Ryan M, Sallé A, Guilloteau G, Genaitay M, Livingstone M B E, Ritz P
Department of Diabetes and Nutrition, CHU , Angers, F-49033, France.
Br J Nutr. 2006 Nov;96(5):945-8. doi: 10.1017/bjn20061744.
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.
静息能量消耗（REE）在2型糖尿病患者中被认为有所增加，这种增加与其发展过程中糖耐量恶化有关。同时，胰岛素抵抗与肥胖相关且在所有2型糖尿病患者中均有观察到，它与REE降低有关。我们的目的是比较患有和未患有糖尿病的肥胖患者的REE。对50名患有糖尿病的肥胖白人患者（糖化血红蛋白水平为7.6（标准差1.5）%）和50名非糖尿病肥胖患者评估了REE、身体成分（总体水、密度、脂肪百分比和去脂体重：三室模型）以及代谢控制情况。尽管非糖尿病肥胖患者超重更明显且更年轻，但他们的绝对REE（7.73（标准差1.44）对8.12（标准差1.37）兆焦；P = 0.17）和去脂体重百分比与糖尿病肥胖患者相似。即使对身体成分差异进行校正后，两组的REE仍相似。此外，REE（绝对和校正后）不受血糖水平和控制情况（糖化血红蛋白）的影响，去脂体重是REE的唯一决定因素。我们得出结论，肥胖人群中糖尿病的存在不一定会使REE增加。
