超重受试者限制热量摄入六周后，早期适应性生热是体重减轻的决定因素。
Early adaptive thermogenesis is a determinant of weight loss after six weeks of caloric restriction in overweight subjects.
机构信息
Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, 4212 North 16th Street, Phoenix, AZ 85016, USA; Department of Internal Medicine, Clinic for Endocrinology, Nephrology and Rheumatology, University of Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany; Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG) of the Helmholtz Zentrum München at the University of Leipzig and University Hospital Leipzig, Philipp-Rosenthal-Strasse, 27, 04103 Leipzig, Germany.
Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, 4212 North 16th Street, Phoenix, AZ 85016, USA.
出版信息
Metabolism. 2020 Sep;110:154303. doi: 10.1016/j.metabol.2020.154303. Epub 2020 Jun 27.
BACKGROUND
Adaptive thermogenesis during prolonged energy deficit refers to the greater than expected reduction in energy expenditure (EE) independent of concomitant loss of metabolically active body mass.
OBJECTIVE
As inter-individual variability in the magnitude of adaptive thermogenesis may influence the extent of energy deficit thereby predicting the amount of weight reduction, we investigated whether early adaptive thermogenesis is a determinant of weight loss after 6 weeks of daily 50% caloric restriction in an inpatient setting.
DESIGN AND METHODS
The current study reports the results of an exploratory, secondary analysis in overweight but otherwise healthy subjects (n = 11, 7 men, 35 ± 9y, BMI = 40 ± 7 kg/m, body fat = 63.3 ± 5.3%). Body composition and 24-h EE (24hEE) measurement in a whole-room indirect calorimeter were used to calculate the magnitude of adaptive thermogenesis while on caloric restriction after 1, 3 and 6 weeks. Energy deficit during caloric restriction was quantified via food, stool, and urine bomb calorimetry. Fasting hormonal concentrations (FT4, FT3, FGF21, leptin) were obtained at baseline and at weeks 3 and 6 during caloric restriction.
RESULTS
The magnitude of adaptive thermogenesis in 24hEE after 1 week of caloric restriction was -178 ± 137 kcal/day (mean ± SD), was overall stable during and following caloric restriction, and demonstrated remarkable intra-individual consistency. A relatively greater decrease in 24hEE of 100 kcal/d after 1 week of caloric restriction was associated on average with reduced energy deficit by 8195 kcal over 6 weeks and predicted 2.0 kg less weight loss, of which 0.5 kg was fat mass, after 6 weeks. No correlations were found between hormonal concentrations and weight loss.
CONCLUSIONS
The extent of weight loss is influenced by the magnitude of adaptive thermogenesis in the early stage of caloric restriction. Although these results need replication in larger study groups with adequate statistical power, targeting adaptive thermogenesis may help to optimize long-term interventions in obesity therapy.
背景
长期能量不足时的适应性产热是指能量消耗（EE）的预期下降超过代谢活跃体重的相应损失。
目的
由于个体间适应性产热的幅度差异可能会影响能量不足的程度，从而预测体重减轻的程度，我们研究了在住院环境中每日进行 50%热量限制的 6 周内，早期适应性产热是否是体重减轻的决定因素。
设计和方法
本研究报告了超重但健康的受试者（n=11，7 名男性，35±9 岁，BMI=40±7kg/m，体脂=63.3±5.3%）中一项探索性、二次分析的结果。在整个房间间接测热仪中进行身体成分和 24 小时 EE（24hEE）测量，以计算热量限制时的适应性产热幅度，分别在限制热量后的 1、3 和 6 周。通过食物、粪便和尿液弹式量热法来量化热量限制期间的能量不足。在热量限制期间的基线和第 3 和第 6 周时，获得禁食激素浓度（FT4、FT3、FGF21、瘦素）。
结果
热量限制 1 周后，24hEE 中的适应性产热幅度为-178±137kcal/d（平均值±标准差），在热量限制期间和之后总体保持稳定，并且表现出显著的个体内一致性。热量限制 1 周后，24hEE 平均减少 100kcal/d，与 6 周内减少 8195kcal 的能量不足相关，预测 6 周后体重减轻 2.0kg，其中 0.5kg 为脂肪量。未发现激素浓度与体重减轻之间存在相关性。
结论
体重减轻的程度受热量限制早期适应性产热幅度的影响。尽管这些结果需要在具有足够统计能力的更大研究组中进行复制，但针对适应性产热可能有助于优化肥胖症治疗的长期干预。
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