Resting Whole Body Energy Metabolism in Class 3 Obesity; from Preserved Insulin Sensitivity to Overt Type 2 Diabetes

Giuseppina Manzoni,1 Alice Oltolini,1 Silvia Perra,1 Emanuele Muraca,1 Stefano Ciardullo,1,2 Mattia Pizzi,3 Giovanna Castoldi,2 Guido Lattuada,1 Pietro Pizzi,3 Gianluca Perseghin1,2 1Department of Medicine and Rehabilitation, Policlinico di Monza, Monza, Italy; 2Department of Medicine and Surgery, U...

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Autores principales:	Manzoni G, Oltolini A, Perra S, Muraca E, Ciardullo S, Pizzi M, Castoldi G, Lattuada G, Pizzi P, Perseghin G
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	indirect calorimetry insulin resistance energy expenditure bariatric surgery respiratory quotient Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/bf5067564fbc414fb0d70ffbffb85da1
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spelling	oai:doaj.org-article:bf5067564fbc414fb0d70ffbffb85da12021-12-02T09:09:10ZResting Whole Body Energy Metabolism in Class 3 Obesity; from Preserved Insulin Sensitivity to Overt Type 2 Diabetes1178-7007https://doaj.org/article/bf5067564fbc414fb0d70ffbffb85da12020-02-01T00:00:00Zhttps://www.dovepress.com/resting-whole-body-energy-metabolism-in-class-3-obesity-from-preserved-peer-reviewed-article-DMSOhttps://doaj.org/toc/1178-7007Giuseppina Manzoni,1 Alice Oltolini,1 Silvia Perra,1 Emanuele Muraca,1 Stefano Ciardullo,1,2 Mattia Pizzi,3 Giovanna Castoldi,2 Guido Lattuada,1 Pietro Pizzi,3 Gianluca Perseghin1,2 1Department of Medicine and Rehabilitation, Policlinico di Monza, Monza, Italy; 2Department of Medicine and Surgery, Università Degli Studi di Milano Bicocca, Monza, Italy; 3Centre for Obesity Research, Policlinico di Monza, Monza, ItalyCorrespondence: Gianluca PerseghinDepartment of Medicine and Rehabilitation, Policlinico di Monza, Via Modigliani 10, Monza, MB 20900, ItalyTel +39 039 281 0430Email gianluca.perseghin@policlinicodimonza.itContext: Insulin resistance and diabetes may influence separately or in combination whole body energy metabolism.Objective: To assess the impact of insulin resistance and/or overt type 2 diabetes on resting energy expenditure (REE) in class 3 obese individuals.Design and Setting: Retrospective, cross-sectional analysis of a set of data about individuals attending the outpatients service of a single center of bariatric surgery between January 2015 and December 2017.Patients: We screened 382 patients in which abnormal thyroid function was excluded, and segregated them in three groups of subjects: patients with type 2 diabetes (T2DM; n=70), non-diabetic insulin-resistant patients with HOMA-IR ≥ 3 (n=236), non-diabetic insulin-sensitive patients with HOMA-IR < 3 (n=75).Main Outcome Measure: Resting energy expenditure (REE), body composition and insulin resistance assessed using indirect calorimetry, bioimpedance and HOMA-IR.Results: Non-diabetic insulin-sensitive patients resulted to be younger, with lower BMI and higher prevalence of female subjects; meanwhile, non-diabetic but insulin-resistant patients and T2DM patients were not different in terms of anthropometric parameters. REE was higher in T2DM than in non-diabetic insulin-resistant and insulin-sensitive individuals when expressed as percent of the predicted REE (based on Harris Benedict equation) (p< 0.0001) or when adjusted for kg of free fat mass (p< 0.0001) and was found to be higher also in insulin-resistant vs insulin-sensitive patients (p< 0.001). The respiratory quotient was different between groups (0.87± 0.11, 0.86± 0.12 and 0.91± 0.14 in T2DM, insulin-resistant and insulin-sensitive patients, respectively; p< 0.03). Regression analysis confirmed that HOMA-IR was independently associated with the REE (R2=0.110, p< 0.001).Conclusion: Class 3 obese patients with normal insulin sensitivity are characterized by reduced fasting REE in comparison to insulin-resistant obese patients and obese patients with short duration of diabetes supporting the hypothesis that down-regulation of nutrients’ oxidative disposal may represent an adaptation of energy metabolism in obese individuals with preserved insulin sensitivity.Keywords: indirect calorimetry, insulin resistance, energy expenditure, bariatric surgery, respiratory quotientManzoni GOltolini APerra SMuraca ECiardullo SPizzi MCastoldi GLattuada GPizzi PPerseghin GDove Medical Pressarticleindirect calorimetryinsulin resistanceenergy expenditurebariatric surgeryrespiratory quotientSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol Volume 13, Pp 489-497 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	indirect calorimetry insulin resistance energy expenditure bariatric surgery respiratory quotient Specialties of internal medicine RC581-951
spellingShingle	indirect calorimetry insulin resistance energy expenditure bariatric surgery respiratory quotient Specialties of internal medicine RC581-951 Manzoni G Oltolini A Perra S Muraca E Ciardullo S Pizzi M Castoldi G Lattuada G Pizzi P Perseghin G Resting Whole Body Energy Metabolism in Class 3 Obesity; from Preserved Insulin Sensitivity to Overt Type 2 Diabetes
description	Giuseppina Manzoni,1 Alice Oltolini,1 Silvia Perra,1 Emanuele Muraca,1 Stefano Ciardullo,1,2 Mattia Pizzi,3 Giovanna Castoldi,2 Guido Lattuada,1 Pietro Pizzi,3 Gianluca Perseghin1,2 1Department of Medicine and Rehabilitation, Policlinico di Monza, Monza, Italy; 2Department of Medicine and Surgery, Università Degli Studi di Milano Bicocca, Monza, Italy; 3Centre for Obesity Research, Policlinico di Monza, Monza, ItalyCorrespondence: Gianluca PerseghinDepartment of Medicine and Rehabilitation, Policlinico di Monza, Via Modigliani 10, Monza, MB 20900, ItalyTel +39 039 281 0430Email gianluca.perseghin@policlinicodimonza.itContext: Insulin resistance and diabetes may influence separately or in combination whole body energy metabolism.Objective: To assess the impact of insulin resistance and/or overt type 2 diabetes on resting energy expenditure (REE) in class 3 obese individuals.Design and Setting: Retrospective, cross-sectional analysis of a set of data about individuals attending the outpatients service of a single center of bariatric surgery between January 2015 and December 2017.Patients: We screened 382 patients in which abnormal thyroid function was excluded, and segregated them in three groups of subjects: patients with type 2 diabetes (T2DM; n=70), non-diabetic insulin-resistant patients with HOMA-IR ≥ 3 (n=236), non-diabetic insulin-sensitive patients with HOMA-IR < 3 (n=75).Main Outcome Measure: Resting energy expenditure (REE), body composition and insulin resistance assessed using indirect calorimetry, bioimpedance and HOMA-IR.Results: Non-diabetic insulin-sensitive patients resulted to be younger, with lower BMI and higher prevalence of female subjects; meanwhile, non-diabetic but insulin-resistant patients and T2DM patients were not different in terms of anthropometric parameters. REE was higher in T2DM than in non-diabetic insulin-resistant and insulin-sensitive individuals when expressed as percent of the predicted REE (based on Harris Benedict equation) (p< 0.0001) or when adjusted for kg of free fat mass (p< 0.0001) and was found to be higher also in insulin-resistant vs insulin-sensitive patients (p< 0.001). The respiratory quotient was different between groups (0.87± 0.11, 0.86± 0.12 and 0.91± 0.14 in T2DM, insulin-resistant and insulin-sensitive patients, respectively; p< 0.03). Regression analysis confirmed that HOMA-IR was independently associated with the REE (R2=0.110, p< 0.001).Conclusion: Class 3 obese patients with normal insulin sensitivity are characterized by reduced fasting REE in comparison to insulin-resistant obese patients and obese patients with short duration of diabetes supporting the hypothesis that down-regulation of nutrients’ oxidative disposal may represent an adaptation of energy metabolism in obese individuals with preserved insulin sensitivity.Keywords: indirect calorimetry, insulin resistance, energy expenditure, bariatric surgery, respiratory quotient
format	article
author	Manzoni G Oltolini A Perra S Muraca E Ciardullo S Pizzi M Castoldi G Lattuada G Pizzi P Perseghin G
author_facet	Manzoni G Oltolini A Perra S Muraca E Ciardullo S Pizzi M Castoldi G Lattuada G Pizzi P Perseghin G
author_sort	Manzoni G
title	Resting Whole Body Energy Metabolism in Class 3 Obesity; from Preserved Insulin Sensitivity to Overt Type 2 Diabetes
title_short	Resting Whole Body Energy Metabolism in Class 3 Obesity; from Preserved Insulin Sensitivity to Overt Type 2 Diabetes
title_full	Resting Whole Body Energy Metabolism in Class 3 Obesity; from Preserved Insulin Sensitivity to Overt Type 2 Diabetes
title_fullStr	Resting Whole Body Energy Metabolism in Class 3 Obesity; from Preserved Insulin Sensitivity to Overt Type 2 Diabetes
title_full_unstemmed	Resting Whole Body Energy Metabolism in Class 3 Obesity; from Preserved Insulin Sensitivity to Overt Type 2 Diabetes
title_sort	resting whole body energy metabolism in class 3 obesity; from preserved insulin sensitivity to overt type 2 diabetes
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/bf5067564fbc414fb0d70ffbffb85da1
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Resting Whole Body Energy Metabolism in Class 3 Obesity; from Preserved Insulin Sensitivity to Overt Type 2 Diabetes

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