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Hypogonadal Men with Higher Body Mass Index have Higher Bone Density and Better Bone Quality but Reduced Muscle Density

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Abstract

Although hypogonadism is a risk factor for bone loss and fractures, the different etiopathophysiology and hormonal profile of classical and obesity-induced hypogonadism may lead to differences in musculoskeletal profile. This is a cross-sectional study of hypogonadal men between 40 and 74 years old. Our outcomes include: areal bone mineral density (aBMD) and body composition by dual-energy X-ray absorptiometry; volumetric BMD (vBMD) and soft tissue composition of the tibia by peripheral quantitative computed tomography. Fracture risk assessment tool (FRAX) scores were evaluated. Testosterone, estradiol, luteinizing hormone, follicle stimulating hormone, sex hormone-binding globulin, C-telopeptide, osteocalcin, and sclerostin were measured. We divided the population into subgroups of BMI: group 1: BMI < 30; group 2: BMI ≥30 to <35 and group 3: BMI ≥ 35 kg/m2. One-hundred five men were enrolled. Spine and hip aBMD, and total and trabecular vBMD at the 4% tibia significantly increased with increasing BMI. Cortical thickness (330.7 ± 53.2, 343.3 ± 35.4, and 358.7 ± 38.2 mm, p = 0.04; groups 1, 2 and 3, respectively) and cortical area (5.3 ± 0.7, 5.5 ± 0.6, and 5.7 ± 0.6 mm, p = 0.01; groups 1, 2 and 3, respectively) at 38% tibia increased with increasing BMI. While absolute lean mass increased with increasing BMI, % lean mass and muscle density (70.2 ± 5.0, 71.3 ± 6.4, and 67.1 ± 5.1 mg/cm3; groups 1, 2 and 3, respectively) were lowest in group 3. Although severely obese hypogondal men have better BMD and bone quality, they have reduced muscle density, the significance of which remains to be determined.

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Acknowledgements

This study was supported by the resources at the New Mexico VA Health Care System in Albuquerque, NM, USA; the Biomedical Research of New Mexico Albuquerque, NM, USA; the Michael E. DeBakey VA Medical Center, Houston, TX, USA and the Center for Translational Research in Inflammatory Diseases (CTRID) at the Michael E. DeBakey VA Medical Center, Houston, TX.

Funding

This work was funded by VA Merit Review 5 101 CX00042403.

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Author notes

    Authors and Affiliations

    1. Department of Medicine, New Mexico VA Health Care System, Albuquerque, NM, USA

      Lina E. Aguirre, Richard Dorin, David Robbins & Clifford Qualls

    2. Biomedical Research of New Mexico, Albuquerque, NM, USA

      Lina E. Aguirre & Clifford Qualls

    3. University of New Mexico School of Medicine, Albuquerque, NM, USA

      Lina E. Aguirre, Richard Dorin, David Robbins & Clifford Qualls

    4. University Campus Bio-Medico of Rome, Rome, Italy

      Georgia Colleluori

    5. Department of Medicine, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd., Houston, TX, USA

      Georgia Colleluori, Rui Chen, Bryan Jiang, Dennis T. Villareal & Reina Armamento-Villareal

    6. Baylor College of Medicine, Houston, TX, USA

      Georgia Colleluori, Rui Chen, Bryan Jiang, Dennis T. Villareal & Reina Armamento-Villareal

    Authors
    1. Lina E. Aguirre
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    2. Georgia Colleluori
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    Contributions

    Author Contributions

    RAV designed the study. LA, GC, RD, DR, DV, RAV conducted the study and collected the data. LA, GC, CQ, DV, RAV analyzed and interpreted the data. LA, GC, RC, BJ, CQ, DV, RV drafted the manuscript. Revising manuscript content and approving the final version: all take responsibility for the manuscript content, the integrity of the data analysis and approval of the final version of the manuscript.

    Corresponding author

    Correspondence to Reina Armamento-Villareal.

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    Conflict of interest

    Lina E. Aguirre, Georgia Colleluori, Richard Dorin, David Robbins, Rui Chen, Bryan Jiang, Clifford Qualls, Dennis T. Villareal, Reina Armamento-Villareal declare that they have no conflict of interest.

    Human and Animal Rights and Informed Consent

    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

    Additional information

    Lina E. Aguirre and Georgia Colleluori contributed equally to this manuscript and are considered as co-first authors.

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    Aguirre, L.E., Colleluori, G., Dorin, R. et al. Hypogonadal Men with Higher Body Mass Index have Higher Bone Density and Better Bone Quality but Reduced Muscle Density. Calcif Tissue Int 101, 602–611 (2017). https://doi.org/10.1007/s00223-017-0316-x

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    • DOI: https://doi.org/10.1007/s00223-017-0316-x

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