingdom; MRC/CSO Social and Public Health Sciences Unit (K.R.M.), University of Glasgow, Glasgow G12 8QQ, United Kingdom; Kinsey Institute (J.B.), Indiana University, Bloomington, Indiana 47405; Department of Clinical Biochemistry (A.M.W.), Royal Infirmary, Glasgow G4 0SF, United Kingdom; and Andrology Research Unit (F.C.W.W.), Manchester Centre of Endocrinology and Diabetes, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, United Kingdom.
authors.forename: A J
authors.initials: AJ
authors.lastname: Copas
authors.affiliation: Research Department of Infection and Population Health (S.C., A.J.C., C.T., N.F., P.S., C.H.M., A.M.J.), University College London, London WC1E 6BT, United Kingdom; Department of Social and Environmental Health Research (W.M., K.R.M., K.W.), London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Department of Clinical Biochemistry (B.G.K.), University Hospital S Manchester, Manchester M13 9WL, United Kingdom; Cathie Marsh Institute for Social Research, School of Social Sciences (D.M.L.), The University of Manchester, Manchester M13 9WL, United Kingdom; MRC/CSO Social and Public Health Sciences Unit (K.R.M.), University of Glasgow, Glasgow G12 8QQ, United Kingdom; Kinsey Institute (J.B.), Indiana University, Bloomington, Indiana 47405; Department of Clinical Biochemistry (A.M.W.), Royal Infirmary, Glasgow G4 0SF, United Kingdom; and Andrology Research Unit (F.C.W.W.), Manchester Centre of Endocrinology and Diabetes, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, United Kingdom.
authors.forename: C
authors.initials: C
authors.lastname: Tanton
authors.affiliation: Research Department of Infection and Population Health (S.C., A.J.C., C.T., N.F., P.S., C.H.M., A.M.J.), University College London, London WC1E 6BT, United Kingdom; Department of Social and Environmental Health Research (W.M., K.R.M., K.W.), London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Department of Clinical Biochemistry (B.G.K.), University Hospital S Manchester, Manchester M13 9WL, United Kingdom; Cathie Marsh Institute for Social Research, School of Social Sciences (D.M.L.), The University of Manchester, Manchester M13 9WL, United Kingdom; MRC/CSO Social and Public Health Sciences Unit (K.R.M.), University of Glasgow, Glasgow G12 8QQ, United Kingdom; Kinsey Institute (J.B.), Indiana University, Bloomington, Indiana 47405; Department of Clinical Biochemistry (A.M.W.), Royal Infirmary, Glasgow G4 0SF, United Kingdom; and Andrology Research Unit (F.C.W.W.), Manchester Centre of Endocrinology and Diabetes, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, United Kingdom.
authors.forename: B G
authors.initials: BG
authors.lastname: Keevil
authors.affiliation: Research Department of Infection and Population Health (S.C., A.J.C., C.T., N.F., P.S., C.H.M., A.M.J.), University College London, London WC1E 6BT, United Kingdom; Department of Social and Environmental Health Research (W.M., K.R.M., K.W.), London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Department of Clinical Biochemistry (B.G.K.), University Hospital S Manchester, Manchester M13 9WL, United Kingdom; Cathie Marsh Institute for Social Research, School of Social Sciences (D.M.L.), The University of Manchester, Manchester M13 9WL, United Kingdom; MRC/CSO Social and Public Health Sciences Unit (K.R.M.), University of Glasgow, Glasgow G12 8QQ, United Kingdom; Kinsey Institute (J.B.), Indiana University, Bloomington, Indiana 47405; Department of Clinical Biochemistry (A.M.W.), Royal Infirmary, Glasgow G4 0SF, United Kingdom; and Andrology Research Unit (F.C.W.W.), Manchester Centre of Endocrinology and Diabetes, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, United Kingdom.
authors.forename: D M
authors.initials: DM
authors.lastname: Lee
authors.affiliation: Research Department of Infection and Population Health (S.C., A.J.C., C.T., N.F., P.S., C.H.M., A.M.J.), University College London, London WC1E 6BT, United Kingdom; Department of Social and Environmental Health Research (W.M., K.R.M., K.W.), London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Department of Clinical Biochemistry (B.G.K.), University Hospital S Manchester, Manchester M13 9WL, United Kingdom; Cathie Marsh Institute for Social Research, School of Social Sciences (D.M.L.), The University of Manchester, Manchester M13 9WL, United Kingdom; MRC/CSO Social and Public Health Sciences Unit (K.R.M.), University of Glasgow, Glasgow G12 8QQ, United Kingdom; Kinsey Institute (J.B.), Indiana University, Bloomington, Indiana 47405; Department of Clinical Biochemistry (A.M.W.), Royal Infirmary, Glasgow G4 0SF, United Kingdom; and Andrology Research Unit (F.C.W.W.), Manchester Centre of Endocrinology and Diabetes, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, United Kingdom.
authors.forename: K R
authors.initials: KR
authors.lastname: Mitchell
authors.affiliation: Research Department of Infection and Population Health (S.C., A.J.C., C.T., N.F., P.S., C.H.M., A.M.J.), University College London, London WC1E 6BT, United Kingdom; Department of Social and Environmental Health Research (W.M., K.R.M., K.W.), London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Department of Clinical Biochemistry (B.G.K.), University Hospital S Manchester, Manchester M13 9WL, United Kingdom; Cathie Marsh Institute for Social Research, School of Social Sciences (D.M.L.), The University of Manchester, Manchester M13 9WL, United Kingdom; MRC/CSO Social and Public Health Sciences Unit (K.R.M.), University of Glasgow, Glasgow G12 8QQ, United Kingdom; Kinsey Institute (J.B.), Indiana University, Bloomington, Indiana 47405; Department of Clinical Biochemistry (A.M.W.), Royal Infirmary, Glasgow G4 0SF, United Kingdom; and Andrology Research Unit (F.C.W.W.), Manchester Centre of Endocrinology and Diabetes, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, United Kingdom.
authors.forename: N
authors.initials: N
authors.lastname: Field
authors.affiliation: Research Department of Infection and Population Health (S.C., A.J.C., C.T., N.F., P.S., C.H.M., A.M.J.), University College London, London WC1E 6BT, United Kingdom; Department of Social and Environmental Health Research (W.M., K.R.M., K.W.), London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Department of Clinical Biochemistry (B.G.K.), University Hospital S Manchester, Manchester M13 9WL, United Kingdom; Cathie Marsh Institute for Social Research, School of Social Sciences (D.M.L.), The University of Manchester, Manchester M13 9WL, United Kingdom; MRC/CSO Social and Public Health Sciences Unit (K.R.M.), University of Glasgow, Glasgow G12 8QQ, United Kingdom; Kinsey Institute (J.B.), Indiana University, Bloomington, Indiana 47405; Department of Clinical Biochemistry (A.M.W.), Royal Infirmary, Glasgow G4 0SF, United Kingdom; and Andrology Research Unit (F.C.W.W.), Manchester Centre of Endocrinology and Diabetes, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, United Kingdom.
authors.forename: P
authors.initials: P
authors.lastname: Sonnenberg
authors.affiliation: Research Department of Infection and Population Health (S.C., A.J.C., C.T., N.F., P.S., C.H.M., A.M.J.), University College London, London WC1E 6BT, United Kingdom; Department of Social and Environmental Health Research (W.M., K.R.M., K.W.), London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Department of Clinical Biochemistry (B.G.K.), University Hospital S Manchester, Manchester M13 9WL, United Kingdom; Cathie Marsh Institute for Social Research, School of Social Sciences (D.M.L.), The University of Manchester, Manchester M13 9WL, United Kingdom; MRC/CSO Social and Public Health Sciences Unit (K.R.M.), University of Glasgow, Glasgow G12 8QQ, United Kingdom; Kinsey Institute (J.B.), Indiana University, Bloomington, Indiana 47405; Department of Clinical Biochemistry (A.M.W.), Royal Infirmary, Glasgow G4 0SF, United Kingdom; and Andrology Research Unit (F.C.W.W.), Manchester Centre of Endocrinology and Diabetes, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, United Kingdom.
authors.forename: J
authors.initials: J
authors.lastname: Bancroft
authors.affiliation: Research Department of Infection and Population Health (S.C., A.J.C., C.T., N.F., P.S., C.H.M., A.M.J.), University College London, London WC1E 6BT, United Kingdom; Department of Social and Environmental Health Research (W.M., K.R.M., K.W.), London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Department of Clinical Biochemistry (B.G.K.), University Hospital S Manchester, Manchester M13 9WL, United Kingdom; Cathie Marsh Institute for Social Research, School of Social Sciences (D.M.L.), The University of Manchester, Manchester M13 9WL, United Kingdom; MRC/CSO Social and Public Health Sciences Unit (K.R.M.), University of Glasgow, Glasgow G12 8QQ, United Kingdom; Kinsey Institute (J.B.), Indiana University, Bloomington, Indiana 47405; Department of Clinical Biochemistry (A.M.W.), Royal Infirmary, Glasgow G4 0SF, United Kingdom; and Andrology Research Unit (F.C.W.W.), Manchester Centre of Endocrinology and Diabetes, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, United Kingdom.
authors.forename: C H
authors.initials: CH
authors.lastname: Mercer
authors.affiliation: Research Department of Infection and Population Health (S.C., A.J.C., C.T., N.F., P.S., C.H.M., A.M.J.), University College London, London WC1E 6BT, United Kingdom; Department of Social and Environmental Health Research (W.M., K.R.M., K.W.), London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Department of Clinical Biochemistry (B.G.K.), University Hospital S Manchester, Manchester M13 9WL, United Kingdom; Cathie Marsh Institute for Social Research, School of Social Sciences (D.M.L.), The University of Manchester, Manchester M13 9WL, United Kingdom; MRC/CSO Social and Public Health Sciences Unit (K.R.M.), University of Glasgow, Glasgow G12 8QQ, United Kingdom; Kinsey Institute (J.B.), Indiana University, Bloomington, Indiana 47405; Department of Clinical Biochemistry (A.M.W.), Royal Infirmary, Glasgow G4 0SF, United Kingdom; and Andrology Research Unit (F.C.W.W.), Manchester Centre of Endocrinology and Diabetes, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, United Kingdom.
authors.forename: A M
authors.initials: AM
authors.lastname: Wallace
authors.affiliation: Research Department of Infection and Population Health (S.C., A.J.C., C.T., N.F., P.S., C.H.M., A.M.J.), University College London, London WC1E 6BT, United Kingdom; Department of Social and Environmental Health Research (W.M., K.R.M., K.W.), London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Department of Clinical Biochemistry (B.G.K.), University Hospital S Manchester, Manchester M13 9WL, United Kingdom; Cathie Marsh Institute for Social Research, School of Social Sciences (D.M.L.), The University of Manchester, Manchester M13 9WL, United Kingdom; MRC/CSO Social and Public Health Sciences Unit (K.R.M.), University of Glasgow, Glasgow G12 8QQ, United Kingdom; Kinsey Institute (J.B.), Indiana University, Bloomington, Indiana 47405; Department of Clinical Biochemistry (A.M.W.), Royal Infirmary, Glasgow G4 0SF, United Kingdom; and Andrology Research Unit (F.C.W.W.), Manchester Centre of Endocrinology and Diabetes, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, United Kingdom.
authors.forename: A M
authors.initials: AM
authors.lastname: Johnson
authors.affiliation: Research Department of Infection and Population Health (S.C., A.J.C., C.T., N.F., P.S., C.H.M., A.M.J.), University College London, London WC1E 6BT, United Kingdom; Department of Social and Environmental Health Research (W.M., K.R.M., K.W.), London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Department of Clinical Biochemistry (B.G.K.), University Hospital S Manchester, Manchester M13 9WL, United Kingdom; Cathie Marsh Institute for Social Research, School of Social Sciences (D.M.L.), The University of Manchester, Manchester M13 9WL, United Kingdom; MRC/CSO Social and Public Health Sciences Unit (K.R.M.), University of Glasgow, Glasgow G12 8QQ, United Kingdom; Kinsey Institute (J.B.), Indiana University, Bloomington, Indiana 47405; Department of Clinical Biochemistry (A.M.W.), Royal Infirmary, Glasgow G4 0SF, United Kingdom; and Andrology Research Unit (F.C.W.W.), Manchester Centre of Endocrinology and Diabetes, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, United Kingdom.
authors.forename: K
authors.initials: K
authors.lastname: Wellings
authors.affiliation: Research Department of Infection and Population Health (S.C., A.J.C., C.T., N.F., P.S., C.H.M., A.M.J.), University College London, London WC1E 6BT, United Kingdom; Department of Social and Environmental Health Research (W.M., K.R.M., K.W.), London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom; Department of Clinical Biochemistry (B.G.K.), University Hospital S Manchester, Manchester M13 9WL, United Kingdom; Cathie Marsh Institute for Social Research, School of Social Sciences (D.M.L.), The University of Manchester, Manchester M13 9WL, United Kingdom; MRC/CSO Social and Public Health Sciences Unit (K.R.M.), University of Glasgow, Glasgow G12 8QQ, United Kingdom; Kinsey Institute (J.B.), Indiana University, Bloomington, Indiana 47405; Department of Clinical Biochemistry (A.M.W.), Royal Infirmary, Glasgow G4 0SF, United Kingdom; and Andrology Research Unit (F.C.W.W.), Manchester Centre of Endocrinology and Diabetes, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, United Kingdom.
authors.forename: F C W
authors.initials: FC
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000375:Aging / Q000378:metabolism*; D015415:Biomarkers / Q000378:metabolism; D015992:Body Mass Index; D002851:Chromatography, High Pressure Liquid; D003430:Cross-Sectional Studies; D015536:Down-Regulation; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D012463:Saliva / Q000378:metabolism*; D057566:Self Report; D012727:Sex Characteristics; D053719:Tandem Mass Spectrometry; D013739:Testosterone / Q000378:metabolism*; D006113:United Kingdom; D055815:Young Adult
chemical_list: D015415:Biomarkers; D013739:Testosterone