Dual-energy x-ray absorptiometry -derived adiposity and retinal arteriolar structure in men with hypogonadism: an exploratory cross-sectional pilot study

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Introduction Previous studies showed correlations between body mass index (BMI) and microvascular remodeling. Materials and methods Using Adaptive Optics, we assessed the retinal arteriolar morphology of men with hypogonadism undergoing a dual-energy x-ray absorptiometry (DXA) and an endocrinological evaluation. Obesity was defined according to total body fat (BF [%]) ≥ 30%. Results We recruited 43 men; 46.5% were people with obesity. People with obesity had a higher arteriolar wall thickness (WT) (12.87 µm vs 11.98 µm, p=0.025) and wall cross-sectional area (WCSA) (4558.46 µm2 vs 4006.76 µm2, p=0.022). WCSA and WT resulted directly associated with waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR); their association with BMI was not significant (p=0.052 and p=0.053). WT and WCSA were significantly associated with BF (%), Fat mass/height 2 , Estimated visceral adiposity mass. Wall-to-lumen ratio (WLR) was directly associated with global adiposity distribution indices like Android to gynoid ratio and % Fat trunk/% Fat legs. Conclusions People with obesity showed hypertrophic remodeling. WHR, WHtR and actual adiposity indices from DXA displayed numerically more robust associations with retinal parameters compared to BMI, which may not fully capture such vascular impairments. The alterations of retinal microcirculation could be differently influenced by the extension and distribution of adipose tissue.