The DOI matches its Crossref record; 42 of the 42 references it cites were found in a registry or an index; 5 of the 38 sources its claims cite were checked for support.
Association of cigarette smoking, alcohol consumption, and physical activity with sex steroid hormone levels in US men
Open accessAbstract
BackgroundWe evaluated the associations of smoking, alcohol consumption, and physical activity with sex steroid hormone concentrations among 1,275 men ≥20 years old who participated in the Third National Health and Nutrition Examination Survey (NHANES III).MethodsSerum concentrations of testosterone, estradiol, and sex hormone-binding globulin (SHBG) were measured. We compared geometric mean concentrations across levels of smoking, alcohol, and physical activity using multiple linear regression.ResultsCurrent smokers had higher total testosterone (5.42, 5.10, and 5.26 ng/ml in current, former, and never smokers), free testosterone (0.110, 0.102, and 0.104 ng/ml), total estradiol (40.0, 34.5, and 33.5 pg/ml), and free estradiol (1.05, 0.88, and 0.84 pg/ml) compared with former and never smokers (all p ≤ 0.05). Men who consumed ≥1 drink/day had lower SHBG than men who drank less frequently (31.5 vs. 34.8 nmol/l, p = 0.01); total (p-trend = 0.08) and free testosterone (p-trend = 0.06) increased with number of drinks per day. Physical activity was positively associated with total (p-trend = 0.01) and free testosterone (p-trend = 0.05).ConclusionsIn this nationally representative sample of men, smoking, alcohol, and physical activity were associated with hormones and SHBG, thus these factors should be considered as possible confounders or upstream variables in studies of hormones and men’s health, including prostate cancer.
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
In NHANES III, current smoking, alcohol intake, and physical activity were associated with sex steroid hormone and SHBG concentrations in 1,275 U.S. men. The authors conclude these modifiable factors should be considered as possible confounders or upstream variables in studies of hormones and men’s health.
Key findings
Current smokers had higher total testosterone (5.42, 5.10, and 5.26 ng/mL in current, former, and never smokers), free testosterone (0.110, 0.102, and 0.104 ng/mL), total estradiol (40.0, 34.5, and 33.5 pg/mL), and free estradiol (1.05, 0.88, and 0.84 pg/mL) than former and never smokers (all P≤0.05). Men who consumed ≥1 drink/day had lower SHBG than men who drank less frequently (31.5 vs. 34.8 nmol/L, P=0.01); total and free testosterone increased with number of drinks per day (P-trend=0.08 and P-trend=0.06). Men in the highest physical activity category had higher total testosterone (5.42 vs. 5.05 ng/mL, P=0.003) and free testosterone (0.109 vs. 0.098 ng/mL, P=0.005) and lower total estradiol (35.2 vs. 38.1 pg/mL, P=0.009) than those reporting no activity; the abstract reports positive trends for total and free testosterone (P-trend=0.01 and P-trend=0.05), while the results text states trends across activity levels were not statistically significant. Men passively exposed to cigarette smoke had greater total testosterone (5.21 vs. 4.90 ng/mL, P=0.03) and free testosterone (0.104 vs. 0.096 ng/mL, P=0.005) than those unexposed.
Methods
Cross-sectional analysis of 1,275 men aged 20–90 in NHANES III Phase I morning examination, after exclusions for prostate cancer, wheelchair/leg paralysis, missing or extreme hormone values, and missing exposure or percent body fat data. Serum testosterone, estradiol, and SHBG were measured by competitive electrochemiluminescence immunoassays; free testosterone and free estradiol were estimated from total hormones, SHBG, and albumin using mass action equations; androstanediol glucuronide was measured by enzyme immunoassay. Multivariable linear regression used Phase I morning sampling weights, natural-log-transformed hormones, and adjustment for age, race/ethnicity, percent body fat, mutual adjustment for smoking, alcohol, and physical activity, and mutual adjustment for other hormones; tests for trend and age interaction were performed.
Limitations
The authors state that the cross-sectional design precludes conclusions about temporality (e.g., higher testosterone could increase exercise capacity rather than physical activity influencing testosterone), that self-reported lifestyle factors may cause misclassification, and that residual confounding by unrecognized factors is possible. Evident from the text, though not framed by the authors as a limitation: the study was restricted to Phase I morning-session men with available stored serum and complete exposure/body-fat data, which may limit generalizability.
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Claims the paper makes
77 Own result · 9 Own method · 8 No full text of the sources · 5 Own interpretation · 2 Partly supported · 2 No basis given · 1 Supported · 1 Supported so far · 1 Not supported · accuracy not yet measured
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“current drinkers had lower concentrations of SHBG and possibly higher testosterone and free testosterone levels compared with non-drinkers”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > DISCUSSION
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Both total (P-trend=0.06) and free (P-trend=0.05) testosterone increased with an increasing number of drinks consumed per day among younger,(<44 years), but not older men (P-trend=0.4 and P-trend=0.3, respectively).”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > RESULTS
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Self-reported alcohol consumption frequency from the food frequency questionnaire accurately reflects usual alcohol intake.
- Rests on an assumption: Stored serum samples assayed in 2005 provide valid measurements of hormone concentrations at the time of the survey.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“total and free estradiol concentrations decreased with increasing frequency of physical activity among younger men (<44 years; P-trend=0.03 and P-trend=0.03, respectively)”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > RESULTS
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“No consistent patterns were seen between the amount of alcohol consumed, as measured by the 24-hour dietary recall, or the frequency of heavy episodic drinking and any of the hormones or SHBG.”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > RESULTS
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Self-reported alcohol consumption frequency from the food frequency questionnaire accurately reflects usual alcohol intake.
- Rests on an assumption: Stored serum samples assayed in 2005 provide valid measurements of hormone concentrations at the time of the survey.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“free testosterone (0.110, 0.102 and 0.104 ng/mL)”
- Also stated in: § RESULTS · plain
“free testosterone (0.110, 0.102 and 0.104 ng/mL)”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > Abstract > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Self-reported smoking status accurately classifies lifetime and current smoking exposure.
- Rests on an assumption: Stored serum samples assayed in 2005 provide valid measurements of hormone concentrations at the time of the survey.
- Also stated in: § RESULTS · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Men passively exposed to cigarette smoke also had greater total testosterone (5.21 compared with 4.90 ng/mL, P=0.03)”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > RESULTS
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Self-reported smoking status accurately classifies lifetime and current smoking exposure.
- Rests on an assumption: Stored serum samples assayed in 2005 provide valid measurements of hormone concentrations at the time of the survey.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, higher daily number of cigarettes smoked, pack-years smoked and serum cotinine were all associated with greater concentrations of total estradiol and free estradiol (all P-trend≤0.06; table 2).”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > RESULTS
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Self-reported smoking status accurately classifies lifetime and current smoking exposure.
- Rests on an assumption: Stored serum samples assayed in 2005 provide valid measurements of hormone concentrations at the time of the survey.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, a significant interaction was observed between age and smoking status and androstanediol glucuronide (P-interaction=0.01)”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > RESULTS
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Self-reported smoking status accurately classifies lifetime and current smoking exposure.
- Rests on an assumption: Stored serum samples assayed in 2005 provide valid measurements of hormone concentrations at the time of the survey.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“current cigarette smokers had higher concentrations of total testosterone, total estradiol, free testosterone and free estradiol compared with never smokers”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > DISCUSSION
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“current cigarette smokers had higher concentrations of total testosterone, total estradiol, free testosterone and free estradiol compared with never smokers”
- Also stated in: § Cigarette smoking · plain
“we observed that total and free estradiol concentrations were higher in current smokers than in never smokers, with a positive dose-response relationship seen with increasing number of cigarettes smoked per day and number of pack-years smoked”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > DISCUSSION
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Cigarette smoking · plain
- It may state two separate claims as one. 10
- Probably not a substantial claim. 16
At least one cited source doesn’t support this claim or points to a different paper, and none confirmed it — see the verdicts below.
In the paper
“Previous studies of cigarette smoking, alcohol consumption and physical activity with sex steroid hormones and SHBG levels in men were limited by small sample sizes [22], were restricted to older men [17], or both [20].”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > INTRODUCTION
What the sources say
- Not checked — no full text of the sourcecites [22] Barrett-Connor E, Khaw KT (1987) Cigarette smoking and increased endogenous estrogen levels in men. Am J Epidemiol 126:187–192 source
- Not checked — no full text of the sourcecites [17] Muller M, den Tonkelaar I, Thijssen JH, Grobbee DE, van der Schouw YT (2003) Endogenous sex hormones in men aged 40–80 years. Eur J Endocrinol 149:583–589. doi: 10.1530/eje.0.1490583 source
- Disputedcites [20] Svartberg J, Jorde R (2007) Endogenous testosterone levels and smoking in men. The fifth Tromso study. Int J Androl 30:137–143. doi: 10.1111/j.1365-2605.2006.00720.x sourceExperimental — accuracy not yet measured
The citation is attached to “or both,” attributing to this paper a study that was both small and restricted to older men. Instead, the Introduction reports 3,427 men, and Subjects and methods says participants aged 30 and older were eligible. The paper’s discussion describes some *earlier* studies as small or involving older men; that does not describe this study. (LLM, conf=0.88)
Checked by a reasoning model — may be wrong.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Adiposity is a well-known modifiable predictor of sex steroid hormones in men [14, 16–20]”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > INTRODUCTION
What the sources say
- Not checked — no full text of the sourcecites [14] Rohrmann S, Nelson WG, Rifai N, Brown TR, Dobs A, Kanarek N et al (2007) Serum estrogen, but not testosterone levels differ between black and white men in a nationally representative sample of Americans. J Clin Endocrinol Metab 92:2519–2525 source
- Not checked — no full text of the sourcecites [16] Handa K, Ishii H, Kono S, Shinchi K, Imanishi K, Mihara H et al (1997) Behavioral correlates of plasma sex hormones and their relationships with plasma lipids and lipoproteins in Japanese men. Atherosclerosis 130:37–44. doi: 10.1016/S0021-9150(96)06041-8 source
- Not checked — no full text of the sourcecites [17] Muller M, den Tonkelaar I, Thijssen JH, Grobbee DE, van der Schouw YT (2003) Endogenous sex hormones in men aged 40–80 years. Eur J Endocrinol 149:583–589. doi: 10.1530/eje.0.1490583 source
- Not checked — no full text of the sourcecites [18] Svartberg J, Midtby M, Bonaa KH, Sundsfjord J, Joakimsen RM, Jorde R (2003) The associations of age, lifestyle factors and chronic disease with testosterone in men: the Tromso Study. Eur J Endocrinol 149:145–152. doi: 10.1530/eje.0.1490145 source
- Not checked — no full text of the sourcecites [19] Tamimi R, Mucci LA, Spanos E, Lagiou A, Benetou V, Trichopoulos D (2001) Testosterone and oestradiol in relation to tobacco smoking, body mass index, energy consumption and nutrient intake among adult men. Eur J Cancer Prev 10:275–280. doi: 10.1097/00008469-200106000-00012 source
- Partly supportedcites [20] Svartberg J, Jorde R (2007) Endogenous testosterone levels and smoking in men. The fifth Tromso study. Int J Androl 30:137–143. doi: 10.1111/j.1365-2605.2006.00720.x sourceExperimental — accuracy not yet measured
The Subjects and methods section says waist circumference is associated with total and free testosterone, and the discussion calls anthropometric measurements strong predictors of testosterone levels. The paper supports adiposity-related measures as predictors of testosterone in men, but does not establish the broader claim about sex steroid hormones generally or test whether modifying adiposity changes hormone levels. (LLM, conf=0.84)
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
Every source the paper cites for this claim was checked and supports it.
In the paper
“In previous studies published in NHANES III, low free and bioavailable testosterone were associated with type 2 diabetes [2]”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > INTRODUCTION
What the sources say
- Supportedcites [2] Selvin E, Feinleib M, Zhang L, Rohrmann S, Rifai N, Nelson WG et al (2007) Androgens and diabetes in men: results from the Third National Health and Nutrition Examination Survey (NHANES III). Diabetes Care 30:234–238. doi: 10.2337/dc06-1579 source
The NHANES III Results report that lower estimated free and bioavailable testosterone were associated with prevalent diabetes in men after multivariable adjustment. The paper’s introduction discusses type 2 diabetes as the context for this analysis; the finding is an association, not evidence of causation. (LLM, conf=0.92)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Sex steroid hormone concentrations have been previously shown to be associated with health conditions in men, including prostate cancer [1], diabetes [2, 3], low bone mineral density [4], lower urinary tract symptoms [5], impaired cognitive function [6, 7] and cardiovascular disease [8–10].”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > INTRODUCTION
What the sources say
- Not checked — no full text of the sourcecites [1] Platz EA, Giovannucci E (2004) The epidemiology of sex steroid hormones and their signaling and metabolic pathways in the etiology of prostate cancer. J Steroid Biochem Mol Biol 92:237–253. doi: 10.1016/j.jsbmb.2004.10.002 source
- Supportedcites [2] Selvin E, Feinleib M, Zhang L, Rohrmann S, Rifai N, Nelson WG et al (2007) Androgens and diabetes in men: results from the Third National Health and Nutrition Examination Survey (NHANES III). Diabetes Care 30:234–238. doi: 10.2337/dc06-1579 source
This source is cited for diabetes, not for the other conditions listed in the sentence. In the Results (Table 3), lower estimated free and bioavailable testosterone concentrations are associated with higher odds of diabetes in men. (LLM, conf=0.93)
- Not checked — no full text of the sourcecites [3] Ding EL, Song Y, Malik VS, Liu S (2006) Sex differences of endogenous sex hormones and risk of type 2 diabetes: a systematic review and meta-analysis. JAMA 295:1288–1299. doi: 10.1001/jama.295.11.1288 source
- Not checked — no full text of the sourcecites [4] Paller CJ, Shiels MS, Rohrmann S, Basaria S, Rifai N, Nelson W et al (2009) Relationship of sex steroid hormones with bone mineral density in a nationally-representative sample of men. Clin Endocrinol (Oxf) 70:26–34. doi: 10.1111/j.1365-2265.2008.03300.x source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In some studies, current smokers had higher circulating concentrations of total testosterone, free testosterone, total estradiol and sex hormone-binding globulin (SHBG) [16, 18–23]”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > INTRODUCTION
What the sources say
- Not checked — no full text of the sourcecites [16] Handa K, Ishii H, Kono S, Shinchi K, Imanishi K, Mihara H et al (1997) Behavioral correlates of plasma sex hormones and their relationships with plasma lipids and lipoproteins in Japanese men. Atherosclerosis 130:37–44. doi: 10.1016/S0021-9150(96)06041-8 source
- Not checked — no full text of the sourcecites [18] Svartberg J, Midtby M, Bonaa KH, Sundsfjord J, Joakimsen RM, Jorde R (2003) The associations of age, lifestyle factors and chronic disease with testosterone in men: the Tromso Study. Eur J Endocrinol 149:145–152. doi: 10.1530/eje.0.1490145 source
- Not checked — no full text of the sourcecites [19] Tamimi R, Mucci LA, Spanos E, Lagiou A, Benetou V, Trichopoulos D (2001) Testosterone and oestradiol in relation to tobacco smoking, body mass index, energy consumption and nutrient intake among adult men. Eur J Cancer Prev 10:275–280. doi: 10.1097/00008469-200106000-00012 source
- Partly supportedcites [20] Svartberg J, Jorde R (2007) Endogenous testosterone levels and smoking in men. The fifth Tromso study. Int J Androl 30:137–143. doi: 10.1111/j.1365-2605.2006.00720.x sourceExperimental — accuracy not yet measured
The Results (page unavailable) report higher total and free testosterone in current smokers than in never-smokers and a positive association between smoking and SHBG. The Subjects and methods section lists the hormones measured but not estradiol; our copy does not substantiate the claim about higher total estradiol. (LLM, conf=0.90)
- Not checked — no full text of the sourcecites [21] English KM, Pugh PJ, Parry H, Scutt NE, Channer KS, Jones TH (2001) Effect of cigarette smoking on levels of bioavailable testosterone in healthy men. Clin Sci 100:661–665. doi: 10.1042/CS20010011 source
- Not checked — no full text of the sourcecites [22] Barrett-Connor E, Khaw KT (1987) Cigarette smoking and increased endogenous estrogen levels in men. Am J Epidemiol 126:187–192 source
- Not checked — no full text of the sourcecites [23] Hackney AC, Fahrner CL, Gulledge TP (1998) Basal reproductive hormonal profiles are altered in endurance trained men. J Sports Med Phys Fitness 38:138–141
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Former smokers appeared to have lower concentrations of both total and free testosterone than never smokers, although the differences were not statistically significant (P=0.3 and 0.6, respectively).”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > RESULTS
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: Self-reported smoking status accurately classifies lifetime and current smoking exposure.
- Rests on an assumption: Stored serum samples assayed in 2005 provide valid measurements of hormone concentrations at the time of the survey.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The frequency of alcohol consumption was positively associated with total testosterone (P-trend= 0.08) and free testosterone (P-trend=0.06), although these associations were not statistically significant.”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > RESULTS
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: Self-reported alcohol consumption frequency from the food frequency questionnaire accurately reflects usual alcohol intake.
- Rests on an assumption: Stored serum samples assayed in 2005 provide valid measurements of hormone concentrations at the time of the survey.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Former smokers appeared to have lower concentrations of both total and free testosterone than never smokers, although the differences were not statistically significant (P=0.3 and 0.6, respectively).”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > RESULTS
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: Self-reported smoking status accurately classifies lifetime and current smoking exposure.
- Rests on an assumption: Stored serum samples assayed in 2005 provide valid measurements of hormone concentrations at the time of the survey.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Laboratory technicians were blinded to participant characteristics.”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > METHODS > Hormone measurements
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“The association between alcohol consumption and sex steroid hormone concentrations has been inconsistent, with some evidence suggesting no association [16–19], and other evidence supporting increased levels of androstanediol glucuronide [16], and estradiol [17], and decreased levels of SHBG [18] with increased alcohol consumption.”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > INTRODUCTION
What the sources say
- Not checked — no full text of the sourcecites [16] Handa K, Ishii H, Kono S, Shinchi K, Imanishi K, Mihara H et al (1997) Behavioral correlates of plasma sex hormones and their relationships with plasma lipids and lipoproteins in Japanese men. Atherosclerosis 130:37–44. doi: 10.1016/S0021-9150(96)06041-8 source
- Not checked — no full text of the sourcecites [17] Muller M, den Tonkelaar I, Thijssen JH, Grobbee DE, van der Schouw YT (2003) Endogenous sex hormones in men aged 40–80 years. Eur J Endocrinol 149:583–589. doi: 10.1530/eje.0.1490583 source
- Not checked — no full text of the sourcecites [18] Svartberg J, Midtby M, Bonaa KH, Sundsfjord J, Joakimsen RM, Jorde R (2003) The associations of age, lifestyle factors and chronic disease with testosterone in men: the Tromso Study. Eur J Endocrinol 149:145–152. doi: 10.1530/eje.0.1490145 source
- Not checked — no full text of the sourcecites [19] Tamimi R, Mucci LA, Spanos E, Lagiou A, Benetou V, Trichopoulos D (2001) Testosterone and oestradiol in relation to tobacco smoking, body mass index, energy consumption and nutrient intake among adult men. Eur J Cancer Prev 10:275–280. doi: 10.1097/00008469-200106000-00012 source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The large sample size and the generalizability of these results to the adult United States male population are major strengths of this analysis.”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > DISCUSSION > Physical activity
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“men with low free testosterone, low bioavailable testosterone, and low estradiol had a higher risk of mortality, while men with low SHBG had a lower risk of mortality [11]”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > INTRODUCTION
What the sources say
- Not checked — no full text of the sourcecites [11] Platz EA (2008) Low testosterone and risk of premature death in older men: analytical and preanalytical issues in measuring circulating testosterone. Clin Chem 54:1110–1112. doi: 10.1373/clinchem.2008.104901 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Reliance on self-report for many of the lifestyle factors may have led to misclassification.”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > DISCUSSION > Physical activity
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Morning sample participants were chosen for this hormone study to reduce variation due to diurnal production of sex hormones.”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > METHODS > Study population
plaindirectn = 2,205- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Additionally, endurance athletes may have lower concentrations of free and total testosterone than non-athletes [24, 25].”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > INTRODUCTION
What the sources say
- Not checked — no full text of the sourcecites [24] Maimoun L, Lumbroso S, Manetta J, Paris F, Leroux JL, Sultan C (2003) Testosterone is significantly reduced in endurance athletes without impact on bone mineral density. Horm Res 59:285–292. doi: 10.1159/000070627 source
- Not checked — no full text of the sourcecites [25] Vermeulen A, Verdonck L, Kaufman JM (1999) A critical evaluation of simple methods for the estimation of free testosterone in serum. J Clin Endocrinol Metab 84:3666–3672. doi: 10.1210/jc.84.10.3666 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“increased androstanediol glucuronide and total estradiol were associated with lower urinary tract symptoms [5]”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > INTRODUCTION
What the sources say
- Not checked — no full text of the sourcecites [5] Rohrmann S, Nelson WG, Rifai N, Kanarek N, Basaria S, Tsilidis KK et al (2007) Serum sex steroid hormones and lower urinary tract symptoms in Third National Health and Nutrition Examination Survey (NHANES III). Urology 69:708–713. doi: 10.1016/j.urology.2007.01.011 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“low free estradiol and low free testosterone were associated with osteopenia [4]”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > INTRODUCTION
What the sources say
- Not checked — no full text of the sourcecites [4] Paller CJ, Shiels MS, Rohrmann S, Basaria S, Rifai N, Nelson W et al (2009) Relationship of sex steroid hormones with bone mineral density in a nationally-representative sample of men. Clin Endocrinol (Oxf) 70:26–34. doi: 10.1111/j.1365-2265.2008.03300.x source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“In all analyses, we applied the Phase I morning sampling weights to account for the complex NHANES sampling design, including unequal probabilities of selection, over-sampling, and non-response [34].”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > METHODS > Statistical Analysis
What the sources say
- Not checked — no full text of the sourcecites [34] Gann PH, Hennekens CH, Ma J, Longcope C, Stampfer MJ (1996) Prospective study of sex hormone levels and risk of prostate cancer. J Natl Cancer Inst 88:1118–1126. doi: 10.1093/jnci/88.16.1118 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“All models included terms for adjustment for age (continuous), race/ethnicity (non-Hispanic white, non-Hispanic black, Mexican-American, other race/ethnicity), percent body fat (continuous), mutual adjustment for other exposures of interest”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > METHODS > Statistical Analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Additionally, there may have been confounding by unrecognized factors associated with smoking, alcohol, and physical activity and with hormone concentrations.”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > DISCUSSION > Physical activity
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In this nationally-representative sample of men, smoking, alcohol and physical activity were associated with hormones and SHBG”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > Abstract > Conclusions
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: The observed cross-sectional associations reflect effects of smoking, alcohol consumption, and physical activity on sex steroid hormone levels rather than reverse causation or residual confounding.
- Rests on an assumption: Self-reported smoking status accurately classifies lifetime and current smoking exposure.
- Rests on an assumption: Self-reported alcohol consumption frequency from the food frequency questionnaire accurately reflects usual alcohol intake.
- Rests on an assumption: Self-reported physical activity accurately reflects usual physical activity.
- Rests on an assumption: Stored serum samples assayed in 2005 provide valid measurements of hormone concentrations at the time of the survey.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Age [13, 14] and race [13–15] are well-established, but non-modifiable, predictors of sex steroid hormone concentrations in men.”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > INTRODUCTION
What the sources say
- Not checked — no full text of the sourcecites [13] Ukkola O, Gagnon J, Rankinen T, Thompson PA, Hong Y, Leon AS et al (2001) Age, body mass index, race and other determinants of steroid hormone variability: the HERITAGE Family Study. Eur J Endocrinol 145:1–9. doi: 10.1530/eje.0.1450001 source
- Not checked — no full text of the sourcecites [14] Rohrmann S, Nelson WG, Rifai N, Brown TR, Dobs A, Kanarek N et al (2007) Serum estrogen, but not testosterone levels differ between black and white men in a nationally representative sample of Americans. J Clin Endocrinol Metab 92:2519–2525 source
- Not checked — no full text of the sourcecites [15] Allen NE, Appleby PN, Davey GK, Key TJ (2002) Lifestyle and nutritional determinants of bioavailable androgens and related hormones in British men. Cancer Causes Control 13:353–363. doi: 10.1023/A:1015238102830 source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Few studies have addressed the association between physical activity and hormone levels, with inconsistent findings [16–19].”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > INTRODUCTION
What the sources say
- Not checked — no full text of the sourcecites [16] Handa K, Ishii H, Kono S, Shinchi K, Imanishi K, Mihara H et al (1997) Behavioral correlates of plasma sex hormones and their relationships with plasma lipids and lipoproteins in Japanese men. Atherosclerosis 130:37–44. doi: 10.1016/S0021-9150(96)06041-8 source
- Not checked — no full text of the sourcecites [17] Muller M, den Tonkelaar I, Thijssen JH, Grobbee DE, van der Schouw YT (2003) Endogenous sex hormones in men aged 40–80 years. Eur J Endocrinol 149:583–589. doi: 10.1530/eje.0.1490583 source
- Not checked — no full text of the sourcecites [18] Svartberg J, Midtby M, Bonaa KH, Sundsfjord J, Joakimsen RM, Jorde R (2003) The associations of age, lifestyle factors and chronic disease with testosterone in men: the Tromso Study. Eur J Endocrinol 149:145–152. doi: 10.1530/eje.0.1490145 source
- Not checked — no full text of the sourcecites [19] Tamimi R, Mucci LA, Spanos E, Lagiou A, Benetou V, Trichopoulos D (2001) Testosterone and oestradiol in relation to tobacco smoking, body mass index, energy consumption and nutrient intake among adult men. Eur J Cancer Prev 10:275–280. doi: 10.1097/00008469-200106000-00012 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper relies on this without support.
The observed cross-sectional associations reflect effects of smoking, alcohol consumption, and physical activity on sex steroid hormone levels rather than reverse causation or residual confounding.
“If these lifestyle factors are shown to be associated with sex steroid hormone concentrations among men, they should be considered as possible confounders or upstream variables (variables that are related to the outcome only via their influence on sex steroid hormones) in future studies of hormones and men’s health.”
The paper relies on this without support.
Self-reported smoking status accurately classifies lifetime and current smoking exposure.
“Participants were classified as never, former and current smokers based on self-reported smoking habits”
The paper relies on this without support.
Self-reported alcohol consumption frequency from the food frequency questionnaire accurately reflects usual alcohol intake.
“Frequency of alcohol consumption was measured by a food frequency questionnaire.”
The paper relies on this without support.
Self-reported physical activity accurately reflects usual physical activity.
“A standardized scheme [30] was utilized to code and classify each reported physical activity by rate of energy expenditure.”
The paper relies on this without support.
Stored serum samples assayed in 2005 provide valid measurements of hormone concentrations at the time of the survey.
“Stored serum samples, which had been aliquotted and stored at −70°C since the time of the survey, were assayed for sex steroid hormones at the Children’s Hospital Boston, MA.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source says what the claim attributes to it.
In the citing paper
“Probable and possible associations of several factors, including age, cigarette smoking, body mass index (BMI), alcohol consumption and physical activity with hormone levels have been reported. 11-17”
From Cigarette smoking has a positive and independent effect on testosterone levels (2013) · cites this paper as [13]
The cited source says what the claim attributes to it.
In the citing paper
“However, the reported effects of smoking on testosterone levels in men are controversial, with some evidence even suggesting no association 15,19-24 and others reporting higher 13,14,25-32 or lower 33,34 levels of TT among smokers compared to nonsmokers.”
From Cigarette smoking has a positive and independent effect on testosterone levels (2013) · cites this paper as [13]
The cited source says what the claim attributes to it.
In the citing paper
“It is well known that male cigarette smokers have higher testosterone levels compared to non-smokers, however, the mechanism behind this is debated (Shiels et al., 2009;Holmboe et al., 2015).”
From Use of e-cigarettes associated with lower sperm counts in a cross-sectional study of young men from the general population (2020) · cites this paper as Shiels et al., 2009
The cited source says what the claim attributes to it.
In the citing paper
“However, it has previously been shown that testosterone levels were different for smokers and non-smokers but within the group of smokers, testosterone levels did not differ according to number of cigarettes smoked per day (Shiels et al., 2009)”
From Use of e-cigarettes associated with lower sperm counts in a cross-sectional study of young men from the general population (2020) · cites this paper as Shiels et al., 2009
The cited source says what the claim attributes to it.
In the citing paper
“previous studies have shown that smokers have significantly higher levels of TST and EST than non-smokers [16–19]”
From Associations between smoking, sex steroid hormones, trouble sleeping, and depression among U.S. adults: a cross-sectional study from NHANES (2013–2016) (2024) · cites this paper as [19]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > Abstract > Results
“Physical activity was positively associated with total (P-trend=0.01) and free testosterone (P-trend=0.05).”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > RESULTS
“although the trends in concentrations across activity levels were not statistically significant (table 4).”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > DISCUSSION > Alcohol consumption
“However, the increase in SHBG seen in our study occurred at a low level of alcohol consumption, thus it is unlikely that it is due to liver damage.”
§ Association of cigarette smoking, alcohol consumption and physical activity with sex steroid hormone levels in U.S. men > RESULTS
“men with usual intake of at least one drink per day had lower concentrations of SHBG than men who consumed 0 to 6 drinks/week (31.5 vs. 34.8 nmol/L, P=0.01)”
Citations
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Metadata
- Authors
- Shiels, M. S., Rohrmann, S., Menke, A., Selvin, E., Crespo, C. J., Rifai, N., Dobs, A., Feinleib, M., Guallar, E., & Platz, E. A.
- Affiliations
- Johns Hopkins University (US)
- German Cancer Research Center (DE)
- Portland State University (US)
- Boston Children's Hospital (US)
- Corresponding author
- Platz, Elizabeth A.
- ORCID
- Venue
- Cancer Causes & Control
- Published
- 2009-03-10
- Volume
- 20
- Issue
- 6
- Pages
- 877-886
- ISSN
- 0957-5243 (ISSN-L)
- 1573-7225
- PMC
- PMC3004151
- OpenAlex
- W1965390566
- Semantic Scholar
- df854099339168b23f3ce761777bc99cac2f2644
- Cited by
- 166
- References
- 42
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 7 · 2023: 18 · 2022: 6 · 2021: 20 · 2020: 14 · 2019: 7 · 2018: 7 · 2017: 4 · 2016: 9 · 2015: 14 · 2014: 12 · 2013: 16 · 2012: 11
- FWCI
- 6.63
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Cancer Causes & Control (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Johns Hopkins University
- National Institute for Health and Care Research
- National Institutes of Health
- National Cancer Institute (T32CA009314)
- National Institute of Diabetes and Digestive and Kidney Diseases (K01DK076595)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Keywords
- cigarette smoking, alcohol consumption, physical activity, sex hormones, testosterone, estradiol, sex hormone-binding globulin, free testosterone, free estradiol, men's health, prostate cancer, NHANES III
- MeSH terms
- Adult, Alcohol Drinking, Estradiol, Humans, Male, Motor Activity, Nutrition Surveys, Sex Hormone-Binding Globulin, Smoking, Testosterone, United States, Linear Models, Age Distribution
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