Relationship between resting energy expenditure and metabolic disorders in Chinese obese children and adolescents / 中华实用儿科临床杂志

ABSTRACT

Objective To study the characteristics of resting energy expenditure (REE) and evaluate the association between REE and obesity-related comorbidities in obese children and adolescents.Methods Recruited obese children and adolescents were recruited from the Department of Child Health Care in Nanjing Children's Hospital from July,2015 to September,2016.Height,weight(WT),waist circumference,hip circumference,blood pressure were measured.Puberty status was determined by Tanner staging.REE was measured by indirect calorimetry.Body composition,including fat mass (FM),fat free mass (FFM) were assessed in terms of bioelectrical impedance.Serum biochemical parameters were assessed,including fasting blood glucose (FBG),fasting blood insulin (FBI),total cholesterol (TC),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C) and uric acid (UA).B-model ultrasonography of the liver was conducted.Results One hundred and ninety-six obese children (143 boys and 53 girls) aged 7-15 years were recruited.The measured REE was (1 497.2 ± 312.1) kcal/d.Pearson correlation analysis indicated that REE was positively related to age (r =0.386,P ＜ 0.001),WT(r =0.676,P ＜ 0.001),FM (r =0.629,P ＜0.001),FFM(r=0.635,P＜0.001) and FM％ (r =0.335,P＜0.001),but negatively related to FFM％ (r=-0.335,P ＜0.001).By studying stepwise linear regression,it was found that the factors which influenced REE were age and weight[REE(kcal/d) =899.469-32.098 × age (year) + 16.143 × weight (kg),P ＜ 0.001].REE was expressed per kg of body weight (REE/WT),and there was a significant difference in REE/WT during pubertal development (P ＜0.001) in both males and females and the pubertal males had lower REE/WT than females.Moreover,REE/WT was lower in insulin resistant group compared to the normal insulin group.Meanwhile,REE/WT in hypertension group was lower than that in the normal blood pressure group.The above differences remained after adjusted for age adjustment(P ＜0.O1).Conclusion The decrease in REE/WT level in obese children and adolescents is correlated with puberty development and obesity complicated with insulin resistance and hypertension.