Obez bireylerde biyokimyasal parametreler istirahat enerji tüketimi ile ilişkili midir?

Abstract

Stimulan Hormon (TSH) seviyeleri, kardiyo-metabolik etkileri olan lipit profili ve glukoz düzeyleri arasındaki ilişkinin araştırılmasıdır. Yöntem: Retrospektif olarak gerçekleştirilen bu çalışmaya yaş ortalaması 41.59±11.78 olan 76 birey katılmıştır. Dosya taraması yapılarak bireylere ait düşük dansiteli lipoprotein (LDL kolestrol), yüksek dansiteli lipoprotein (HDL kolestrol), total kolestrol, trigliserid, açlık kan glikozu ve TSH verileri kayıt edilmiştir. Bununla birlikte indirekt kalorimetri yöntemi ile tespit edilen İET verileri de analiz edilerek kkal/gün ve vücut ağırlığına göre normalize edilerek İET/kg olarak raporlanmıştır. İET değerlerinin, serum TSH, açlık glikoz düzeyi ve lipid profili ile ilişkisi incelendi. Bulgular: İET ile vücut kitle indeksi (VKİ) arasında pozitif yönlü zayıf-orta derecede bir korelasyon vardı (p=0.001, r=0.39). İET/kg ile VKİ arasında negatif yönlü orta derecede bir korelasyon saptandı. (p<0.001, r=-0.53). İET ile serum TSH düzeyleri arasında korelasyon saptanmadı. İET ile total kolesterol ve LDL arasında istatistiksel olarak anlamlı zayıf bir negatif yönlü bir korelasyon saptandı (p=0.006, r=-0.31 ve p=0.009, r=-0.3). İET/kg ile TSH, glukoz parametreleri arasında korelasyon gözlenmezken İET/kg ile total kolesterol ve LDL arasında istatistiksel olarak anlamlı zayıf bir negatif yönlü bir korelasyon vardı (p=0.007, r=-0.31 ve p=0.009, r=-0.3, sırasıyla). Sonuç: Kilolu ve obez bireylerde VKİ arttıkça İET artmaktayken İET ağırlığa göre normalize edildiğinde tam tersi bir eğilim gözlenmiştir. VKİ, İET, serum TSH, lipit parametreleri arasındaki ilişkiyi daha iyi anlayabilmek için iyi kurgulanmış prospektif çalışmalara ihtiyaç vardır.

Keywords

• istirahat enerji tüketimi
• lipit profili
• obezite
• tiroid hormon fonksiyonları

Are biochemical parameters associated with resting energy expenditure in obese subjects?

Abstract

Aim: To investigate the relationship between resting energy expenditure (REE) and thyroid stimulating hormone (TSH) levels, lipid profile and glucose levels with cardio-metabolic effects in obese and overweight subjects. Method: Seventy-nine subjects with a mean age of 41.59 ± 11.78 participated in this retrospective study. Low-density lipoprotein (LDL cholesterol), high-density lipoprotein (HDL cholesterol), total cholesterol, triglyceride, fasting blood glucose and TSH parameters were recorded retrospectively. In addition, REE data that measured with indirect calorimetry method was analyzed and expressed as kcal/day and REE/kg (normalized with body mass). The relationship of REE values with serum TSH, fasting glucose level and lipid profile was examined. Results: There was a moderate positive correlation between REE and body mass index (BMI) (p=0.001, r=0.39). A moderate negative correlation was found between REE/ kg and BMI. (p<0.001, r=-0.53). There was no correlation between REE and serum TSH levels (P>0.05). A statistically significant weak negative correlation was found between REE and total cholesterol and LDL (p=0.006, r=-0.31 ve p=0.009, r=-0.3). While there was no correlation between REE/kg and TSH and fasting glucose level (P>0.05), a statistically significant weak negative correlation was found between REE/kg and total cholesterol and LDL(p=0.007, r=-0.31 ve p=0.009, r=-0.3, respectively). Conclusion: While REE increased as BMI increased, the opposite trend was observed when REE normalized with body weight in obese and overweight subjects. Well-designed prospective studies are needed to better understand the relationship between BMI, REE, serum TSH, and lipid parameters.

Keywords

• Resting energy expenditure
• lipid profile
• obesity
• thyroid hormone functions

References

1. 1. Carneiro IP, Elliott SA, Siervo M, et al. Is Obesity Associated with. Adv Nutr. 2016;7:476-487. doi:10.3945/an.115.008755.findings
2. 2. Smyth S, Heron A. Diabetes and obesity: The twin epidemics. Nat Med. 2006;12(1):75-80. doi:10.1038/nm0106-75
3. 3. Elbelt U, Schuetz T, Hoffmann I, Pirlich M, Strasburger CJ, Lochs H. Differences of energy expenditure and physical activity patterns in subjects with various degrees of obesity. Clin Nutr. 2010;29(6):766-772. doi:10.1016/j.clnu.2010.05.003
4. 4. Faria SL, Faria OP, Menezes CS, De Gouvêa HR, De Almeida Cardeal M. Metabolic profile of clinically severe obese patients. Obes Surg. 2012;22(8):1257-1262. doi:10.1007/s11695-012-0651-y
5. 5. Delany JP, Kelley DE, Hames KC, Jakicic JM, Goodpaster BH. High energy expenditure masks low physical activity in obesity. Int J Obes. 2013;37(7):1006-1011. doi:10.1038/ijo.2012.172
6. 6. Teixeira P de F dos S, dos Santos PB, Pazos-Moura CC. The role of thyroid hormone in metabolism and metabolic syndrome. Ther Adv Endocrinol Metab. 2020;11:204201882091786. doi:10.1177/2042018820917869
7. 7. Hollenberg AN. The Role of the Thyrotropin-Releasing Hormone (TRH) Neuron as a Metabolic Sensor. Thyroid. 2008;18(2):131-139. doi:10.1089/thy.2007.0251
8. 8. Paz-Filho G, Mastronardi C, Franco CB, Wang KB, Wong M-L, Licinio J. Leptin: molecular mechanisms, systemic pro-inflammatory effects, and clinical implications. Arq Bras Endocrinol Metabol. 2012;56(9):597-607. doi:10.1590/s0004-27302012000900001

9. 9. Feingold KR. Obesity and Dyslipidemia. MDText.com, Inc.; 2000. Accessed January 24, 2021. http://www.ncbi.nlm.nih.gov/pubmed/26247088
10. 10. Meisinger C, Ittermann T, Tiller D, et al. Sex-Specific Associations Between Thyrotropin and Serum Lipid Profiles. Thyroid. 2014;24(3):424-432. doi:10.1089/thy.2013.0259
11. 11. Spadafranca A, Cappelletti C, Leone A, et al. Relationship between thyroid hormones, resting energy expenditure and cardiometabolic risk factors in euthyroid subjects. Clin Nutr. 2015;34(4):674-678. doi:10.1016/j.clnu.2014.07.014
12. 12. Weir CB, Jan A. BMI Classification Percentile And Cut Off Points. [Updated 2020 Jul 10]. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2021 Jan.
13. 13. Lowe JC, Yellin J, Honeyman-Lowe G. Female fibromyalgia patients: lower resting metabolic rates than matched healthy controls. Med Sci Monit. 2006 Jul;12(7):CR282-9.
14. 14. Matarese LE. Indirect calorimetry: technical aspects. J Am Diet Assoc. 1997;97(10 Suppl 2). doi:10.1016/s0002-8223(97)00754-2
15. 15. Siervo M, Oggioni C, Lara J, et al. Age-related changes in resting energy expenditure in normal weight, overweight and obese men and women. Maturitas. 2015;80(4):406-413. doi:10.1016/j.maturitas.2014.12.023
16. 16. Dal U, Erdogan AT, Cureoglu A, Beydagi H. Resting energy expenditure in normal-weight and overweight/obese subjects was similar despite elevated sympathovagal balance. Obes Facts. 2012;5(5):776-783. doi:10.1159/000345189
17. 17. Segal KR, Edano A, Blando L, Pi-Sunyer FX. Comparison of thermic effects of constant and relative caloric loads in lean and obese men. Am J Clin Nutr. 1990;51(1):14-21. doi:10.1093/ajcn/51.1.14
18. 18. Segal KR, Edaño A, Tomas MB. Thermic effect of a meal over 3 and 6 hours in lean and obese men. Metabolism. 1990;39(9):985-992. doi:10.1016/0026-0495(90)90312-Z
19. 19. Heymsfield SB, Gallagher D, Kotler DP, Wang Z, Allison DB, Heshka S. Body-size dependence of resting energy expenditure can be attributed to nonenergetic homogeneity of fat-free mass. Am J Physiol Endocrinol Metab. 2002;282(1):E132-8. doi:10.1152/ajpendo.2002.282.1.E132
20. 20. Altınkaya Z, Dal U, Dağ F, Türkegün M. Different Normalization Strategies Could Be Applied to Evaluate the Resting and Walking Energy Expenditures of Individuals with Different Body Mass Index. Turkiye Klin J Sport Sci. 2020;12(1):84-93. doi:10.5336/sportsci.2019-71539
21. 21. Åsvold BO, Bjøro T, Vatten LJ. Association of Serum TSH with High Body Mass Differs between Smokers and Never-Smokers. J Clin Endocrinol Metab. 2009;94(12):5023-5027. doi:10.1210/jc.2009-1180
22. 22. Nyrnes A, Jorde R, Sundsfjord J. Serum TSH is positively associated with BMI. Int J Obes. 2006;30:100-105. doi:10.1038/sj.ijo.0803112
23. 23. Makepeace AE, Bremner AP, O’Leary P, et al. Significant inverse relationship between serum free T4 concentration and body mass index in euthyroid subjects: differences between smokers and nonsmokers. Clin Endocrinol (Oxf). 2008;69(4):648-652. doi:10.1111/j.1365-2265.2008.03239.x
24. 24. De A, Souza M, Sichieri R. Association between serum TSH concentration within the normal range and adiposity. Eur J Endocrinol 2011;165:11-15. doi:10.1530/EJE-11-0261
25. 25. Tagliaferri M, Berselli ME, Calò G, et al. Subclinical hypothyroidism in obese Patients: Relation to resting energy expenditure, serum leptin, body composition, and lipid profile. Obes Res. 2001;9(3):196-201. doi:10.1038/oby.2001.21
26. 26. Meisinger C, Ittermann T, Tiller D, et al. Sex-specific associations between thyrotropin and serum lipid profiles. Thyroid. 2014;24(3):424-432. doi:10.1089/thy.2013.0259
27. 27. Swinburn BA, Nyomba BL, Saad MF, et al. Insulin resistance associated with lower rates of weight gain in pima indians. J Clin Invest. 1991;88(1):168-173. doi:10.1172/JCI115274
28. 28. Piaggi P, Thearle MS, Bogardus C, Krakoff J. Fasting hyperglycemia predicts lower rates of weight gain by increased energy expenditure and fat oxidation rate. J Clin Endocrinol Metab. 2015;100(3):1078-1087. doi:10.1210/jc.2014-3582