A body shape index reflects body composition changes in response to TRT in obese men

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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.

In conclusion, a simple and readily available anthropomorphic measure of body shape (ABSI) reflected the differential loss of fat mass observed in dieting obese men and responded more sensitively to testosterone treatment than other traditional markers of obesity risk, such as weight, BMI, and waist circumference. It may therefore be clinically useful and warrants further evaluation as a prognostic marker to monitor potentially metabolically relevant changes in body composition in response to more weight and BMI-neutral interventions such as testosterone treatment.


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