Obezitesi Olan Diyabetli Bireylerde Dinlenme Metabolik Hızının Belirlenmesinde Kullanılan Yöntemler

Abstract

Tip 2 diabetes mellitus (DM), dünya nüfusunun önemli bir bölümünü etkileyen ve obezite ile ilişkilendirilen kronik bir hastalıktır. Tip 2 diyabetli obezitesi olan bireylerin tedavisinde birincil strateji, yaşam tarzı değişiklikleri yoluyla ağırlık kaybının sağlanmasıdır. Toplam enerji harcamasının önemli bir bileşeni olan dinlenme metabolik hızının (DMH) hesaplanmasında en güvenilir yöntem indirekt kalorimetredir. İndirekt kalorimetreye ulaşım mümkün olmadığında enerji denklemleri kullanılabilmektedir. Çeşitli araştırmalarla geliştirilen farklı enerji denklemleri bulunmaktadır. Gougeon, Huang, Ikeda ve Martin formülleri diyabetlilere yöneliktir. Yapılan çalışmalarda, FAO/WHO/UNU, Harris-Benedict, Huang denklemlerinin ve biyoelektrik impedans analizinin indirekt kalorimetreye kıyasla DMH’ı daha yüksek tahmin ettiği gösterilmiştir. Gougeon, obezitesi olan diyabetlilere yönelik geliştirmiş olduğu denkleme, değişken olarak plazma glikozunu eklemiş ve daha doğru DMH sonucu elde ettiklerini belirtmiştir. Ayrıca, Mifflin denkleminin obezitesi olan diyabetiklerde daha doğru sonuç verdiği gösterilmiştir. Sonuç olarak, enerji denklemleri, sağlıklı bireylerde doğru sonuçlar verebilmesine karşın daha yaşlı veya hasta bireylerde yeterince doğru sonuçlar vermemektedir. Bu nedenle, enerji denklemleri bireysel olarak hassasiyetle seçilmelidir. İndirekt kalorimetreye ulaşılamadığında, doğruluk oranı yüksek denklemlerin kullanımı enerji gereksinimini belirlemede kolaylık sağlayabilir.

Keywords

• diabetes mellitus
• obezite
• dinlenme metabolik hızı
• enerji denklemleri

Methods Used to Determine the Resting Metabolic Rate of Obese Diabetic Individuals

Abstract

Diabetes mellitus (DM) is a chronic disease affecting a significant portion of the world’s population and is associated with obesity. The primary strategy in the treatment of obese individuals with type 2 DM is to achieve weight loss through lifestyle changes. Indirect calorimetry is the most reliable method for calculating resting metabolic rate (RMR), an important component of total energy expenditure. When indirect calorimetry is not available, energy equations can be used. There are various equations developed in several studies. Gougeon, Huang, Ikeda and Martin’s equations are aimed at diabetic patients. Studies have shown that FAO/WHO/UNU, Harris-Benedict, Huang equations, and bioelectric impedance analysis predict a higher RMR compared to indirect calorimetry. Gougeon added plasma glucose level as a variable to the equation developed for obese diabetics and stated that they obtained a more accurate RMR results. Additionally, the Mifflin equation has been shown to be more accurate in obese diabetics. In conclusion, although energy equations can give accurate results in healthy individuals, they don’t provide accurate results in older individuals or patients. Therefore, energy equations should be selected individually and sensitively. When indirect calorimetry is not available, the use of equations with a high accuracy rate may provide convenience in determining the energy requirement.

Keywords

• diabetes mellitus
• obesity
• resting metabolic rate
• energy equations

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