. 2022 Apr 29;14(9):1873. doi: 10.3390/nu14091873

Table 1.

Definition of Clinical Indicators of LEA.

Primary Indicators	Secondary Indicators
Low T₃: lowest quartile * (<3.5 pmmol/L) [5]. Low total or free testosterone: Lowest quartile (<16 nmol/L, <333 pmol/L, respectively) [5]. Low BMD: Z-score <−1 for either AP spine or proximal femur [5,7]. Low body weight: Body Mass Index (BMI) <18.5 kg/m² [5,91].	Low RMR_ratio [5] lowest quartile for the testing method (<1.11 for first principles and <0.88 for metabolic cart measures). Hypotension: <90 mmHg systolic and/or diastolic <60 mmHg [59]. Low body fat: <5% as measured by DXA [92]. Low IGF-1: lowest quartile of the age dependent reference range at the testing site [90]. High LDL cholesterol (>3mmol/L) [59]. High cortisol (>550 nmol/L) or cortisol (nmol/l) insulin ratio (pmol/l) (>26.6).

Primary Indicators

Secondary Indicators

Low T₃: lowest quartile * (<3.5 pmmol/L) [5].
Low total or free testosterone: Lowest quartile (<16 nmol/L, <333 pmol/L, respectively) [5].
Low BMD: Z-score <−1 for either AP spine or proximal femur [5,7].
Low body weight: Body Mass Index (BMI) <18.5 kg/m² [5,91].

Low RMR_ratio [5] lowest quartile for the testing method (<1.11 for first principles and <0.88 for metabolic cart measures).
Hypotension: <90 mmHg systolic and/or diastolic <60 mmHg [59].
Low body fat: <5% as measured by DXA [92].
Low IGF-1: lowest quartile of the age dependent reference range at the testing site [90].
High LDL cholesterol (>3mmol/L) [59].
High cortisol (>550 nmol/L) or cortisol (nmol/l) insulin ratio (pmol/l) (>26.6).

Subjects were categorized as LEA if they had two or more primary indicators or three or more indicators overall. * “Lowest quartile” refers to the lowest quartile of the reference range at the specific testing site where the measure was taken.