Correlation of per- and poly-fluoroalkyl substances (PFAS) exposure with testosterone levels in the male population

Human exposure to per- and poly-fluoroalkyl substances (PFAS) occurs from environmentally contaminated food and water. PFAS are a health concern because they are associated with various neurological, developmental, and endocrine disorders. Despite causes of infertility being equal, male causes are less studied, with etiologies ranging from genetic to anatomic to physiologic dysfunctions. This study aimed to investigate a correlation between six subtypes of PFAS with low male testosterone levels. Data from the National Health and Nutrition Examination Survey (NHANES) cycles 2013-2016 were utilized to assess serum PFAS and testosterone levels. This study observed age, marital status, body mass index, smoking status, alcohol consumption, and diabetic status being significantly correlated with low testosterone levels. PFNA exposure was observed to have a strong inverse relationship with male testosterone levels in low/medium (ORs 0.518, 0.571, 0.322, 0.455) and low/high-medium exposure levels (ORs 0.262, 0.262, 0.321, and 0.310), indicating exposure-dependent effects on testosterone levels.