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Clinical Research

A body shape index (ABSI) reflects body composition changes in response to testosterone treatment in obese men

International Journal of Obesity volume 43, pages 2210–2216 (2019)Cite this article

Subjects

Abstract

Background

Interventions such as testosterone treatment may change body composition and metabolic outcomes without substantial changes in weight and BMI.

Objectives

Using testosterone treatment as a paradigm, we hypothesized that a body shape index (ABSI) reflects body composition changes more accurately than traditional markers, such as weight, BMI and waist circumference.

Intervention

Secondary analysis of a 56-week RCT in 100 dieting obese men with low–normal testosterone receiving testosterone treatment or placebo, and subsequent off-treatment follow-up.

Results

At the end of the trial period, ABSI—unlike weight, BMI or waist circumference—had significantly decreased in the treatment group, compared with placebo (mean adjusted difference −0.18 [95% CI: −0.32, −0.05] × 10−2 m11/6kg−2/3, overall P<0.001). Changes in ABSI during the active trial phase correlated with changes in fat mass (tau = 0.18, P = 0.02), and not with lean mass (tau = −0.11, P = 0.14), BMI (tau = 0.10, P = 0.17), or visceral fat (tau = 0.07, P = 0.37). ABSI baseline values were positively correlated with waist circumference (tau = 0.21, P = 0.002) and visceral fat (tau = 0.18, P = 0.009), correlated inversely with lean mass (tau = −0.21, P = 0.002), and were uncorrelated with BMI (tau = −0.10, P = 0.15) and fat mass (tau = 0.01, P = 0.83). Two years after cessation of treatment, ABSI again reflected body composition as the between-group differences in all parameters did not persist.

Conclusions

A readily obtainable anthropomorphic measure, ABSI reflects the differential loss of fat mass mediated by testosterone in dieting obese men more closely than BMI or waist circumference. It may serve as a clinically useful marker to monitor body composition changes, particularly in response to interventions.

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References

  1. Wu FCW, Tajar A, Pye SR, Silman AJ, Finn JD, O’Neill TW, et al. Hypothalamic-pituitary-testicular axis disruptions in older men are differentially linked to age and modifiable risk factors: the European male aging study. J Clin Endocrinol Metab. 2008;93:2737–45.

    Article  CAS  Google Scholar 

  2. Grossmann M. Hypogonadism and male obesity: focus on unresolved questions. Clin Endocrinol (Oxf). 2018;89:11–21.

    Article  Google Scholar 

  3. Bhasin S. The brave new world of function-promoting anabolic therapies: testosterone and frailty. J Clin Endocrinol Metab. 2010;95:509–11.

    Article  CAS  Google Scholar 

  4. Corona G, Giagulli VA, Maseroli E, Vignozzi L, Aversa A, Zitzmann M, et al. Testosterone supplementation and body composition: Results from a meta-analysis of observational studies. J Endocrinol Invest. 2016;39:967–81.

    Article  CAS  Google Scholar 

  5. Storer TW, Basaria S, Traustadottir T, Harman SM, Pencina K, Li Z, et al. Effects of testosterone supplementation for 3 years on muscle performance and physical function in older men. J Clin Endocrinol Metab. 2017;102:583–93.

    PubMed  Google Scholar 

  6. Traish AM, Haider A, Haider KS, Doros G, Saad F. Long-term testosterone therapy improves cardiometabolic function and reduces risk of cardiovascular disease in men with hypogonadism: A real-life observational registry study setting comparing treated and untreated (control) groups. J Cardiovasc Pharmacol Ther. 2017;22:414–33.

    Article  CAS  Google Scholar 

  7. Haider KS, Haider A, Doros G, Traish A. Long-term testosterone therapy improves urinary and sexual function, and quality of life in men with hypogonadism: results from a propensity matched subgroup of a controlled registry study. J Urol. 2018;199:257–65.

    Article  CAS  Google Scholar 

  8. Ng Tang Fui M, Prendergast LA, Dupuis P, Raval M, Strauss BJ, Zajac JD, et al. Effects of testosterone treatment on body fat and lean mass in obese men on a hypocaloric diet: a randomised controlled trial. BMC Med. 2016;14:153.

    Article  Google Scholar 

  9. Romero-Corral A, Lopez-Jimenez F, Sierra-Johnson J, Somers VK. Differentiating between body fat and lean mass-how should we measure obesity. Nat Clin Pract Endocrinol Metab. 2008;4:322–3.

    Article  Google Scholar 

  10. Okorodudu DO, Jumean MF, Montori VM, Romero-Corral A, Somers VK, Erwin PJ, et al. Diagnostic performance of body mass index to identify obesity as defined by body adiposity: a systematic review and meta-analysis. Int J Obes (Lond). 2010;34:791–9.

    Article  CAS  Google Scholar 

  11. Segal KR, Dunaif A, Gutin B, Albu J, Nyman A, Pi-Sunyer FX. Body composition, not body weight, is related to cardiovascular disease risk factors and sex hormone levels in men. J Clin Invest. 1987;80:1050–5.

    Article  CAS  Google Scholar 

  12. Bigaard J, Frederiksen K, Tjønneland A, Thomsen BL, Overvad K, Heitmann BL, et al. Body fat and fat-free mass and all-cause mortality. Obes Res. 2004;12:1042–9.

    Article  Google Scholar 

  13. Gómez-Ambrosi J, Silva C, Galofré JC, Escalada J, Santos S, Millán D, et al. Body mass index classification misses subjects with increased cardiometabolic risk factors related to elevated adiposity. Int J Obes (Lond). 2012;36:286–94.

    Article  Google Scholar 

  14. Nevill AM, Stewart AD, Olds T, Holder R. Relationship between adiposity and body size reveals limitations of BMI. Am J Phys Anthropol. 2006;129:151–6.

    Article  Google Scholar 

  15. Balkau B, Deanfield JE, Després JP, Bassand JP, Fox KA, Smith SC, et al. International day for the evaluation of abdominal obesity (IDEA): a study of waist circumference, cardiovascular disease, and diabetes mellitus in 168,000 primary care patients in 63 countries. Circulation. 2007;116:1942–51.

    Article  Google Scholar 

  16. Moore SC. Waist versus weight: which matters more for mortality. Am J Clin Nutr. 2009;89:1003–4.

    Article  CAS  Google Scholar 

  17. World Health Organisation. Waist Circumference and Waist-Hip Ratio: Report of a WHO Expert Consultation, Geneva, 8–11 December 2008. Technical Report, World Health Organization, 2011.

  18. Krakauer NY, Krakauer JC. A new body shape index predicts mortality hazard independently of body mass index. PLoS One. 2012;7:e39504.

    Article  CAS  Google Scholar 

  19. Krakauer NY, Krakauer JC. Untangling waist circumference and hip circumference from body mass index with a body shape index, hip index, and anthropometric risk indicator. Metab Syndr Relat Disord. 2018;16:160–5.

    Article  Google Scholar 

  20. Krakauer NY, Krakauer JC. Dynamic association of mortality hazard with body shape. PLoS ONE. 2014;9:e88793.

    Article  Google Scholar 

  21. Ji M, Zhang S, An R. Effectiveness of a body shape index (ABSI) in predicting chronic diseases and mortality: a systematic review and meta-analysis. Obes Rev. 2018;19:737–59.

    Article  CAS  Google Scholar 

  22. Harwood DT, Handelsman DJ. Development and validation of a sensitive liquid chromatography-tandem mass spectrometry assay to simultaneously measure androgens and estrogens in serum without derivatization. Clin Chim Acta. 2009;409:78–84.

    Article  CAS  Google Scholar 

  23. Ng Tang Fui M, Hoermann R, Zajac JD, Grossmann M. The effects of testosterone on body composition in obese men are not sustained after cessation of testosterone treatment. Clin Endocrinol (Oxf). 2017;87:336–43.

    Article  Google Scholar 

  24. Mason C, Katzmarzyk PT. Variability in waist circumference measurements according to anatomic measurement site. Obesity . 2009;17:1789–95.

    Article  Google Scholar 

  25. Kapoor D, Clarke S, Stanworth R, Channer KS, Jones TH. The effect of testosterone replacement therapy on adipocytokines and C-reactive protein in hypogonadal men with type 2 diabetes. Eur J Endocrinol. 2007;156:595–602.

    Article  CAS  Google Scholar 

  26. Heymsfield SB, Martin-Nguyen A, Fong TM, Gallagher D, Pietrobelli A. Body circumferences: clinical implications emerging from a new geometric model. Nutr Metab (Lond). 2008;5:24.

    Article  Google Scholar 

  27. Vermeulen A, Verdonck L, Kaufman JM. A critical evaluation of simple methods for the estimation of free testosterone in serum. J Clin Endocrinol Metab. 1999;84:3666–72.

    Article  CAS  Google Scholar 

  28. R Core Team. R: a language and environment for statistical computing. R Foundation for Statistical Computing. 2016;ISBN 3-900051-07-0. https://CRAN.R-project.org/.

  29. Bates D, Mächler M, Bolker B, Walker S. Fitting linear mixed-effects models using lme4. J Stat Softw. 2015;67:1–48.

    Article  Google Scholar 

  30. De Rosario-Martinez H phia: Post-hoc interaction analysis. R package version 0.2-1. 2015. https://CRAN.R-project.org/package=phia.

  31. Weinheimer EM, Sands LP, Campbell WW. A systematic review of the separate and combined effects of energy restriction and exercise on fat-free mass in middle-aged and older adults: implications for sarcopenic obesity. Nutr Rev. 2010;68:375–88.

    Article  Google Scholar 

  32. Snyder PJ, Peachey H, Berlin JA, Hannoush P, Haddad G, Dlewati A, et al. Effects of testosterone replacement in hypogonadal men. J Clin Endocrinol Metab. 2000;85:2670–7.

    CAS  PubMed  Google Scholar 

  33. Biolo G, Di Girolamo FG, Breglia A, Chiuc M, Baglio V, Vinci P, et al. Inverse relationship between “a body shape index” (ABSI) and fat-free mass in women and men: insights into mechanisms of sarcopenic obesity. Clin Nutr. 2015;34:323–7.

    Article  Google Scholar 

  34. Gomez-Peralta F, Abreu C, Cruz-Bravo M, Alcarria E, Gutierrez-Buey G, Krakauer NY, et al. Relationship between “a body shape index (ABSI)” and body composition in obese patients with type 2 diabetes. Diabetol Metab Syndr. 2018;10:21.

    Article  Google Scholar 

  35. Dhindsa S, Miller MG, McWhirter CL, Mager DE, Ghanim H, Chaudhuri A, et al. Testosterone concentrations in diabetic and nondiabetic obese men. Diabetes Care. 2010;33:1186–92.

    Article  CAS  Google Scholar 

  36. Tay L, Ding YY, Leung BP, Ismail NH, Yeo A, Yew S, et al. Sex-specific differences in risk factors for sarcopenia amongst community-dwelling older adults. Age (Dordr). 2015;37:121.

    Article  CAS  Google Scholar 

  37. Grossmann M, Matsumoto AM. A perspective on middle-aged and older men with functional hypogonadism: focus on holistic management. J Clin Endocrinol Metab. 2017;102:1067–75.

    PubMed  PubMed Central  Google Scholar 

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Acknowledgements

MNTF was supported by a postgraduate scholarship (1055305) and MG by a Career Development Fellowship (1024139), both from the National Health and Medical Research Council (Australia). Bayer Pharma AG (Berlin, Germany) provided testosterone, placebo and financial support to conduct investigations during the RCT phase but did not provide funding for the extended follow-up study. Bayer Pharma AG had no role in trial design, data analysis or writing the paper.

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Authors and Affiliations

  1. Department of Medicine Austin Health, University of Melbourne, Heidelberg, VIC, Australia

    Rudolf Hoermann, Mark Ng Tang Fui & Mathis Grossmann

  2. Department of Endocrinology, Austin Health, Heidelberg, VIC, Australia

    Mark Ng Tang Fui & Mathis Grossmann

  3. Metro Detroit Diabetes and Endocrinology, Southfield, MI, USA

    Jesse C. Krakauer

  4. Department of Civil Engineering, City College of New York, New York, NY, USA

    Nir Y. Krakauer

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  1. Rudolf Hoermann
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Correspondence to Rudolf Hoermann.

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Conflict of interest

MG has received research funding from Bayer Pharma, Novartis, Weight Watchers, Lilly, and speaker’s honoraria from Besins Healthcare. MNTF has received research funding from Bayer Pharma. RH, JCK, and NYK have nothing to declare.

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Hoermann, R., Fui, M.N.T., Krakauer, J.C. et al. A body shape index (ABSI) reflects body composition changes in response to testosterone treatment in obese men. Int J Obes 43, 2210–2216 (2019). https://doi.org/10.1038/s41366-018-0311-y

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