Asthma prevalence decreases post-puberty in males. Testosterone inhibits airway smooth muscle contraction and attenuates type 2 inflammation.
To investigate the relationship between serum testosterone and current asthma prevalence and lung function in a nationally-representative dataset.
Serum testosterone and self-reported physician-diagnosed current asthma were obtained from 7,584 participants ages 6-80 years from the cross-sectional 2011-2012 National Health and Nutrition Examination Survey (NHANES). We used logistic regression to test associations between testosterone and current asthma, adjusting for demographics and stratifying by sex and age; linear regression to evaluate correlations between testosterone and lung function among asthmatic patients; and interaction terms to test for effect modification by blood eosinophils and FeNO.
Serum testosterone inversely associated with odds of current asthma in both men and women but this association was nonlinear. Similar protective effect sizes were observed for both sexes after log-transformation of serum testosterone. For every 1-unit increase in log testosterone, the odds of current asthma decreased by 11% in men and 10% in women, although the association was statistically significant in women only among those ≥12 years old after multiple imputation. Serum testosterone did not associate with current asthma prevalence among those <12 years old. Testosterone associated with increases in FEV in asthmatic participants of both sexes. Neither blood eosinophils nor FeNO modified the association between testosterone and current asthma.
Serum testosterone inversely associates with current asthma prevalence regardless of sex and correlates with better lung function in a nationally-representative database. Androgen therapy for asthma should be further investigated.

Copyright © 2020. Published by Elsevier Inc.