Serum testosterone levels may influence body composition and cardiometabolic health in men with spinal cord injury

Sally M Abilmona, Ryan M Sumrell, Ranjodh S Gill, Robert A Adler, Ashraf S Gorgey, Sally M Abilmona, Ryan M Sumrell, Ranjodh S Gill, Robert A Adler, Ashraf S Gorgey

Abstract

Study design: Cross-sectional study.

Objective: To establish the association between serum testosterone (T) levels, biomarkers of cardiometabolic health and regional body composition variables after spinal cord injury (SCI).

Setting: Medical research center.

Methods: Metabolic and body composition measurements were collected from thirty-six men with chronic motor complete SCI. Serum T, carbohydrate, and lipid profiles were measured after an overnight fast. Body composition was measured using anthropometrics, dual-energy X-ray absorptiometry, and magnetic resonance imaging. Participants were evenly classified into tertiles based on their serum T levels into low, mid-normal and normal ranges.

Results: Low, mid-normal, and normal range serum T were 288.8 ± 84.9 ng/dL, 461.0 ± 52.5 ng/dL and 648.0 ± 53.5 ng/dL, respectively. Low range serum T group had greater total (9.6%, P = 0.04) percentage fat mass and visceral adipose tissue (VAT) area (72%, P = 0.01) compared to normal range serum T group. Serum T was related to the absolute whole thigh muscle area (r = 0.40, P < 0.05) after controlling for body mass index. Serum T was negatively related to fasting plasma glucose (r = -0.46, P = 0.006) and insulin (r = -0.42, P = 0.01), HbA1c (r = -0.39, P = 0.02) and triglycerides (r = -0.36, P = 0.03).

Conclusion: Men with low serum T have more unfavorable body composition and cardiometabolic health outcomes after SCI. Testosterone replacement therapy may serve as a potential strategy in preventing cardiometabolic disorders after SCI.

Conflict of interest statement

Disclosure of interest:

The authors have no conflicts of interest.

Figures

Figure 1.
Figure 1.
Mean total, trunk and leg percent fat as analyzed by DXA based on low, mid-normal and normal serum testosterone levels. *P< 0.05 versus T≤ 400ng/dL.
Figure 2.
Figure 2.
Relationships between serum testosterone and MRI outcomes including (a) VATCSA, (b) VAT:SAT ratio, (c) absolute whole thigh muscle CSA and (d) thigh %IMF. The r and P values presented in relationship (c) are those after accounting for BMI as a covariate.
Figure 3.
Figure 3.
Relationships between serum testosterone and (a) serum TG, (b) fasting glucose, (c) fasting insulin and (d) insulin sensitivity (Si).

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