Body mass index, waist circumference and waist to hip ratio and change in sex steroid hormones: the Massachusetts Male Ageing Study.
OBJECTIVE
Cross-sectional data suggest that obesity, particularly central obesity, may be associated with decreased production of sex steroid hormones in men. However, longitudinal hormone data on men in relation to obesity status are limited. Previous studies have not consistently demonstrated whether sex steroids are associated specifically to body mass index or to measures of central obesity. Our objective was to examine the relation of obesity (body mass index > 30 kg/m2), and of central obesity (waist circumference > 100 cm or waist to hip ratio > 0.95) to longitudinal change in sex steroid hormones in men.


METHODS
Prospective follow-up of a population-based sample of men in Boston.


METHODS
Nine hundred forty-two (942) men in the Massachusetts Male Ageing Study with complete anthropometry and hormone data at baseline (1987-1989, ages 40-70) and follow-up (1995-1997).


METHODS
Free and total testosterone (FT and TT), dehydroepiandrosterone sulphate (DHEAS), and sex hormone-binding globulin (SHBG) were assessed using standardized methods. Health behaviours and medical history were obtained by structured interview. Repeated measures regression was used to describe trends in steroid hormones and SHBG in relation to obesity status, adjusting for age, smoking, alcohol, comorbidities, and physical activity.


RESULTS
Obesity was associated with decreased levels of total and free testosterone, and of SHBG at follow-up relative to baseline. For any given baseline concentration of TT, FT or SHBG, follow-up levels were lowest among men who remained obese or who became obese during follow-up. This was true for all three indices of obesity. Central adiposity was associated with lower DHEAS levels at follow-up, while elevated body mass index was not.


CONCLUSIONS
Obesity may predict greater decline in testosterone and SHBG levels with age. Central adiposity may be a more important predictor of decline in DHEAS than is body mass index.
Derby
Carol A
CA
Albert Einstein College of Medicine, Bronx, NY 10461, USA. cderby@aecom.yu.edu
Zilber
Sophia
S
Brambilla
Don
D
Morales
Knashawn H
KH
McKinlay
John B
JB
D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology*; D000886:Anthropometry; D001824:Body Constitution; D015992:Body Mass Index; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000097:blood* / Q000503:physiopathology; D011446:Prospective Studies; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013739:Testosterone / Q000097:blood; D049629:Waist-Hip Ratio
D012739:Gonadal Steroid Hormones; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D019314:Dehydroepiandrosterone Sulfate