Ide Risa, Ogata Makiko, Iwasaki Naoko, Babazono Tetsuya
1Diabetes Center, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan.
2Department of Food and Nutrition, Faculty of home Economics, Tokyo Kasei University, 1-18-1 Itabashiku, Tokyo, 1738602 Japan.
Diabetol Int. 2019 Feb 28;10(4):268-278. doi: 10.1007/s13340-019-00391-z. eCollection 2019 Oct.
Resting energy expenditure (REE) is an important tool in nutrition management, especially in type 2 diabetes mellitus (T2DM). The predicted REE (pREE) was reported to be inaccurate, compared with measured REE (mREE) in Japanese T2DM patients. Despite the accuracy of REE, measured via indirect calorimetry (mREE), the technique is demanding. This study evaluated the associated clinical factors of the difference between pREE and mREE in Japanese patients with T2DM.
Forty-nine Japanese patients with T2DM but no severe complications (32 men and 17 women) were enrolled. mREE was determined via indirect calorimetry.
Participants average age was 56.3 ± 11.0 years, body mass index was 25.2 ± 3.6 kg/m, and HbA1c was 9.6 ± 1.6%. The mean mREE was 1099 ± 212 kcal/day. Age, body mass index, hemoglobin, and uric acid levels were all associated with mREE by simple regression; of these, body weight was the significant factor in the multiple regression analysis. When the patients were divided into tertiles, the average mREE values were lower than the pREE values for each group. The difference between mREE and pREE was largest in the lowest value group, whose subjects were mostly women aged over 50 years. This group of women showed significantly lower mREE (904 ± 121 kcal) in comparison with men in the same age group, with 26% overestimation of pREE, even when the equation that yielded the closest mREE value was used.
The previously reported pREE overestimates mREE in Japanese patients with T2DM, especially in postmenopausal women.
静息能量消耗(REE)是营养管理中的一项重要工具,尤其是在2型糖尿病(T2DM)中。据报道,在日本T2DM患者中,预测的REE(pREE)与测量的REE(mREE)相比不准确。尽管通过间接测热法测量的REE(mREE)具有准确性,但该技术要求较高。本研究评估了日本T2DM患者中pREE与mREE差异的相关临床因素。
纳入49例无严重并发症的日本T2DM患者(32例男性和17例女性)。通过间接测热法测定mREE。
参与者的平均年龄为56.3±11.0岁,体重指数为25.2±3.6kg/m,糖化血红蛋白为9.6±1.6%。平均mREE为1099±212千卡/天。通过简单回归分析,年龄、体重指数、血红蛋白和尿酸水平均与mREE相关;其中,体重是多元回归分析中的显著因素。当将患者分为三分位数时,每组的平均mREE值均低于pREE值。mREE与pREE之间的差异在最低值组中最大,该组受试者大多为50岁以上的女性。与同年龄组的男性相比,这组女性的mREE显著较低(904±121千卡),即使使用产生最接近mREE值的方程,pREE也高估了26%。
先前报道的pREE高估了日本T2DM患者的mREE,尤其是绝经后女性。