Abstract
BACKGROUND: Insulin resistance (IR) is strongly correlated with the decreased deficiency of testosterone levels in males. The metabolic score for insulin resistance (METS-IR) index is regarded as an innovative measure for the assessment on IR. The research aims to explore the correlation between the METS-IR index and the testosterone levels in males. METHODS: In this study, a cross-sectional design was made through the data obtained from the National Health and Nutrition Examination Survey (NHANES) from 2013 to 2020. Besides, the METS-IR index was derived from serum triglyceride levels, fasting plasma glucose, HDL-C and BMI. RESULTS: A total of 2082 participants were included in the final analysis. After controlling for confounding variables, it was found that METS-IR was independently and negatively correlated with testosterone levels (β = -3.88, 95% CI = -4.49, -3.27, P < 0.001). As shown by the generalized smooth curve fitting, METS-IR had a linear correlation with testosterone levels without threshold or saturation effects, which was consistently observed across all subgroups through stratified analysis (all P > 0.05). As revealed by the analysis on the ROC curve, the area under the curve (AUC) for the METS-IR index (0.732, 95% CI = 0.705, 0.760) was significantly larger than that of homeostatic model assessment of insulin resistance (HOMA-IR), TG/HDL ratio, triglyceride-glucose index (TyG) and body mass index (BMI). CONCLUSION: The findings suggest a negative relationship between the METS-IR index and the testosterone levels in male adults. Furthermore, the METS-IR index demonstrates superior predictive ability for testosterone deficiency in comparison to HOMA-IR, TG/HDL ratio, TyG and BMI.