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Obesity in pseudohypoparathyroidism reduces resting energy expenditure
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In patients with pseudohypoparathyroidism type 1A, obesity appears to be caused mainly by decreased resting energy expenditure, rather than increased energy intake or endocrine dysfunction, according to recent findings.
Jeffrey D. Roizen, MD, PhD, FAAP, of The Children’s Hospital of Philadelphia, evaluated 12 patients aged 5 to 46 years with a diagnosis of pseudohypoparathyroidism type 1A (PHP1A) and features of Albright’s hereditary osteodystrophy. Twenty-five percent of patients were normal weight, 50% were overweight and 25% were obese. Researchers assessed the patients’ endocrine function, metabolic biochemical variables, genetic alterations, physical growth and resting energy expenditure. Researchers also evaluated 156 controls with obesity with similar demographic and anthropometric characteristics.
The study’s primary outcome was resting energy expenditure as a percent of predicted resting energy expenditure.
Researchers found that the entire PHP1A group had normal thyroid status and normal levels of total or free thyroxine; 17% had mildly increased levels of thyroid-stimulating hormone. Seventy-five percent of the PHP1A group had increased parathyroid hormone concentrations but normal or near-normal calcium levels. Serum insulin-like growth factor I levels were normal in all but one adult participant, and only two of the participants were prescribed growth hormone.
Significantly lower resting energy expenditure and resting energy expenditure/predicted resting energy expenditure were seen in the PHP1A group compared with controls.
“Participants with PHP1A ... had even greater decreases in [resting energy expenditure] from expected than obese controls, providing evidence of a unique and significant defect that likely accounts for early-onset obesity in this disorder,” the researchers wrote. “Among those participants that provided dietary data, we found that they consumed significantly fewer calories than their recommended daily allowance. Hence, our results provide evidence that increased BMI in PHP1A is due principally to decreased [resting energy expenditure].” – by Jennifer Byrne
Disclosure: The researchers report no relevant financial disclosures.
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