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组织损失和代谢适应都有助于减肥后静息代谢率的降低。

Tissue losses and metabolic adaptations both contribute to the reduction in resting metabolic rate following weight loss.

机构信息

Department of Sport and Health Sciences, Technical University Munich, Munich, Germany.

Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE, USA.

出版信息

Int J Obes (Lond). 2022 Jun;46(6):1168-1175. doi: 10.1038/s41366-022-01090-7. Epub 2022 Feb 18.

Abstract

OBJECTIVE

To characterize the contributions of the loss of energy-expending tissues and metabolic adaptations to the reduction in resting metabolic rate (RMR) following weight loss.

METHODS

A secondary analysis was conducted on data from the Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy study. Changes in RMR, body composition, and metabolic hormones were examined over 12 months of calorie restriction in 109 individuals. The contribution of tissue losses to the decline in RMR was determined by weighing changes in the size of energy-expending tissues and organs (skeletal muscle, adipose tissue, bone, brain, inner organs, residual mass) assessed by dual-energy X-ray absorptiometry with their tissue-specific metabolic rates. Metabolic adaptations were quantified as the remaining reduction in RMR.

RESULTS

RMR was reduced by 101 ± 12 kcal/d as participants lost 7.3 ± 0.2 kg (both p < 0.001). On average, 60% of the total reduction in RMR were explained by energy-expending tissues losses, while 40% were attributed to metabolic adaptations. The loss of skeletal muscle mass (1.0 ± 0.7 kg) was not significantly related to RMR changes (r = 0.14, p = 0.16), whereas adipose tissue losses (7.2 ± 3.0 kg) were positively associated with the reduction in RMR (r = 0.42, p < 0.001) and metabolic adaptations (r = 0.31, p < 0.001). Metabolic adaptations were correlated with declines in leptin (r = 0.27, p < 0.01), triiodothyronine (r = 0.19, p < 0.05), and insulin (r = 0.25, p < 0.05).

CONCLUSIONS

During weight loss, tissue loss and metabolic adaptations both contribute to the reduction in RMR, albeit variably. Contrary to popularly belief, it is not skeletal muscle, but rather adipose tissue losses that seem to drive RMR reductions following weight loss. Future research should target personalized strategies addressing the predominant cause of RMR reduction for weight maintenance.

摘要

目的

描述能量消耗组织的损失和代谢适应在减肥后静息代谢率(RMR)下降中的作用。

方法

对减少能量摄入的长期影响综合评估研究的数据进行二次分析。在 109 名参与者接受 12 个月的热量限制期间,检查了 RMR、身体成分和代谢激素的变化。通过双能 X 射线吸收法测量能量消耗组织和器官(骨骼肌、脂肪组织、骨骼、大脑、内部器官、残余质量)的大小变化,并根据其组织特异性代谢率来确定组织损失对 RMR 下降的贡献。代谢适应被量化为 RMR 剩余的减少量。

结果

参与者体重减轻 7.3±0.2kg,RMR 降低 101±12kcal/d(均 p<0.001)。平均而言,RMR 总降低量的 60%可归因于能量消耗组织的损失,而 40%归因于代谢适应。骨骼肌质量的损失(1.0±0.7kg)与 RMR 变化无显著相关性(r=0.14,p=0.16),而脂肪组织的损失(7.2±3.0kg)与 RMR 的降低呈正相关(r=0.42,p<0.001)和代谢适应(r=0.31,p<0.001)。代谢适应与瘦素(r=0.27,p<0.01)、三碘甲状腺原氨酸(r=0.19,p<0.05)和胰岛素(r=0.25,p<0.05)的下降相关。

结论

在减肥期间,组织损失和代谢适应都有助于 RMR 的降低,尽管程度不同。与普遍观点相反,似乎是脂肪组织的损失而不是骨骼肌的损失导致减肥后 RMR 的降低。未来的研究应该针对针对体重维持时 RMR 降低的主要原因的个体化策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f94/9151388/9bc4e87e5d60/41366_2022_1090_Fig1_HTML.jpg

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