Association of Waist-Height-Ratio, Waist Circumference, and Body Mass Index with Serum Testosterone Level in Apparently Healthy Men
Biochemistry and Molecular Biology
Volume 4, Issue 1, January 2019, Pages: 1-5
Received: Feb. 9, 2019;
Accepted: Mar. 11, 2019;
Published: Apr. 13, 2019
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Agbecha Ayu, Department of Chemical Pathology, Federal Medical Center, Makurdi, Nigeria
Gberindyer James Saa-Aondo, Department of Veterinary Pathology, University of Agriculture, Makurdi, Nigeria
Previous studies have shown that waist circumference (WC) may be a better predictor of serum testosterone level than body mass index (BMI). The determination of the waist-to-height ratio (WHt ratio) is reported to have certain advantages over other adiposity measures. Our study thus aimed at examining the utility of WHt ratio in addition to WC and BMI in determining their association with testosterone level. The case-control study involved apparently healthy male participants aged between 40 to 60 years. The study participants were divided into normal and abnormal groups according to WC, BMI, WHt ratio with their mean total testosterone level compared. The correlations of total testosterone and adiposity measures along with age adjustments were also determined. Individuals with WC>100cm had a significant low (P=0.003) testosterone level compared to their counterparts with WC<100cm. A significantly lowered (P=0.042) testosterone was observed in the study group with BMI>25kg/m2 compared to the group with <25kg/m2. The study group with a WHt ratio of >0.5 had a significantly lower (P=0.012) testosterone than the group with <0.5. An inverse correlation of testosterone was observed with age (r=-0.567), BMI (r=-0.265), WC (r=-0.406), and WHt ratio (r=-0.412) in the apparently healthy Men studied. After adjustment for age, the correlation observed between testosterone and BMI (P=0.010), testosterone and WC (P=0.004), testosterone and WHt ratio (P=0.014) remained significant. After height adjustment, the correlation between testosterone and WHt ratio (P=0.002) also remained significant. In conclusion, the WHt ratio and WC independent of age were the best predictors of the total testosterone level in men.
Gberindyer James Saa-Aondo,
Association of Waist-Height-Ratio, Waist Circumference, and Body Mass Index with Serum Testosterone Level in Apparently Healthy Men, Biochemistry and Molecular Biology.
Vol. 4, No. 1,
2019, pp. 1-5.
Bhasin S, Brito JP, Cunningham GR, Hayes FJ, Hodis HN, Matsumotom AM, et al. Testosterone therapy in men with hypogonadism: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2018; 103 (5): 1715– 44.
Goodale T, Sadhu A, Petak S, Robbins R. Testosterone and the Heart. Methodist Debakey Cardiovasc J 2017; 13 (2): 68-72.
Lv W, Du N, Liu Y, Fan X, Wang Y, Jia X, et al. Low Testosterone Level and Risk of Alzheimer's Disease in the Elderly Men: a Systematic Review and Meta-Analysis. Mol Neurobiol 2016 May; 53 (4): 2679-84. doi: 10.1007/s12035-015-9315-y.
Shamim MO, Ali Khan FM, Arshad R. Association between serum total testosterone and Body Mass Index in middle aged healthy men. Pak J Med Sci 2015; 31 (2): 355-9.
Rotter I, Rył A, Grzesiak K, Szylińska A, Pawlukowska W, Lubkowska A. et al. Cross-Sectional Inverse Associations of Obesity and Fat Accumulation Indicators with Testosterone in Non-Diabetic Aging Men. Int J Environ Res Public Health 2018; 15 (6): 1207. Published 2018 Jun 8. doi: 10.3390/ijerph15061207
Jabłonowska-Lietz B, Wrzosek M, Włodarczyk M, Nowicka G. New indexes of body fat distribution, visceral adiposity index, body adiposity index, waist-to-height ratio, and metabolic disturbances in the obese. Kardiol Pol 2017; 75 (11): 1185-1191. doi: 10.5603/KP.a2017.0149
Yassin AA, Nettleship JE, Salman M, Almehmadi Y. Waist circumference is superior to weight and BMI in predicting sexual symptoms, voiding symptoms and psychosomatic symptoms in men with hypogonadism and erectile dysfunction. Andrologia 2017; 49: e12634.
Browning LM, Hsieh SD, Ashwell M. A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0.5 could be a suitable global boundary value. Nutrition Research Reviews 2010; 23 (2): 247-269.
Yoo EG. Waist-to-height ratio as a screening tool for obesity and cardiometabolic risk. Korean J Pediatr 2016; 59 (11): 425-431.
Aguilar-Morales I, Colin-Ramirez E, Rivera-Mancía S, Vallejo M, Vázquez-Antona C. Performance of Waist-To-Height Ratio, Waist Circumference, and Body Mass Index in Discriminating Cardio-Metabolic Risk Factors in a Sample of School-Aged Mexican Children. Nutrients 2018; 10 (12): 1850. Published 2018 Dec 1. doi: 10.3390/nu10121850
Sinaga M, Worku M, Yemane T, Tegene E. Wakayo T, Girma T. et al. Optimal cut-off for obesity and markers of metabolic syndrome for Ethiopian adults. Nutr J 2018; 17 (1): 109. Published 2018 Nov 22. doi: 10.1186/s12937-018-0416-0
World Health Organization. Obesity: preventing and managing the global epidemic. WHO: Geneva, Switzerland, 2000. Technical report no. 894.
Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. American Heart Association; National Heart, Lung, and Blood Institute. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005; 112 (17): 2735-52.
World Health Organization. Obesity and overweight. WHO: Geneva, Switzerland, 2018. Fact sheet
Yao QM, Wang B, An XF, Zhang JA, Ding L. Testosterone level and risk of type 2 diabetes in men: a systematic review and meta-analysis. Endocr Connect 2017; 7 (1): 220-231.
Mohr BA, Bhasin S, Link CL, O'Donnell AB, McKinlay JB. The effect of changes in adiposity on testosterone levels in older men: longitudinal results from the Massachusetts male aging study. Eur J Endocrinol. 2006; 155 (3): 443–52.
Tajar A, Huhtaniemi IT, O'Neill TW, Finn JD, Pye SR, Lee DM, et al. Characteristics of androgen deficiency in late-onset hypogonadism: results from the European Male Aging Study (EMAS). J Clin Endocrinol Metab 2012; 97 (5): 1508–16.
Jaworski PED, Ramos A, Nicoleit AR, Bacarin LF, Neto PO. Importance of abdominal circumference and body mass index values in predicting male hypogonadism – A practicalapproach. Arch Endocrinol Metab 2017; 61.
Allan CA, Peverill RE, Strauss BJ, Forbes EA, McLachlan RI. Waist-to-height ratio as a predictor of serum testosterone in aging men with symptoms of androgen deficiency. Asian J Androl. 2011; 13 (3): 424-31. doi: 10.1038/aja.2011.13.
Fillo J, Levcikova M, Ondrusova M, Breza J, Labas P. Importance of Different Grades of Abdominal Obesity on Testosterone Level, Erectile Dysfunction, and Clinical Coincidence. American Journal of Men’s Health 2017; 11 (2) 240–245 DOI: 10.1177/1557988316642213.
Wu F, Tajar A, Beynon J, Pye S, Silman A, Finn J, et al. Identification of late-onset hypogonadism in middle-aged and elderly men. N Engl J Med 2010; 363: 123–135.
Travison TG, Araujo AB, Kupelian V, O'Donnell AB, McKinlay JB. The relative contributions of aging, health, and lifestyle factors to serum testosterone decline in men. J Clin Endocrinol Metab. 2007; 92 (2): 549-55.
Daka B, Rosen T, Jansson PA, Råstam L, Larsson CA, Lindblad U. Inverse association between serum insulin and sex hormone-binding globulin in a population survey in Sweden. Endocr Connect. 2012; 2 (1): 18-22. Published 2012 Nov 19. doi: 10.1530/EC-12-0057.
Winters SJ, Gogineni J, Karegar M, Scoggins C, Wunderlich CA, Baumgartner R, et al. Sex Hormone-Binding Globulin Gene Expression and Insulin Resistance, The Journal of Clinical Endocrinology & Metabolism 2014, 99 (12), E2780–E2788, https://doi.org/10.1210/jc.2014-2640.
Ahn SW, Gang GT, Kim YD, Ahn RS, Harris RA, Lee CH, et al. Insulin directly regulates steroidogenesis via induction of the orphan nuclear receptor DAX-1 in testicular Leydig cells. J Biol Chem 2013; 288 (22): 15937-46.
Pelusi C & Pasquali R. The Significance of Low Testosterone Levels in Obese Men. Curr Obes Rep 2012; 1 (4): 181–190. DOI 10.1007/s13679-012-0029-4.
Kang YE, Kim JM, Joung KH, Lee JH, You BR, Choi MJ. et al. The Roles of Adipokines, Proinflammatory Cytokines, and Adipose Tissue Macrophages in Obesity-Associated Insulin Resistance in Modest Obesity and Early Metabolic Dysfunction. PLoS One 2016; 11 (4): e0154003. doi: 10.1371/journal.pone.0154003.
Ouchi N, Ohashi K, Shibata R, Murohara T. Adipocytokines and obesity-linked disorders. Nagoya J Med Sci. 2012; 74 (1-2): 19–30.