Recategorisation of body mass index to achieve andrological predictive power: a study in more than 20 000 patients
Nicolás Ramírez A , Rosa Inés Molina B , Andrea Tissera B , Eugenia Mercedes Luque A , Pedro Javier Torres A C , Santiago Bianconi A C , Fernando Beltramone D , José Sad-Larcher D , Gustavo Estofán D , Arnaldo Mangeaud E * and Ana Carolina Martini
A C F *
+ Author Affiliations
- Author Affiliations
A Instituto de Fisiología, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Santa Rosa 1085, X5000ESU Córdoba, Argentina.
B Laboratorio de Andrología y Reproducción, Chacabuco 1089, X5000IIK Córdoba, Argentina.
C Instituto de Investigaciones en Ciencias de la Salud, Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET)–Facultad de Ciencias Médicas, Enrique Barros, Pabellón de Biología Celular, X5000 Córdoba, Argentina.
D Centro Integral de Ginecología, Obstetricia y Reproducción, Chacabuco 1123, X5000IIL Córdoba, Argentina.
E Cátedra de Bioestadística, Facultad de Ciencias Exactas, Físicas y Naturales, Universidad Nacional de Córdoba, Vélez Sarsfield 299, 5000 Córdoba, Argentina.
F Corresponding author. Email: acmartini2000@yahoo.com
Reproduction, Fertility and Development 32(7) 648-656 https://doi.org/10.1071/RD19429
Submitted: 27 November 2019 Accepted: 30 December 2019 Published: 11 March 2020
Abstract
The aim of this study was to recategorise body mass index (BMI) in order to classify patients according to their risk of semen abnormalities. Patients (n = 20 563) presenting at an andrology laboratory were classified into five groups according to BMI: underweight (BMI <20 kg m−2), normal weight (BMI 20–24.9 kg m−2), overweight (BMI 25–29.9 kg m−2), obese (BMI 30–39.9 kg m−2) and morbidly obese (BMI >40 kg m−2). Semen quality was evaluated to determine: (1) differences between groups using analysis of variance (ANOVA); (2) the chances of semen abnormalities (using generalised linear models, Chi-squared tests and odds ratios); (3) reference BMI values with andrological predictive power (multivariate conglomerate analyses and multivariate analysis of variance (MANOVA)); and (4) expected values of abnormalities for each new group resulting from BMI recategorisation. Morbidly obese and underweight patients exhibited the highest decrease in semen quality and had higher chances of semen abnormalities. The smallest number of sperm abnormalities was found at a BMI of 27 kg m−2. Four reference values were identified, recategorising BMI into four groups according to their risk of semen abnormalities (from lowest to highest risk): Group1,BMI between 20 and 32 kg m−2; Group2, BMI <20 and BMI >32–37 kg m−2; Group3, BMI >37–42 kg m−2; and Group4, BMI >42 kg m−2. A BMI <20 or >32 kg m−2 is negatively associated with semen quality; these negative associations on semen quality increase from a BMI >37 kg m−2 and increase even further for BMI >42 kg m−2. The BMI recategorisation in this study has andrological predictive power.
Additional keywords: morbid obesity, obesity, semen, sperm quality, underweight.
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