Resting energy expenditure is not increased in mildly hyperglycaemic obese diabetic patients

Resting energy expenditure (REE) is believed to be increased in type 2 diabetes, an increase that is associated with deteriorating glucose tolerance during its development. Meanwhile, insulin resistance, a state linked to obesity and observed in all type 2 diabetic patients, is associated with reduced REE. Our aim was to compare REE in obese patients with and without diabetes. REE, body composition (total body water, density, percentage fat and fat-free mass: 3-compartment model) and metabolic control were assessed in fifty obese Caucasian patients with diabetes (glycated haemoglobin level 7·6 (sd 1·5) %) and fifty obese patients who were non-diabetic. Despite being more overweight and younger, obese non-diabetic patients had an absolute REE (7·73 (sd 1·44) v. 8·12 (sd 1·37) MJ; P=0·17) and percentage fat-free mass similar to those of obese diabetic patients. Even when adjusted for differences in body composition, REE remained similar in both groups. Furthermore, REE (absolute and adjusted) was unaffected by both glucose level and control (glycated haemoglobin), with fat-free mass being the only determinant of REE. We conclude that REE is not necessarily increased by the presence of diabetes in obese people.

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Accuracy of predictive equations for evaluation of resting energy expenditure in Brazilian patients with type 2 diabetes.

10.21203/rs.3.rs-25229/v1 ◽

2020 ◽

Author(s):

Thaiciane Grassi ◽

Francesco Pinto Boeno ◽

Mauren Minuzzo de Freitas ◽

Tatiana Pedroso de Paula ◽

Luciana Vercoza Viana ◽

...

Keyword(s):

Type 2 Diabetes ◽

Body Composition ◽

Energy Expenditure ◽

Resting Energy Expenditure ◽

Fat Free Mass ◽

Composition Analysis ◽

Cross Sectional ◽

Predictive Equations ◽

Resting Energy

Abstract Background Evaluation of the resting energy expenditure (REE) is essential to ensure an appropriate dietary prescription for patients with type 2 diabetes. The aim of this study was to evaluate the accuracy of predictive equations for REE estimation in patients with type 2 diabetes, considering indirect calorimetry (IC) as the reference method.Methods A cross-sectional study was conducted in 62 patients (31 men and 31 women) with type 2 diabetes. Clinical and laboratory variables were evaluated, as well as body composition by electrical bioimpedance. The REE was measured by IC (QUARK RMR, Cosmed, Rome, Italy) and estimated by predictive equations. Data were analyzed using Bland–Altman plots, paired t-tests, and Pearson’s correlation coefficients.Results Patients in the sample had a mean age of 63.1 ± 5.2 years, median diabetes duration of 11 (1–36) years, and mean A1C of 7.6 ± 1.2%. Body composition analysis revealed a mean fat free mass of 35.2 ± 11.8 kg and fat mass of 29.1 ± 8.8 kg. There was wide variation in the accuracy of REE values predicted by equations when compared to those measured by IC. For women, the FAO/WHO/UNO equation provided the best REE prediction in comparison to measured REE (-1.8% difference). For men, the Oxford equation yielded values closest to those measured by IC (-1.3% difference).Conclusions In this sample of the patients with type 2 diabetes, the best predictive equations to estimate REE were FAO/WHO/UNO and Oxford for women and men, respectively.

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Resting energy expenditure in type 2 diabetic patients and the effect of insulin bolus

Diabetes Research and Clinical Practice ◽

10.1016/j.diabres.2014.09.016 ◽

2014 ◽

Vol 106 (3) ◽

pp. 605-610 ◽

Cited By ~ 10

Author(s):

Silvio Buscemi ◽

Maria Donatelli ◽

Giuseppe Grosso ◽

Sonya Vasto ◽

Fabio Galvano ◽

...

Keyword(s):

Energy Expenditure ◽

Resting Energy Expenditure ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Type 2 Diabetic ◽

Resting Energy

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Resting Energy Expenditure in Obese Women with Primary Hypothyroidism and Appropriate Levothyroxine Replacement Therapy

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa097 ◽

2020 ◽

Vol 105 (4) ◽

pp. e1741-e1748 ◽

Cited By ~ 3

Author(s):

Emanuele Muraca ◽

Stefano Ciardullo ◽

Alice Oltolini ◽

Francesca Zerbini ◽

Eleonora Bianconi ◽

...

Keyword(s):

Body Composition ◽

Energy Expenditure ◽

Replacement Therapy ◽

Resting Energy Expenditure ◽

Primary Hypothyroidism ◽

Normal Serum ◽

Fat Free Mass ◽

Model Assessment ◽

Obese Women ◽

Resting Energy

Abstract Context Growing evidence suggests that appropriate levothyroxine (LT4) replacement therapy may not correct the full set of metabolic defects afflicting individuals with hypothyroidism. Objective To assess whether obese subjects with primary hypothyroidism are characterized by alterations of the resting energy expenditure (REE). Design Retrospective analysis of a set of data about obese women attending the outpatients service of a single obesity center from January 2013 to July 2019. Patients A total of 649 nondiabetic women with body mass index (BMI) > 30 kg/m2 and thyrotropin (TSH) level 0.4–4.0 mU/L were segregated into 2 groups: patients with primary hypothyroidism taking LT4 therapy (n = 85) and patients with normal thyroid function (n = 564). Main outcomes REE and body composition assessed using indirect calorimetry and bioimpedance. Results REE was reduced in women with hypothyroidism in LT4 therapy when compared with controls (28.59 ± 3.26 vs 29.91 ± 3.59 kcal/kg fat-free mass (FFM)/day), including when adjusted for age, BMI, body composition, and level of physical activity (P = 0.008). This metabolic difference was attenuated only when adjustment for homeostatic model assessment of insulin resistance (HOMA-IR) was performed. Conclusions This study demonstrated that obese hypothyroid women in LT4 therapy, with normal serum TSH level compared with euthyroid controls, are characterized by reduced REE, in line with the hypothesis that standard LT4 replacement therapy may not fully correct metabolic alterations related to hypothyroidism. We are not able to exclude that this feature may be influenced by the modulation of insulin sensitivity at the liver site, induced by LT4 oral administration.

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Body composition and resting energy expenditure in humans: role of fat, fat-free mass and extracellular fluid

International Journal of Obesity ◽

10.1038/sj.ijo.0801317 ◽

2000 ◽

Vol 24 (9) ◽

pp. 1153-1157 ◽

Cited By ~ 46

Author(s):

S Nielsen ◽

DD Hensrud ◽

S Romanski ◽

JA Levine ◽

B Burguera ◽

...

Keyword(s):

Body Composition ◽

Energy Expenditure ◽

Extracellular Fluid ◽

Resting Energy Expenditure ◽

Fat Free Mass ◽

Resting Energy

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The Effect of Laparoscopic Gastric Plication Surgery on Body Composition, Resting Energy Expenditure, Thyroid Hormones, and Physical Activity in Morbidly Obese Patients

Bariatric Surgical Practice and Patient Care ◽

10.1089/bari.2015.0031 ◽

2015 ◽

Vol 10 (4) ◽

pp. 173-179 ◽

Cited By ~ 4

Author(s):

Motahareh Hasani ◽

Mehri Mirahmadian ◽

Ehsaneh Taheri ◽

Mostafa Qorbani ◽

Mohammad Talebpour ◽

...

Keyword(s):

Physical Activity ◽

Body Composition ◽

Energy Expenditure ◽

Thyroid Hormones ◽

Resting Energy Expenditure ◽

Morbidly Obese ◽

Gastric Plication ◽

Obese Patients ◽

Laparoscopic Gastric Plication ◽

Resting Energy

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Effects of a Personalized VLCKD on Body Composition and Resting Energy Expenditure in the Reversal of Diabetes to Prevent Complications

Nutrients ◽

10.3390/nu11071526 ◽

2019 ◽

Vol 11 (7) ◽

pp. 1526 ◽

Cited By ~ 2

Author(s):

Romano ◽

Marchetti ◽

Gualtieri ◽

Renzo ◽

Belcastro ◽

...

Keyword(s):

Body Composition ◽

Energy Expenditure ◽

Lean Mass ◽

Resting Energy Expenditure ◽

Protein Supplementation ◽

Rapid Weight Loss ◽

Prevention Of Diabetes ◽

Resting Energy

: The reversion of diabetes and the treatment of long-term obesity are difficult challenges. The failure mechanisms of rapid weight loss are mainly related to the wasting of lean mass. This single-arm study aims to evaluate the effects of a very low-calorie ketogenic diet (VLCKD) on body composition and resting energy expenditure in the short term reversal of diabetes mellitus Type 2. For eight weeks, subjects were administered a personalized VLCKD with protein intake based on lean mass and synthetic amino acidic protein supplementation. Each subject was assessed by anthropometry, Dual-energy X-ray Absorptiometry(DXA), bioimpedentiometric analysis (BIA), indirect calorimetry, and biochemical analysis. The main findings were the saving of lean mass, the reduction of abdominal fat mass, restored metabolic flexibility, the maintenance of resting energy expenditure, and the reversion of diabetes. These results highlight how the application of preventive, predictive, personalized, and participative medicine to nutrition may be promising for the prevention of diabetes and enhancement of obesity treatment.

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Resting Energy Expenditure and Body Composition in Overweight Men and Women Living in a Temperate Climate

Journal of Clinical Medicine ◽

10.3390/jcm9010203 ◽

2020 ◽

Vol 9 (1) ◽

pp. 203

Author(s):

Marcos Martin-Rincon ◽

Mario Perez-Valera ◽

David Morales-Alamo ◽

Ismael Perez-Suarez ◽

Cecilia Dorado ◽

...

Keyword(s):

Body Composition ◽

Energy Expenditure ◽

Resting Energy Expenditure ◽

The Body ◽

Temperate Climate ◽

Obese Patients ◽

Men And Women ◽

Significant Bias ◽

Overweight Or Obesity ◽

Resting Energy

This study aimed to determine whether the measured resting energy expenditure (REE) in overweight and obese patients living in a temperate climate is lower than the predicted REE; and to ascertain which equation should be used in patients living in a temperate climate. REE (indirect calorimetry) and body composition (DXA) were measured in 174 patients (88 men and 86 women; 20–68 years old) with overweight or obesity (BMI 27–45 kg m−2). All volunteers were residents in Gran Canaria (monthly temperatures: 18–24 °C). REE was lower than predicted by most equations in our population. Age and BMI were similar in both sexes. In the whole population, the equations of Mifflin, Henry and Rees, Livingston and Owen, had similar levels of accuracy (non-significant bias of 0.7%, 1.1%, 0.6%, and −2.2%, respectively). The best equation to predict resting energy expenditure in overweight and moderately obese men and women living in a temperate climate all year round is the Mifflin equation. In men, the equations by Henry and Rees, Livingston, and by Owen had predictive accuracies comparable to that of Mifflin. The body composition-based equation of Johnston was slightly more accurate than Mifflin’s in men. In women, none of the body composition-based equations outperformed Mifflin’s.

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