Waist circumference does not reflect body fat distribution and insulin resistance in young male patients with idiopathic hypogonadotrophic hypogonadism
Aydogan Aydogdu1, Özge Kücükerdonmez1, Gökhan Üçkaya1, Abdullah Taslipinar1, S Erol Bolu1, Y Alper Sönmez1, Ümit Aydogan2 & Mustafa Kutlu1
Hypogonadism is associated with increased body fat content and insulin resistance. Many associations including ADA, IDF and EASD declare that waist circumference is a reliable measure of visceral adiposity and may account for insulin resistance. Our observations in young male patients with idiopathic hypogonadotrophic hypogonadism (IHH) are opposite. Thus, we aimed to compare body fat content and anthropometric measurements between patients and age-matched eugonadal healthy controls. Forty-nine new diagnosed patients with IHH (mean±S.D., age; 21.7±2.5 years, BMI; 23.2±3.3 kg/m2) and 44 healthy age-matched control (age; 21.4±1.1 years, BMI; 22.8±2.5 kg/m2) were examined with skin-fold caliper in triceps (TSFT), biceps (BSFT), suprailiac (SSFT) regions. Body fat percents (BFP) and truncal fat percents (TFP) were measured by 8-electrode bioimpedance device (BC-418, Tanita). Results were compared with waist circumference (WC) by MannWhitney U test. HOMA-IR was calculated with simultaneous fasting plasma glucose and insulin concentrations. Groups were statistically similar in age (P=0.303), BMI (P=0.887) and WC (80.8±7.6 vs 78.3±6.7 cm, P=0.141). HOMA-IR (2.69±1.6 vs 1.55±0.6, P=0.001) BFP (21.8±6.4 vs 10.3±4.7%, P=0.001), TFP (25.2±7 vs 15.6±6%, P=0.001), TSFT (15.7±4.1 vs 9.1±3.3 mm, P=0.001), BSFT (8.4±2.7 vs 5.1±1.7 mm, P=0.001), SSFT (17.4±6.6 vs 12.2±4.9 mm, P=0.001) were significantly increased in patients with IHH than controls. Waist circumference is not increased in hypogonadal young males with IHH than healthy age-matched control subjects, even though they are more insulin resistant according to HOMA-IR levels and having significantly higher truncal fat content. Diagnostic criteria for metabolic syndrome involve waist circumference. Our results show that significant increase in total and truncal fat content does not result in increased waist circumference but insulin resistance and subcutaneous fat in patients with IHH. Visceral adiposity unfavourably affect glucose metabolism but may not be the unique feature involved in insulin resistance. Waist circumference might be re-examined in some certain conditions that are associated with insulin resistance.