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  • Population Study Article
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Association between endogenous sex hormones and adiposity in youth across a weight status spectrum

Pediatric Research volume 97, pages 1892–1899 (2025)Cite this article

Abstract

Background

While endogenous sex hormones (e.g., testosterone, estradiol) are important factors regulating adipose tissue distribution, studies evaluating such relationships in youth across a wide weight status spectrum are limited.

Methods

We performed a cross-sectional analysis of 8–21-year-old youth. Multiple linear regression models were used to evaluate associations between sex hormones and adiposity measures (android/gynoid ratio (A/G), total fat mass (FM), visceral adipose tissue (VAT), waist circumference (WC)) and total lean mass (LM), adjusting for pubertal stage and race/ethnicity, and stratified by sex and weight status.

Results

Among 342 youth, the mean age was 13.0 ± 2.8 years old (52.6% female; 38.9% normal weight [NW]; 27.8% overweight/obesity [OW/OB]; 33.3% severe obesity [SO]). Testosterone was positively associated with LM among males with NW (1462 g, 95% CI: 255–2668 g) and OW/OB (3792 g, 95% CI: 1244–6340 g), with A/G and WC among males with NW (0.01, 95% CI: 0–0.2 and 10 mm, 95% CI: 4–16 mm, respectively), and negatively associated with WC among males with SO (−43 mm, −81 to −5 mm). Estradiol was positively associated with A/G, FM, and WC among males with SO, and VAT in females with NW.

Conclusion

Our findings showed that sex hormones were associated with adipose tissue deposition in youth across the weight spectrum.

Impact statement

  • Sex hormones (e.g., testosterone, estradiol) are associated with various adiposity measures among male and female children and adolescents across a weight status spectrum.

  • We evaluated associations between sex hormones and various adiposity measures among 8–21-year-olds across a weight status spectrum (normal weight, overweight/class 1 obesity, class 2–3 obesity). We found that estradiol was positively associated with total fat mass, android/gynoid ratio, and waist circumference in males with class 2–3 obesity, and testosterone was positively associated with lean mass in males with normal weight and overweight/class 1 obesity.

  • Sex hormones may influence, or may be influenced by, adiposity in youth.

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Data availability

Owing to the language used in the parental consent forms for this study regarding data sharing, the datasets cannot be shared externally.

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Acknowledgements

The authors would like to thank the individuals who participated in the parent research study from which these analyses were obtained. We also thank Ms. Rebecca Freese for statistical consulting.

Funding

Research reported in this publication was supported by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH) under award number R01 HL110957 (A.S.K.), and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the NIH under award number K23 DK125668 (E.M.B.). Additional support was provided by the NIH National Center for Advancing Translational Sciences (NCATS) under award number UL1TR002494, and an NIH NHLBI National Research Service Award (F32 HL127851-01; J.R.R.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Author information

Authors and Affiliations

  1. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA

    Subin Jang

  2. Center for Pediatric Obesity Medicine, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA

    Subin Jang, Aaron S. Kelly & Eric M. Bomberg

  3. Department of Surgery, Lurie Children’s Hospital, Chicago, IL, USA

    Justin R. Ryder

  4. Division of Endocrinology, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA

    Eric M. Bomberg

Authors
  1. Subin Jang
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  2. Justin R. Ryder
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  4. Eric M. Bomberg
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Contributions

S.J.: Analysis and interpretation of data, Drafting the article, revising it critically for important intellectual content, Final approval of the version to be published. J.R.R.: Substantial contributions to conception and design, acquisition of data, revising it critically for important intellectual content, Final approval of the version to be published. A.S.K.: Substantial contributions to conception and design, acquisition of data, revising it critically for important intellectual content, Final approval of the version to be published. E.M.B.: Substantial contributions to conception and design, interpretation of data, revising it critically for important intellectual content, Final approval of the version to be published.

Corresponding author

Correspondence to Subin Jang.

Ethics declarations

Competing interests

E.M.B. has been a site principal investigator and is a site co-investigator for Novo Nordisk. J.R. receives donation of drug/placebo for Boehringer Ingelheim. A.S.K. serves as an unpaid consultant for Novo Nordisk, Vivus, Eli Lilly, and Boehringer Ingelheim as well as receives donated drug/placebo from Novo Nordisk and Vivus for National Institute of Diabetes, and Digestive, and Kidney Diseases-funded clinical trials. All authors have no relevant conflicts of interest to disclose related to this work.

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Consent/assent were obtained from parents/guardians and participants, respectively.

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Jang, S., Ryder, J.R., Kelly, A.S. et al. Association between endogenous sex hormones and adiposity in youth across a weight status spectrum. Pediatr Res 97, 1892–1899 (2025). https://doi.org/10.1038/s41390-024-03578-6

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