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Clinical Research

A body shape index (ABSI) reflects body composition changes in response to testosterone treatment in obese men



Interventions such as testosterone treatment may change body composition and metabolic outcomes without substantial changes in weight and BMI.


Using testosterone treatment as a paradigm, we hypothesized that a body shape index (ABSI) reflects body composition changes more accurately than traditional markers, such as weight, BMI and waist circumference.


Secondary analysis of a 56-week RCT in 100 dieting obese men with low–normal testosterone receiving testosterone treatment or placebo, and subsequent off-treatment follow-up.


At the end of the trial period, ABSI—unlike weight, BMI or waist circumference—had significantly decreased in the treatment group, compared with placebo (mean adjusted difference −0.18 [95% CI: −0.32, −0.05] × 10−2 m11/6kg−2/3, overall P<0.001). Changes in ABSI during the active trial phase correlated with changes in fat mass (tau = 0.18, P = 0.02), and not with lean mass (tau = −0.11, P = 0.14), BMI (tau = 0.10, P = 0.17), or visceral fat (tau = 0.07, P = 0.37). ABSI baseline values were positively correlated with waist circumference (tau = 0.21, P = 0.002) and visceral fat (tau = 0.18, P = 0.009), correlated inversely with lean mass (tau = −0.21, P = 0.002), and were uncorrelated with BMI (tau = −0.10, P = 0.15) and fat mass (tau = 0.01, P = 0.83). Two years after cessation of treatment, ABSI again reflected body composition as the between-group differences in all parameters did not persist.


A readily obtainable anthropomorphic measure, ABSI reflects the differential loss of fat mass mediated by testosterone in dieting obese men more closely than BMI or waist circumference. It may serve as a clinically useful marker to monitor body composition changes, particularly in response to interventions.

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MNTF was supported by a postgraduate scholarship (1055305) and MG by a Career Development Fellowship (1024139), both from the National Health and Medical Research Council (Australia). Bayer Pharma AG (Berlin, Germany) provided testosterone, placebo and financial support to conduct investigations during the RCT phase but did not provide funding for the extended follow-up study. Bayer Pharma AG had no role in trial design, data analysis or writing the paper.

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Correspondence to Rudolf Hoermann.

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MG has received research funding from Bayer Pharma, Novartis, Weight Watchers, Lilly, and speaker’s honoraria from Besins Healthcare. MNTF has received research funding from Bayer Pharma. RH, JCK, and NYK have nothing to declare.

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Hoermann, R., Fui, M.N.T., Krakauer, J.C. et al. A body shape index (ABSI) reflects body composition changes in response to testosterone treatment in obese men. Int J Obes 43, 2210–2216 (2019).

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