Thyroid Function and Obesity: From Mechanisms to the Benefits of Levothyroxine in Obese Patient

2021 ◽  
Vol 21 ◽  
Author(s):  
Vincenzo De Geronimo ◽  
Rossella Cannarella ◽  
Sandro La Vignera
Keyword(s):  
Energy Expenditure ◽  
Metabolic Rate ◽  
Basal Metabolic Rate ◽  
Hormone Receptors ◽  
Uncoupling Protein ◽  
Resting Energy Expenditure ◽  
The Body ◽  
Expenditure Rate ◽  
Basal Energy Expenditure ◽  
Clinical Conditions

Background: Thyroid disease and obesity are very common clinical conditions in the general population. They can occur together in the same subject, but their relationship does not seem to be exclusively stochastic. Aim: We critically reviewed the evidence of the literature in the attempt to provide explanation for this association, in order to understand the possible benefits of levothyroxine therapy in euthyroid obese patients. Results: A low energy expenditure rate can lead to obesity. Maintaining Basal Metabolic Rate (BMR) is the main cause of energy expenditure for the body, which is regulated by thermogenesis. Thyroid hormone receptors (TR) play different roles in the induction of thermogenetic mechanisms: TRα is fundamental to induce thermogenesis, TRβ triggers the expression of uncoupling protein 1(UCP1). Despite such mechanisms, there is not currently evidence to treat subjects suffering from obesity with thyroid hormones. Conclusion: Replacement therapy should be reserved to patients with obvious signs of subclinical or clinical hypothyroidism. Definitions: Basal metabolic rate (BMR) or basal energy expenditure (BEE): measurement obtained under total inactivity and controlled research conditions; resting energy expenditure (REE): measurement obtained when an individual is sitting quietly (is mildly higher than BMR/BEE).

scholarly journals P566 Impact of induction therapy and clinical remission on resting energy expenditure in children with Crohn’s Disease

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S526-S527
Author(s):  
G Kornitzer ◽  
J Breton ◽  
P Poinsot ◽  
D Godin ◽  
K Grzywacz ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Energy Expenditure ◽  
Nutritional Status ◽  
Metabolic Rate ◽  
Induction Therapy ◽  
Basal Metabolic Rate ◽  
Resting Energy Expenditure ◽  
Biochemical Response ◽  
Resting Energy

Abstract Background Crohn’s Disease (CD) is known to affect nutritional status and linear growth in affected children. Patients with CD often have decreased oral intake, malabsorption, and increased intestinal losses. Basal metabolic rate may be affected by chronic inflammation and states of anorexia or malnutrition in these patients. In this study, our aim was to compare the effect of different induction regimens in children with CD on resting energy expenditure (REE) and nutritional status. Methods We recruited patients under 18 years old with new-onset CD or relapse, diagnosed at our centre over a three-year period from July 2016. Patients included had one of the following induction regimens: corticosteroids, exclusive enteral nutrition (EEN), or anti-TNF therapy (Infliximab). REE was assessed at baseline and 6 to 8 weeks after induction. REE (kcal/d) was measured using an open-circuit indirect calorimeter with computerized metabolic cart (Vmax Encore, Vyaire Medical). Secondary outcomes included anthropometrics and clinical and biochemical response, defined by improved wPCDAI and negative inflammatory markers and fecal calprotectin, respectively. Results 17 patients were enrolled and 8 patients excluded (loss to follow-up (n=3), therapeutic change (n=3), revised diagnosis (n=2)). 9 patients completed REE assessments (44.4% anti-TNF (n=4), 44.4% EEN (n=4), 11.1% corticosteroid (n=1)). 3 out of 4 patients on anti-TNF had clinical and biochemical response, while only 1 of 4 patients responded to EEN. For patients in the EEN group, mean BMI change was +0.9 (SD 0.4), compared to +0.4 (SD 1.1) in the anti-TNF group. There was no difference in REE change between treatment groups. Data was then pooled based on response to treatment. 100% of non-responders had increased per cent of predicted REE (REEPP), while 75% of responders decreased their REEPP. Mean REEPP change in non-responders was +12.5% (1, 22) vs. -4.3% (-10, 6) in responders. Figure I. Relationship between REE and weight at baseline and on follow-up in non-responders. Figure II. Relationship between REE and weight at baseline and on follow-up in responders. Conclusion Our results suggest that induction regimen did not impact REE change on follow-up. In our patients, clinical response to therapy was related to a tendency to decrease REE. Patients who did not achieve remission after induction therapy increased their REE. We suspect that this increase in basal metabolic rate is related to persistent inflammation despite improved nutritional status. Further studies with larger patient populations are needed to infer significance and compare subgroups based on body composition.

Energy expenditure and substrate metabolism measured by 24 h whole-body calorimetry in patients receiving cyclic and continuous total parenteral nutrition

1991 ◽  
Vol 80 (6) ◽  
pp. 571-582 ◽  
Author(s):  
E. Pullicino ◽  
G. R. Goldberg ◽  
M. Elia
Keyword(s):  
Energy Expenditure ◽  
Parenteral Nutrition ◽  
Metabolic Rate ◽  
Total Parenteral Nutrition ◽  
Basal Metabolic Rate ◽  
Resting Energy Expenditure ◽  
Whole Body ◽  
Diet Induced Thermogenesis ◽  
Activity Energy ◽  
Resting Energy

1. Twenty-four hour energy expenditure and its components, i.e. ‘basal metabolic rate', activity energy expenditure and diet-induced thermogenesis were measured, using continuous whole-body indirect calorimetry, in patients receiving total parenteral nutrition while in remission from Crohn's disease (weight 51.9 ± 9.9 kg, body mass index 19.2 ± 2.0 kg/m2). 2. Total parenteral nutrition was infused continuously over 24 h in four subjects and cyclically, between 22.00 and 10.00 hours, in eight subjects. Twenty-four hour energy expenditure (6.83 ± 1.10 MJ/24 h) was lower than total energy intake (10.09 ± 1.63 MJ/24 h), resulting in a positive energy balance (3.26 ± 1.42 MJ) in all subjects. Repeated measurements of resting energy expenditure in the continuously fed subjects (5.82 ± 1.11 MJ/24 h) did not change significantly at different times of day (coefficient of variation 2.2–6.6%). In contrast, in cyclically fed subjects, resting energy expenditure was 24.2 ± 9.0% higher towards the end of the 12 h feeding period than the ‘basal metabolic rate', which was measured just before the start of the feeding period. 3. Diet-induced thermogenesis, calculated as the increment in resting energy expenditure above ‘basal metabolic rate’ over the 24 h period (adjusted for the reduction in energy expenditure during sleep), was found to be 0.60 ± 0.29 MJ or 6.1 ± 3.1% of the energy intake. 4. The energy cost of activity (activity energy expenditure) in the continuously fed patients, calculated as the difference between 24 h energy expenditure and the integrated 24 h measurements of resting energy expenditure, was 0.88 ± 0.53 MJ, i.e. 12.9 ± 5.9% of the 24 h energy expenditure. 5. The non-protein nonglycerol respiratory quotient exceeded 1.0 for varying periods of time (0.5–17 h) in 11 subjects, indicating net lipogenesis from carbohydrate. 6. The results demonstrate favourable rates of deposition, during intravenous feeding, of both energy and nitrogen over a 24 h period in patients recovering from an episode of Crohn's disease. The efficacy of these commonly used total parenteral nutrition regimens in these patients is related to three features that are absent in normal healthy individuals, namely a low basal metabolic rate, a low activity-related energy expenditure and prolonged periods of lipogenesis from carbohydrate.

Simulated weightlessness alters the nycthemeral distribution of energy expenditure in rats

2001 ◽  
Vol 204 (23) ◽  
pp. 4107-4113
Author(s):  
Stéphane Blanc ◽  
Alain Géloën ◽  
Sylvie Normand ◽  
Claude Gharib ◽  
Laurence Somody
Keyword(s):  
Physical Activity ◽  
Energy Expenditure ◽  
Metabolic Rate ◽  
Basal Metabolic Rate ◽  
Male Rats ◽  
Metabolic Rates ◽  
Tail Suspension ◽  
Simulated Weightlessness ◽  
Basal Energy Expenditure ◽  
The Cost

SUMMARY The energy metabolism adaptations to simulated weightlessness in rats by hindlimb tail suspension are unknown. 12 male rats were assigned to 7 days of isolation, 7 days of habituation to the suspension device, 10 days of simulated weightlessness, and 3 days of recovery. The 24-hour energy expenditure was measured by continuous indirect calorimetry. We calculated the 12-hour energy expenditure during the active (night) and inactive (day) periods, the minimal observed metabolic rates with the day values taken as an index of the basal metabolic rate, and the non-basal energy expenditure representing the cost of physical activity plus the diet-induced thermogenesis. Suspension did not change the mean 24-hour energy expenditure (360.8±15.3 J min–1 kg–0.67), but reduced the night/day difference by 64 % (P<0.05) through a concomitant drop in night-energy expenditure and increase in day values. The difference between night and day minimal metabolic rates was reduced by 81 % (P<0.05), and the transient rise in day values suggests an early and moderate basal metabolic rate increase (9 %). An overall 19 % reduction in non-basal energy expenditure was observed during simulated weightlessness (P<0.05), which was mainly attributable to a reduction in the cost of physical activity. 3 days of recovery restored the night/day differences but increased the 24-hour energy expenditure by 10 % (P<0.05). In conclusion, hindlimb tail suspension in rats did not alter the 24-hour energy expenditure, but it transiently increased the basal metabolic rate, and altered both the energy expended on physical activity and the nycthemeral distribution of motor activity. These data suggest that the circadian rhythms of energy expenditure are affected during simulated weightlessness.

Effects of Television on Metabolic Rate: Potential Implications For Childhood Obesity

PEDIATRICS ◽  
1993 ◽  
Vol 91 (2) ◽  
pp. 281-286
Author(s):  
Robert C. Klesges ◽  
Mary L. Shelton ◽  
Lisa M. Klesges
Keyword(s):  
Energy Expenditure ◽  
Metabolic Rate ◽  
Television Viewing ◽  
Resting Energy Expenditure ◽  
Normal Weight ◽  
Laboratory Setting ◽  
Obese Children ◽  
Two Measures ◽  
The Relationship ◽  
Resting Energy

The effects of television viewing on resting energy expenditure (metabolic rate) in obese and normal-weight children were studied in a laboratory setting. Subjects were 15 obese children and 16 normal-weight children whose ages ranged from 8 to 12 years. All subjects had two measures of resting energy expenditure obtained while at rest and one measurement of energy expenditure taken while viewing television. Results indicated that metabolic rate during television viewing was significantly lower (mean decrease of 211 kcal extrapolated to a day) than during rest. Obese children tended to have a larger decrease, although this difference was not statistically significant (262 kcal/d vs 167 kcal/d, respectively). It was concluded that television viewing has a fairly profound lowering effect of metabolic rate and may be a mechanism for the relationship between obesity and amount of television viewing.

The standard energetics of mammalian carnivores: Felidae and Hyaenidae

2000 ◽  
Vol 78 (12) ◽  
pp. 2227-2239 ◽  
Author(s):  
Brian K McNab
Keyword(s):  
Energy Expenditure ◽  
Metabolic Rate ◽  
Basal Metabolic Rate ◽  
Body Temperatures ◽  
Basal Rate ◽  
The Family ◽  
Small Muscle ◽  
Arboreal Habit ◽  
High Basal Metabolic Rate ◽  
Low Rate

Data concerning the energy expenditure of nine species in the family Felidae and one species in the family Hyaenidae are presented, all of which were obtained under standard conditions. An examination of basal rates of metabolism in these felids and in two species reported in the literature indicates that basal rate is primarily correlated with body mass; of these species, nine have a high basal metabolic rate by general mammalian standards, the two exceptions being the margay and jaguarundi. The low basal metabolic rate of the margay may be related to its arboreal habit in association with small muscle mass, but the reason for the low rate in the jaguarundi is unknown. The omnivorous striped hyaena and termitivorous aardwolf have typical mammalian basal rates. Felids that weigh less than 7 kg have slightly low minimal thermal conductances relative to mammals generally; larger species have high conductances. Felids have slightly high body temperatures.

Percent relative cumulative frequency analysis in indirect calorimetry: application to studies of transgenic mice

2004 ◽  
Vol 82 (12) ◽  
pp. 1075-1083 ◽  
Author(s):  
Marc Riachi ◽  
Jean Himms-Hagen ◽  
Mary-Ellen Harper
Keyword(s):  
Oxygen Consumption ◽  
Energy Expenditure ◽  
Metabolic Rate ◽  
Indirect Calorimetry ◽  
Uncoupling Protein ◽  
Resting Metabolic Rate ◽  
Large Data ◽  
Cumulative Frequency ◽  
And Control ◽  
Deficient Mice

Indirect calorimetry is commonly used in research and clinical settings to assess characteristics of energy expenditure. Respiration chambers in indirect calorimetry allow measurements over long periods of time (e.g., hours to days) and thus the collection of large sets of data. Current methods of data analysis usually involve the extraction of only a selected small proportion of data, most commonly the data that reflects resting metabolic rate. Here, we describe a simple quantitative approach for the analysis of large data sets that is capable of detecting small differences in energy metabolism. We refer to it as the percent relative cumulative frequency (PRCF) approach and have applied it to the study of uncoupling protein-1 (UCP1) deficient and control mice. The approach involves sorting data in ascending order, calculating their cumulative frequency, and expressing the frequencies in the form of percentile curves. Results demonstrate the sensitivity of the PRCF approach for analyses of oxygen consumption ([Formula: see text]02) as well as respiratory exchange ratio data. Statistical comparisons of PRCF curves are based on the 50th percentile values and curve slopes (H values). The application of the PRCF approach revealed that energy expenditure in UCP1-deficient mice housed and studied at room temperature (24 °C) is on average 10% lower (p < 0.0001) than in littermate controls. The gradual acclimation of mice to 12 °C caused a near-doubling of [Formula: see text] in both UCP1-deficient and control mice. At this lower environmental temperature, there were no differences in [Formula: see text] between groups. The latter is likely due to augmented shivering thermogenesis in UCP1-deficient mice compared with controls. With the increased availability of murine models of metabolic disease, indirect calorimetry is increasingly used, and the PRCF approach provides a novel and powerful means for data analysis.Key words: thermogenesis, oxygen consumption, metabolic rate, uncoupling protein, UCP.

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