Lower testosterone levels predict increasing severity and worse outcomes of hepatitis B virus-related acute-on-chronic liver failure in males

Table 5 Results of Cox proportional hazards estimate of the composite outcome of death or liver transplant

Variables	Hazard ratio (95% CI)	P value
Model 1
TT (TT < 142.39 ng/dL vs TT≧142.39 ng/dL)	4.49 (2.12–9.53)	< 0.001
Model 2
TT (TT < 142.39 ng/dL vs TT≧142.39 ng/dL)	3.02 (1.33–6.86)	0.008
Age (years)		0.445
Body mass index (kg/m²)		0.511
1–Ln (sex-hormone-binding globulin [nmol/L])	2.04 (1.08–3.87)	0.028
1–Ln (free testosterone index [%])		0.508
SQRT (dehydroepiandrosterone sulfate [μg/dL])		0.570
SQRT (cortisol [μg/dL])	1.75 (1.32–2.31)	< 0.001
SQRT (androstenedione [ng/mL])		0.353
Model 3
TT (TT < 142.39 ng/dL vs TT≧142.39 ng/dL)	2.57 (1.09–6.02)	0.030
Age (years)		0.837
Body mass index (kg/m²)		0.941
1–Ln (sex-hormone-binding globulin [nmol/L])		0.701
1–Ln (free testosterone index [%])		0.921
SQRT (cortisol [μg/dL])		0.083
SQRT (androstenedione [ng/mL])		0.068
International normalized ratio	2.32 (1.74–3.11)	< 0.001
Ln (urea nitrogen [mmol/L])	2.65 (1.82–3.85)	< 0.001
Total bilirubin (μmol/L)		0.246
Direct bilirubin (μmol/L)		0.410
Ln (white blood cell count [10⁹/L])		0.100
Ln (platelet count [10⁹/L])		0.641
Ln (total cholesterol [mmol/L])		0.343
Total protein (g/L)		0.143

Cox proportional hazards regression models for total testosterone (TT, Model 1) and models additionally adjusted for age; body mass index; sex-hormone-binding globulin; free testosterone index; cortisol; androstenedione; international normalized ratio; urea nitrogen; total bilirubin; direct bilirubin; white blood cell count; platelet count; total cholesterol and total protein. Hazard ratios are given with 95% confidence intervals within parentheses. The null hypotheses for all proportional hazard assumptions tests were not rejected for total testosterone in any model. Twenty-three patients received liver transplants and 32 died within 90 days

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