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We conducted a sensitivity analysis with serum cotinine quartiles, and the s for Q2, Q3, and Q4 in model 3 were 3.67 (-10.50, 17.84), 21.69 (7.10, 36.28), and 35.94 (22.71, 49.16), respectively, participants in Q4 had 35.94 ng/dL higher total testosterone than Q1(p for trend 0.05)

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These findings underscore the pivotal role of the gut microbiome not only in intestinal health but also in the pathogenesis of a broad spectrum of systemic diseases, highlighting its potential as both a therapeutic target and a biomarker for disease detection

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