Gougeon R, Lamarche M, Yale J-F, Venuta T
McGill Nutrition and Food Science Centre, Royal Victoria Hospital, Montreal, Quebec, Canada.
Int J Obes Relat Metab Disord. 2002 Dec;26(12):1547-52. doi: 10.1038/sj.ijo.0802178.
Predictive equations have been reported to overestimate resting energy expenditure (REE) for obese persons. The presence of hyperglycemia results in elevated REE in obese persons with type 2 diabetes, and its effect on the validity of these equations is unknown.
We tested whether (1) indicators of diabetes control were independent associates of REE in type 2 diabetes and (2) their inclusion would improve predictive equations.
A cross-sectional study of 65 (25 men, 40 women) obese type 2 diabetic subjects. Variables measured were: REE by ventilated-hood indirect calorimetry, body composition by bioimpedance analysis, body circumferences, fasting plasma glucose (FPG) and hemoglobin A(1c). Data were analyzed using stepwise multiple linear regression.
REE, corrected for weight, fat-free mass, age and gender, was significantly greater with FPG>10 mmol/l (P=0.017) and correlated with FPG (P=0.013) and hemoglobin A(1c) as percentage upper limit of normal (P=0.02). Weight was the main determinant of REE. Together with hip circumference and FPG, it explained 81% of the variation. FPG improved the predictability of the equation by >3%. With poor glycemic control, it can represent an increase in REE of up to 8%.
Our data indicate that in a population of obese subjects with type 2 diabetes mellitus, REE is better predicted when fasting plasma glucose is included as a variable.
据报道，预测方程会高估肥胖者的静息能量消耗（REE）。高血糖的存在会导致2型糖尿病肥胖者的REE升高，但其对这些方程有效性的影响尚不清楚。
我们测试了（1）糖尿病控制指标是否是2型糖尿病中REE的独立相关因素，以及（2）将它们纳入是否会改善预测方程。
对65名（25名男性，40名女性）肥胖2型糖尿病受试者进行横断面研究。测量的变量包括：通过通风罩间接测热法测量REE，通过生物电阻抗分析测量身体成分、身体周长、空腹血糖（FPG）和糖化血红蛋白A1c。使用逐步多元线性回归分析数据。
校正体重、去脂体重、年龄和性别后，FPG>10 mmol/L时REE显著更高（P=0.017），且与FPG（P=0.013）和糖化血红蛋白A1c占正常上限的百分比（P=0.02）相关。体重是REE的主要决定因素。与臀围和FPG一起，它解释了81%的变异。FPG使方程的预测能力提高了>3%。血糖控制不佳时，它可使REE增加高达8%。
我们的数据表明，在肥胖2型糖尿病患者群体中，将空腹血糖作为变量纳入时，REE能得到更好的预测。
