Testosterone deficiency (TD) is a prevalent disorder in men, associated with a range of health complications. Dietary live microbe intake has garnered attention for its potential to modulate gut microbiota and promote human health. This study aims to investigate the association between dietary live microbe intake and the risk of TD in a large, nationally representative sample. We analyzed data from the National Health and Nutrition Examination Survey (NHANES) for the years 2013-2016. Dietary live microbe intake was estimated using a 24-hour dietary recall, and participants were categorized into low, medium, and high intake groups. TD was defined as a serum testosterone level below 300 ng/dL. Multivariable weighted logistic regression models were used to assess the association between different dietary live microbe intake and TD risk, adjusting for potential confounders. A total of 4,034 male participants were included in the analysis. High dietary live microbe intake was associated with a significantly lower risk of TD in all models. In the fully adjusted model (Model 3), the odds ratio (OR) for TD in the high intake group was 0.71 (95% CI: 0.53 to 0.96; p = 0.03) compared to the low intake group. Subgroup analyses showed consistent results across different population characteristics, particularly among those without diabetes (OR: 0.64; 95% CI: 0.47 to 0.88; p = 0.01) and without cardiovascular disease (OR: 0.64; 95% CI: 0.47 to 0.88; p = 0.02). Restricted Cubic Spline analysis revealed a linear inverse relationship between food intake and TD risk in the medium and high intake groups. Our findings suggest that a higher intake of dietary live microbes is associated with a reduced risk of TD, highlighting the potential of dietary modifications as a preventive strategy for TD. Further research, including longitudinal studies and clinical trials, is necessary to confirm these results and explore the underlying mechanisms.

Keywords: Cross-sectional study; Dietary live microbe; Men’s health; NHANES; Testosterone deficiency.

© 2025. The Author(s).

男性睾酮缺乏（TD）是一种常见的疾病，与一系列健康并发症相关。饮食中摄入活菌引起了人们的关注，因为它们有可能调节肠道微生物群并促进人类健康。本研究旨在调查饮食中摄入活菌与TD风险之间的关联，在一个大型的、具有全国代表性的样本中进行研究。我们分析了2013年至2016年期间国家健康和营养检查调查（NHANES）的数据。通过24小时膳食回顾估计饮食中的活菌摄入量，并将参与者分为低、中和高摄入组。TD定义为血清睾酮水平低于300 ng/dL。使用多变量加权逻辑回归模型来评估不同饮食活菌摄入量与TD风险之间的关联，同时调整潜在的混杂因素。总计4,034名男性参与者被纳入分析。在所有模型中，高饮食活菌摄入量与较低的TD风险显著相关。在完全调整后的模型（模型3）中，与低摄入组相比，高摄入组TD的风险比值比（OR）为0.71（95%置信区间：0.53至0.96；p = 0.03）。亚组分析显示，在不同的人口特征中结果一致，尤其是在没有糖尿病（OR: 0.64；95% CI: 0.47到0.88；p = 0.01）和无心血管疾病（OR: 0.64；95% CI: 0.47到0.88；p = 0.02）的人群中。限制性立方样条分析揭示了食物摄入量与TD风险之间的线性反比关系，在中度和高摄入组尤为明显。我们的研究结果表明，较高的饮食活菌摄入量与降低的TD风险相关，突显了通过饮食调整作为预防TD策略的潜在价值。需要进一步的研究，包括纵向研究和临床试验来确认这些结果并探索背后的机制。

关键词：横断面研究；饮食中的活菌；男性健康；NHANES；睾酮缺乏。

© 2025. The Author(s).