scholarly journals Thyroid Function Variation in the Normal Range, Energy Expenditure, and Body Composition in L-T4–Treated Subjects

2017 ◽  
Vol 102 (7) ◽  
pp. 2533-2542 ◽  
Author(s):  
Mary H. Samuels ◽  
Irina Kolobova ◽  
Megan Antosik ◽  
Meike Niederhausen ◽  
Jonathan Q. Purnell ◽  
...  
Keyword(s):  
Body Composition ◽  
Energy Expenditure ◽  
Thyroid Function ◽  
Fat Mass ◽  
Reference Range ◽  
Resting Energy Expenditure ◽  
Normal Range ◽  
Laboratory Reference ◽  
Tsh Levels ◽  
Resting Energy

Abstract Purpose: It is not clear whether upper limits of the thyrotropin (TSH) reference range should be lowered. This debate can be better informed by investigation of whether variations in thyroid function within the reference range have clinical effects. Thyroid hormone plays a critical role in determining energy expenditure, body mass, and body composition, and therefore clinically relevant variations in these parameters may occur across the normal range of thyroid function. Methods: This was a cross-sectional study of 140 otherwise healthy hypothyroid subjects receiving chronic replacement therapy with levothyroxine (L-T4) who had TSH levels across the full span of the laboratory reference range (0.34 to 5.6 mU/L). Subjects underwent detailed tests of energy expenditure (total and resting energy expenditure, thermic effect of food, physical activity energy expenditure), substrate oxidation, diet intake, and body composition. Results: Subjects with low-normal (≤2.5 mU/L) and high-normal (>2.5 mU/L) TSH levels did not differ in any of the outcome measures. However, across the entire group, serum free triiodothyronine (fT3) levels were directly correlated with resting energy expenditure, body mass index (BMI), body fat mass, and visceral fat mass, with clinically relevant variations in these outcomes. Conclusions: Variations in thyroid function within the laboratory reference range have clinically relevant correlations with resting energy expenditure, BMI, and body composition in L-T4–treated subjects. However, salutary effects of higher fT3 levels on energy expenditure may be counteracted by deleterious effects on body weight and composition. Further studies are needed before these outcomes should be used as a basis for altering L-T4 doses in L-T4–treated subjects.

scholarly journals Effects of Altering Levothyroxine Dose on Energy Expenditure and Body Composition in Subjects Treated With LT4

2018 ◽  
Vol 103 (11) ◽  
pp. 4163-4175 ◽  
Author(s):  
Mary H Samuels ◽  
Irina Kolobova ◽  
Meike Niederhausen ◽  
Jonathan Q Purnell ◽  
Kathryn G Schuff
Keyword(s):  
Body Composition ◽  
Energy Expenditure ◽  
Reference Range ◽  
Resting Energy Expenditure ◽  
Thyroid Status ◽  
Double Blind ◽  
Thermic Effect Of Food ◽  
Effect Of Food ◽  
To Receive ◽  
Tsh Levels

Abstract Background It is unclear whether variations in thyroid status within or near the reference range affect energy expenditure, body mass, or body composition. Methods 138 subjects treated with levothyroxine (LT4) for hypothyroidism with normal TSH levels underwent measurement of total, resting, and physical activity energy expenditure; thermic effect of food; substrate oxidation; dietary intake; and body composition. They were assigned to receive an unchanged, higher, or lower LT4 dose in randomized, double-blind fashion, targeting one of three TSH ranges (0.34 to 2.50, 2.51 to 5.60, or 5.61 to 12.0 mU/L). The doses were adjusted every 6 weeks to achieve target TSH levels. Baseline measures were reassessed at 6 months. Results At study end, the mean LT4 doses and TSH levels were 1.50 ± 0.07, 1.32 ± 0.07, and 0.78 ± 0.08 µg/kg (P < 0.001) and 1.85 ± 0.25, 3.93 ± 0.38, and 9.49 ± 0.80 mU/L (P < 0.001), respectively, in the three arms. No substantial metabolic differences in outcome were found among the three arms, although direct correlations were observed between decreases in thyroid status and decreases in resting energy expenditure for all subjects. The subjects could not ascertain how their LT4 dose had been adjusted but the preferred LT4 dose they perceived to be higher (P < 0.001). Conclusions Altering LT4 doses in subjects with hypothyroidism to vary TSH levels in and near the reference range did not have major effects on energy expenditure or body composition. Subjects treated with LT4 preferred the perceived higher LT4 doses despite a lack of objective effect. Our data do not support adjusting LT4 doses in patients with hypothyroidism to achieve potential improvements in weight or body composition.

scholarly journals P112 Body composition and resting energy expenditure in IBD patients receiving biological therapy

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S191-S192
Author(s):  
D Vranesic Bender ◽  
L Cengic ◽  
D Ljubas Kelecic ◽  
I Karas ◽  
A Grbin Hodžić ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Body Composition ◽  
Energy Expenditure ◽  
Muscle Mass ◽  
Body Mass ◽  
Fat Mass ◽  
Indirect Calorimetry ◽  
Biological Therapy ◽  
Resting Energy Expenditure ◽  
Resting Energy

Abstract Background As a feature of changing phenotype of IBD in the last decade, we observe increased rates of obesity and increased BMI values as well as changes in body composition. Special interest is the impact of biological therapy on body composition and prevalence of obesity in IBD patients, since the data on this topic are limited. The aim of this study was to determine body composition and resting energy expenditure of patients treated with biological therapy. Methods The study included 74 patients (39 male and 35 female) at the Clinical Hospital Center Zagreb (52 patients with Crohn’s disease and 22 with ulcerative colitis) treated with infliximab/adalimumab/ustekinumab/vedolizumab. Resting energy expenditure was measured by the indirect calorimetry (Cosmed Quark CPET) and compared with the predicted resting energy expenditure calculated using Harris-Benedict equation. Detailed medical and nutritional anamnesis was taken and we measured the following body composition parameters using TANITA body composition analyser, BC-420MA: body mass index (BMI), fat mass (FM), visceral fat rating (VFR), muscle mass (MM) and skeletal muscle mass index (SMI) was calculated. Results Increased BMI was observed in 32% of the patients, while 41% of the whole sample had an increased FM. The mean value of skeletal muscle index (SMI) was 9,061,15 kg m−2 and it revealed the presence of moderate sarcopenia in 32 patients (43%), of which 30 were men. Indirect calorimetry (IC) obtained the value of resting energy expenditure (REE), with the measured REE (1569,81240,95 kcal) on average significantly lower than predicted (1640,36255,28 kcal), t(73)=−3.023, p < 0.05. The results of this study revealed a significant prevalence of moderate sarcopenia in men, increased body mass and fat mass, and slightly lowered resting energy expenditure. There was no significant difference between body composition parameters and REE between different types of biological therapy. Conclusion The incidence of classical forms of malnutrition in this group of patients is significantly lower in comparison with standard therapy and previous experience. Most of the patients were well nourished and we observed trends toward overweight and sarcopenic obesity in some patients. A slight decrease in REE in the whole sample could be a reflection of impact of biological therapy on fat tissue and profound modulation of lipid metabolism as well as decreased muscle mass and physical activity level of the patients.

scholarly journals The Diagnostic-Measurement Method—Resting Energy Expenditure Assessment of Polish Children Practicing Football

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 340
Author(s):  
Edyta Łuszczki ◽  
Anna Bartosiewicz ◽  
Katarzyna Dereń ◽  
Maciej Kuchciak ◽  
Łukasz Oleksy ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Body Composition ◽  
Energy Expenditure ◽  
Muscle Mass ◽  
Indirect Calorimetry ◽  
Energy Demand ◽  
Body Height ◽  
Resting Energy Expenditure ◽  
Blood Pressure Monitor ◽  
Resting Energy

Establishing the amount of energy needed to cover the energy demand of children doing sport training and thus ensuring they achieve an even energy balance requires the resting energy expenditure (REE) to be estimated. One of the methods that measures REE is the indirect calorimetry method, which may be influenced by many factors, including body composition, gender, age, height or blood pressure. The aim of the study was to assess the correlation between the resting energy expenditure of children regularly playing football and selected factors that influence the REE in this group. The study was conducted among 219 children aged 9 to 17 using a calorimeter, a device used to assess body composition by the electrical bioimpedance method by means of segment analyzer and a blood pressure monitor. The results of REE obtained by indirect calorimetry were compared with the results calculated using the ready-to-use formula, the Harris Benedict formula. The results showed a significant correlation of girls’ resting energy expenditure with muscle mass and body height, while boys’ resting energy expenditure was correlated with muscle mass and body water content. The value of the REE was significantly higher (p ≤ 0.001) than the value of the basal metabolic rate calculated by means of Harris Benedict formula. The obtained results can be a worthwhile suggestion for specialists dealing with energy demand planning in children, especially among those who are physically active to achieve optimal sporting successes ensuring proper functioning of their body.

scholarly journals Age‐associated changes of resting energy expenditure, body composition and fat distribution in Chinese Han males

2018 ◽  
Vol 6 (23) ◽  
pp. e13940 ◽  
Author(s):  
Nousayhah Amdanee ◽  
Wenjuan Di ◽  
Juan Liu ◽  
Jing Yu ◽  
Yunlu Sheng ◽  
...  
Keyword(s):  
Body Composition ◽  
Energy Expenditure ◽  
Resting Energy Expenditure ◽  
Fat Distribution ◽  
Chinese Han ◽  
Resting Energy

scholarly journals Resting Energy Expenditure and Cold Induced Thermogenesis in Patients with Overt Hyperthyroidism

2021 ◽  
Author(s):  
Claudia Irene Maushart ◽  
Jaël Rut Senn ◽  
Rahel Catherina Loeliger ◽  
Judith Siegenthaler ◽  
Fabienne Bur ◽  
...  
Keyword(s):  
Body Composition ◽  
Energy Expenditure ◽  
Skin Temperature ◽  
Cold Exposure ◽  
Resting Energy Expenditure ◽  
Free T4 ◽  
Free T3 ◽  
Euthyroid State ◽  
Overt Hyperthyroidism ◽  
Resting Energy

Abstract Context Thyroid hormone is crucial for the adaptation to cold. Objective To evaluate the effect of hyperthyroidism on resting energy expenditure (REE), cold-induced thermogenesis (CIT) and changes in body composition and weight. Design Prospective cohort study. Setting Endocrine outpatient clinic at tertiary referral center. Patients Eighteen patients with overt hyperthyroidism. Main Outcome Measures We measured REE during hyperthyroidism, after restoring euthyroid TH levels and after 3 months of normal thyroid function. In fourteen patients energy expenditure (EE) was measured before and after a mild cold exposure of two hours and CIT was the difference between EEcold and EEwarm. Skin temperatures at eight positions were recorded during the study visits. Body composition was assessed by dual X-ray absorption. Results Free T4 (fT4) and free T3 (fT3) decreased significantly over time (fT4, p=0.0003; fT3, p=0.0001). REE corrected for lean body mass (LBM) decreased from 42 ± 6.7 kcal/24h/kg LBM in the hyperthyroid to 33±4.4 kcal/24h/kg LBM (-21%, p<0.0001 vs hyperthyroid) in the euthyroid state and three months later to 33 ± 5.2 kcal/24h/kg LBM (-21%, p=0.0022 vs. hyperthyroid, overall p<0.0001). Free T4 (p=0.0001) and free T3 (p<0.0001) were predictors of REE. CIT did not change from the hyperthyroid to the euthyroid state (p=0.96). Hyperthyroidism led to increased skin temperature at warm ambient conditions but did not alter core body temperature, nor skin temperature after cold exposure. Weight regain and body composition were not influenced by REE and CIT during the hyperthyroid state. Conclusions CIT is not increased in patients with overt hyperthyroidism.

scholarly journals Characteristics of Body Composition and Resting Energy Expenditure in Lean Young Women

2011 ◽  
Vol 57 (1) ◽  
pp. 74-79 ◽  
Author(s):  
Ayana HASEGAWA ◽  
Chiyoko USUI ◽  
Hiroshi KAWANO ◽  
Shizuo SAKAMOTO ◽  
Mitsuru HIGUCHI
Keyword(s):  
Body Composition ◽  
Energy Expenditure ◽  
Young Women ◽  
Resting Energy Expenditure ◽  
Resting Energy

Resting energy expenditure and body composition in patients with head and neck cancer: An observational study leading to a new predictive equation

Nutrition ◽  
2018 ◽  
Vol 51-52 ◽  
pp. 60-65 ◽  
Author(s):  
Micheline Tereza Pires Souza ◽  
Pierre Singer ◽  
Gislaine Aparecida Ozorio ◽  
Vitor Modesto Rosa ◽  
Maria Manuela Ferreira Alves ◽  
...  
Keyword(s):  
Body Composition ◽  
Head And Neck Cancer ◽  
Energy Expenditure ◽  
Observational Study ◽  
Head And Neck ◽  
Neck Cancer ◽  
Resting Energy Expenditure ◽  
Predictive Equation ◽  
Resting Energy

Resting Energy Expenditure in Obese Women with Primary Hypothyroidism and Appropriate Levothyroxine Replacement Therapy

2020 ◽  
Vol 105 (4) ◽  
pp. e1741-e1748 ◽  
Author(s):  
Emanuele Muraca ◽  
Stefano Ciardullo ◽  
Alice Oltolini ◽  
Francesca Zerbini ◽  
Eleonora Bianconi ◽  
...  
Keyword(s):  
Body Composition ◽  
Energy Expenditure ◽  
Replacement Therapy ◽  
Resting Energy Expenditure ◽  
Primary Hypothyroidism ◽  
Normal Serum ◽  
Fat Free Mass ◽  
Model Assessment ◽  
Obese Women ◽  
Resting Energy

Abstract Context Growing evidence suggests that appropriate levothyroxine (LT4) replacement therapy may not correct the full set of metabolic defects afflicting individuals with hypothyroidism. Objective To assess whether obese subjects with primary hypothyroidism are characterized by alterations of the resting energy expenditure (REE). Design Retrospective analysis of a set of data about obese women attending the outpatients service of a single obesity center from January 2013 to July 2019. Patients A total of 649 nondiabetic women with body mass index (BMI) > 30 kg/m2 and thyrotropin (TSH) level 0.4–4.0 mU/L were segregated into 2 groups: patients with primary hypothyroidism taking LT4 therapy (n = 85) and patients with normal thyroid function (n = 564). Main outcomes REE and body composition assessed using indirect calorimetry and bioimpedance. Results REE was reduced in women with hypothyroidism in LT4 therapy when compared with controls (28.59 ± 3.26 vs 29.91 ± 3.59 kcal/kg fat-free mass (FFM)/day), including when adjusted for age, BMI, body composition, and level of physical activity (P = 0.008). This metabolic difference was attenuated only when adjustment for homeostatic model assessment of insulin resistance (HOMA-IR) was performed. Conclusions This study demonstrated that obese hypothyroid women in LT4 therapy, with normal serum TSH level compared with euthyroid controls, are characterized by reduced REE, in line with the hypothesis that standard LT4 replacement therapy may not fully correct metabolic alterations related to hypothyroidism. We are not able to exclude that this feature may be influenced by the modulation of insulin sensitivity at the liver site, induced by LT4 oral administration.

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