ORIGINAL RESEARCH article
Front. Public Health
Sec. Environmental Health and Exposome
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1589047
The association between brominated flame retardants and serum testosterone levels in American adult men: NHANES 2013-2016
Provisionally accepted
- 1Department of Gastrointestinal Surgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
- 2Cancer Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
- 3Department of Endocrinology, The Third Affiliated Hospital of Wenzhou Medical University, Ruian, China
- 4Wenzhou Key Laboratory for the Diagnosis and Prevention of Diabetic Complication, Wenzhou, China
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Background: Brominated flame retardants (BFRs), especially polybrominated diphenyl ethers (PBDEs), are commonly utilized, yet their possible endocrine-disrupting effects have sparked significant concerns. Nonetheless, the link between exposure to BFRs and serum testosterone levels in adult males is still not well comprehended.We analyzed data from 1,150 men aged ≥20 years from the National Health and Nutrition Examination Survey (NHANES) in 2013-2016. Serum concentrations of BFRs (PBDE congeners: PBDE-28, PBDE-47, etc.) and testosterone levels were measured via mass spectrometry and liquid chromatography-tandem mass spectrometry, respectively. Free testosterone (FT) and bioavailable testosterone (BAT) were calculated using the Vermeulen equation, based on measured total testosterone (TT), sex hormone-binding globulin (SHBG), and serum albumin concentrations. Linear regression models were used to evaluate the association between BFRs and TT, BAT, FT, and SHBG, adjusting for confounders including age, race, and lifestyle factors. We also evaluated potential associations modified by age, and conducted a sensitivity analysis to assess the robustness of the observed associations.Results: After all continuous variables were log2-transformed and potential confounders were adjusted, significant inverse associations were found between PBDE-28 and PBDE-47 levels with TT (β = -0.641, 95% CI: -1.098, -0.185) and FT (β = -0.883, 95% CI: -1.616, -0.149). Specifically, in the stratified analysis, older men (≥60 years) showed stronger associations between PBDE-28 and PBDE-47 exposure with lower testosterone levels (β = -0.892, 95%
Keywords: Brominated flame retardants, Serum testosterone, Endocrine disrupting, NHANES, sex hormone binding globulin
Received: 02 Apr 2025; Accepted: 26 Jun 2025.
Copyright: © 2025 Li, Chen, Zheng, Wang, Lin and Peng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Dini Lin, Department of Endocrinology, The Third Affiliated Hospital of Wenzhou Medical University, Ruian, China
Mengmeng Peng, Department of Endocrinology, The Third Affiliated Hospital of Wenzhou Medical University, Ruian, China
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