Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Asadabad School of Medical Sciences, Asadabad, Iran.
Sci Rep. 2023 Mar 4;13(1):3669. doi: 10.1038/s41598-023-30945-w.
Considering the progressive prevalence and co-occurrence of type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD), as well as the current evidence suggesting the elevated levels of basal metabolic rate (BMR) among these individuals, the present study aimed to identify factors determining hypermetabolism in such subjects. This cross sectional study was conducted in 30 to 53-year-old individuals with concurrent T2DM and NAFLD (controlled attenuation parameter score ≥ 260 dB/m). Resting energy expenditure (REE) was determined by an indirect calorimetry device. Hypermetabolism was defined as an elevated measured REE > 110% of the predicted REE. The multivariate logistic regression test was used for detecting factors associated with hypermetabolism. Between September, 2017, and March, 2018, a total of 95 eligible participants (64.40% male) with both T2DM and NAFLD were included, while 32.63% of them were classified as hypermetabolic. Overall, the mean recruitment age ± standard deviation and median (interquartile range) body mass index were 44.69 ± 5.47 years and 30.20 (27.80-33.30) kg/m, respectively. Demographic, anthropometric and biochemical variables did not vary significantly across two groups except for total body water, low-density lipoprotein cholesterol and dipeptidyl peptidase 4 (DPP-4) inhibitors (p < 0.05). According to the results of multivariable logistic regression analyses, hypermetabolism had a positive association with adiponectin (odds ratio [OR] 1.167, 95% confidence interval [CI] 1.015-1.342, p = 0.030), physical activity (OR 1.134, 95% CI 1.002-1.284, p = 0.046), alanine transaminase (OR 1.062, 95% CI 1.006-1.122, p = 0.031) and diastolic blood pressure (OR 1.067, 95% CI 1.010-1.127, p = 0.021). However, fat free mass was inversely related to hypermetabolism (OR 0.935, 95% CI 0.883-0.991, p = 0.023). Adiponectin, alanine transaminase, physical activity, diastolic blood pressure and fat free mass were independently associated with hypermetabolism in subjects with NAFLD and T2DM.
考虑到 2 型糖尿病（T2DM）和非酒精性脂肪性肝病（NAFLD）的患病率逐渐增加且同时存在，以及目前有证据表明这些患者的基础代谢率（BMR）升高，本研究旨在确定这些患者代谢亢进的决定因素。这项横断面研究纳入了年龄在 30 至 53 岁之间、同时患有 T2DM 和 NAFLD（受控衰减参数评分≥260 dB/m）的患者。静息能量消耗（REE）通过间接热量计测定。代谢亢进定义为测定的 REE 高于预测 REE 的 110%。使用多变量逻辑回归检验来检测与代谢亢进相关的因素。2017 年 9 月至 2018 年 3 月期间，共纳入 95 名符合条件的 T2DM 和 NAFLD 患者（64.40%为男性），其中 32.63%的患者被归类为代谢亢进。总体而言，平均招募年龄±标准差和中位数（四分位间距）的体重指数分别为 44.69±5.47 岁和 30.20（27.80-33.30）kg/m2。两组之间除了体水、低密度脂蛋白胆固醇和二肽基肽酶 4（DPP-4）抑制剂外，人口统计学、人体测量学和生化变量均无显著差异（p<0.05）。根据多变量逻辑回归分析的结果，代谢亢进与脂联素（比值比[OR] 1.167，95%置信区间[CI] 1.015-1.342，p=0.030）、体力活动（OR 1.134，95%CI 1.002-1.284，p=0.046）、丙氨酸氨基转移酶（OR 1.062，95%CI 1.006-1.122，p=0.031）和舒张压（OR 1.067，95%CI 1.010-1.127，p=0.021）呈正相关。然而，去脂体重与代谢亢进呈负相关（OR 0.935，95%CI 0.883-0.991，p=0.023）。脂联素、丙氨酸氨基转移酶、体力活动、舒张压和去脂体重与 NAFLD 和 T2DM 患者的代谢亢进独立相关。
