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Int J Obes Relat Metab Disord. 2002 Dec;26(12):1547-52.

The prediction of resting energy expenditure in type 2 diabetes mellitus is improved by factoring for glycemia.

Author information

1
McGill Nutrition and Food Science Centre, Royal Victoria Hospital, Montreal, Quebec, Canada.

Abstract

BACKGROUND:

Predictive equations have been reported to overestimate resting energy expenditure (REE) for obese persons. The presence of hyperglycemia results in elevated REE in obese persons with type 2 diabetes, and its effect on the validity of these equations is unknown.

OBJECTIVE:

We tested whether (1) indicators of diabetes control were independent associates of REE in type 2 diabetes and (2) their inclusion would improve predictive equations.

DESIGN:

A cross-sectional study of 65 (25 men, 40 women) obese type 2 diabetic subjects. Variables measured were: REE by ventilated-hood indirect calorimetry, body composition by bioimpedance analysis, body circumferences, fasting plasma glucose (FPG) and hemoglobin A(1c). Data were analyzed using stepwise multiple linear regression.

RESULTS:

REE, corrected for weight, fat-free mass, age and gender, was significantly greater with FPG>10 mmol/l (P=0.017) and correlated with FPG (P=0.013) and hemoglobin A(1c) as percentage upper limit of normal (P=0.02). Weight was the main determinant of REE. Together with hip circumference and FPG, it explained 81% of the variation. FPG improved the predictability of the equation by >3%. With poor glycemic control, it can represent an increase in REE of up to 8%.

CONCLUSION:

Our data indicate that in a population of obese subjects with type 2 diabetes mellitus, REE is better predicted when fasting plasma glucose is included as a variable.

PMID:
12461671
DOI:
10.1038/sj.ijo.0802178
[Indexed for MEDLINE]

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