睾酮在调节男性发育、生殖和健康方面起着重要作用。生命周期内睾酮水平的下降可能反映或甚至有助于男性慢性疾病和死亡率的发生。使用跨部门全国健康和营养调查的多个样本的数据（n = 10 225），分析了睾酮水平和男性死亡率之间的关系。目标结果包括因心脏病、恶性肿瘤、慢性下呼吸道疾病、脑血管疾病、阿尔茨海默病、糖尿病、流感和肺炎、肾脏疾病以及事故或非故意伤害而导致的已知死亡情况。离散时间危险模型的结果表明，睾酮水平较低与大多数疾病类别的死亡率增加有关，其关系可能是年龄相关或年龄无关的。包括任何已知疾病的全因死亡率的分析结果也显示，睾酮水平较低的人存在更高的总体风险。对于大多数疾病类别，与低睾酮水平相关的危险在较高年龄时尤为显著，当该特定疾病的死亡率已经升高时。值得注意的是，与慢性疾病无关（即事故和伤害）的死亡风险与睾酮水平无关。虽然睾酮与死亡风险之间的因果关系方向尚不清楚，但这些结果可能反映了伴随许多疾病状态而降低的睾酮水平。因此，睾酮与男性死亡率之间的关系可能是间接的；病患者预计具有低睾酮和更高的死亡风险。© 作者 2022。由牛津大学出版社代表进化、医学和公共卫生基金会出版。

Testosterone plays an important role in regulating male development, reproduction and health. Declining levels across the lifespan may reflect, or even contribute to, chronic disease and mortality in men.Relationships between testosterone levels and male mortality were analyzed using data from multiple samples of the cross-sectional National Health and Nutrition Examination Survey (n = 10 225). Target outcomes included known deaths from heart disease, malignant neoplasms, chronic lower respiratory diseases, cerebrovascular diseases, Alzheimer's disease, diabetes mellitus, influenza and pneumonia, kidney diseases, and accidents or unintentional injuries.Results of discrete-time hazard models revealed that lower levels of testosterone were related to higher mortality for the majority of disease categories in either an age-dependent or age-independent fashion. Analysis of all-cause mortality-which included deaths from any known disease-also revealed greater general risk for those with lower testosterone levels. For most disease categories, the hazard associated with low testosterone was especially evident at older ages when mortality from that particular ailment was already elevated. Notably, testosterone levels were not related to mortality risk for deaths unrelated to chronic disease (i.e. accidents and injuries).While the causal direction of relationships between testosterone and mortality risk remains unclear, these results may reflect the decline in testosterone that accompanies many disease states. Accordingly, the relationship between testosterone and male mortality may be indirect; ill individuals are expected to have both lower testosterone and higher mortality risk.© The Author(s) 2022. Published by Oxford University Press on behalf of the Foundation for Evolution, Medicine, and Public Health.