Ravussin E, Lillioja S, Knowler W C, Christin L, Freymond D, Abbott W G, Boyce V, Howard B V, Bogardus C
Clinical Diabetes and Nutrition Section, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, Ariz. 85016.
N Engl J Med. 1988 Feb 25;318(8):467-72. doi: 10.1056/NEJM198802253180802.
The contribution of reduced energy expenditure to the development of obesity has been a point of controversy. We measured 24-hour energy expenditure (adjusted for body composition, age, and sex), in a respiratory chamber, in 95 southwestern American Indians. Energy expenditure correlated with the rate of change in body weight over a two-year follow-up period (r = -0.39, P less than 0.001). The estimated risk of gaining more than 7.5 kg in body weight was increased fourfold in persons with a low adjusted 24-hour energy expenditure (200 kcal per day below predicted values) as compared with persons with a high 24-hour energy expenditure (200 kcal per day above predicted values; P less than 0.01). In another 126 subjects, the adjusted metabolic rate at rest at the initial visit was also found to predict the gain in body weight over a four-year follow-up period. When the 15 subjects who gained more than 10 kg were compared with the remaining 111 subjects, the initial mean (+/- SD) adjusted metabolic rate at rest was lower in those who gained weight (1694 +/- 103 vs. 1764 +/- 109 kcal per day; P less than 0.02) and increased to 1813 +/- 134 kcal per day (P less than 0.01) after a mean weight gain of 15.7 +/- 5.7 kg. In a group of 94 siblings from 36 families, values for adjusted 24-hour energy expenditure aggregated in families (intraclass correlation = 0.48). We conclude that a low rate of energy expenditure may contribute to the aggregation of obesity in families.
能量消耗减少对肥胖发生发展的作用一直存在争议。我们在美国西南部95名印第安人中，使用呼吸舱测量了其24小时能量消耗（根据身体组成、年龄和性别进行了调整）。在为期两年的随访期内，能量消耗与体重变化率相关（r = -0.39，P < 0.001）。与24小时能量消耗高的人（比预测值高200千卡/天）相比，调整后的24小时能量消耗低的人（比预测值低200千卡/天）体重增加超过7.5千克的估计风险增加了四倍（P < 0.01）。在另外126名受试者中，还发现初次就诊时调整后的静息代谢率可预测四年随访期内的体重增加。将体重增加超过10千克的15名受试者与其余111名受试者进行比较时，体重增加者的初次平均（±标准差）调整后静息代谢率较低（1694±103千卡/天对1764±109千卡/天；P < 0.02），在平均体重增加15.7±5.7千克后，增加至1813±134千卡/天（P < 0.01）。在来自36个家庭的94名兄弟姐妹组成的一组中，调整后的24小时能量消耗值在家庭中呈现聚集性（组内相关系数 = 0.48）。我们得出结论，低能量消耗率可能导致肥胖在家庭中的聚集。
